ABSTRACTIn recent years, multiple regions in China have experienced an increase in the occurrence of enzootic nasal tumour virus type 2 (ENTV‐2) infections. This research highlights the initial full genomic sequence of ENTV‐2 isolated from Guizhou, a province in southwest China. The newly identified strain GZZY1, which belongs to the ENTV‐2, had its complete genome analysed and found to be 7504 base pairs in length. Based on a phylogenetic analysis, GZZY1 has been classified as part of the potential sublineage 1.6. Additionally, recombination analysis indicates that GZZY1 may be a recombinant strain, with the gag and env genes serving as the recombination sites, likely originating from sublineages 1.5 and 1.2. In conclusion, this study presents the genomic analysis of GZZY1, a novel ENTV‐2 strain isolated from the Guizhou region of China, providing new information about the evolutionary structure and recombination potential of the virus in China. Our findings provide insights into the genetic makeup and potential variations of ENTV‐2 in China, which could enhance our understanding of its evolutionary patterns.

BackgroundThe relationship between chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) and type 2 inflammation has led to the use of biologic treatment for uncontrolled cases. As biologic treatment remains a relatively new approach for CRSwNP, systematic assessment and collection of high-quality, real-world data are crucial. This study established the national Global Airways registry to collect longitudinal data over a period of 12 months for patients with CRSwNP treated with biological therapies according to criteria established by the Danish Health Authority.MethodsAll participating sites conducted systematic assessments of patients with CRSwNP referred for initiation of biologic treatment. Clinical and patient-reported outcome data were collected at baseline and after 6 and 12 months of treatment and were entered in real-time into the Global Airways registry. Comparisons were performed between patients eligible or not eligible for biologic therapy and between pre- and post-treatment timepoints.ResultsA total of 513 patients were enrolled between November 2022 and December 2024, with 310 receiving treatments with biologics (mepolizumab or dupilumab). Mean [standard deviation (SD)] age in the treatment group was 49.7 (14) years and 66% were male. The median number of previous endoscopic sinus surgeries was 2 (range 1–16). Baseline mean (SD) scores were as follows: Nasal Polyp Score (NPS) 4.8 (1.7); Sinonasal Outcome Test (SNOT)-22 68.7 (18.7); Visual Analog Scale (VAS) CRS 84.1 (16); and Sniffin’ Sticks-16 (SST-16) score 4.8 (3). Asthma was present in 204 (66%) patients, with a mean (SD) Asthma Control Questionnaire (ACQ)-5 score of 2.1 (1.5). Among patients with available data at both 6 and 12 months (n = 160), mean SNOT-22 scores improved from 68 to 29 and 24, NPS from 5.1 to 3.0 and 2.4, SST-16 from 4.7 to 9.2 and 10.0, and ACQ-5 from 2.3 to 1.0 and 0.8 (all p < 0.001).ConclusionsThe Global Airways registry was an effective working tool that ensured collection of important real-world data when moving from surgery to biologics. Furthermore, the registry demonstrated the sustained effectiveness of biologic therapy in patients with refractory CRSwNP and provided a robust foundation for defining CRS phenotypes and advancing targeted treatment strategies.

To characterize the clinical, imaging, and pathological spectrum of pediatric ocular adnexal lymphomas tumors (OAL), including both primary and secondary lesions, using contemporary World Health Organization Haematolymphoid (5th edition) classification. This retrospective case series included patients <18 years with biopsy-proven lymphoma of the orbit or ocular adnexa managed by a single oculoplastic surgeon over a 30-year period. Demographic, clinical, imaging, histopathological, treatment, and outcome data were collected. Lesions were categorized as primary (confined to ocular adnexa with or without regional lymph nodes) or secondary (ocular adnexa involved as part of systemic lymphoproliferative disease). Eleven patients (median age 11 years; 6 male) were identified. Five (45%) had precursor B-cell lymphoblastic leukemia/lymphoma, and 3 (27%) had mature B-cell tumors, including 2 extranodal marginal zone lymphomas and 1 diffuse large B-cell lymphoma. Three (27%) had mature natural killer/T-cell neoplasms, including 1 primary cutaneous anaplastic large cell lymphoma, 1 anaplastic large cell lymphoma, and 1 extranodal natural killer/T-cell lymphoma, nasal type. Six patients (55%) presented with ocular adnexal involvement secondary to systemic disease, most commonly in the orbit. Periorbital swelling, proptosis, and palpable masses were the predominant ocular signs. Management ranged from surgical excision or topical interferon to systemic chemotherapy, radiotherapy, and hematopoietic stem-cell transplantation. At the last follow-up, outcomes varied with histological subtype and disease stage. Pediatric ocular adnexal lymphomas displays striking clinicopathologic heterogeneity, with a predominance of precursor lymphoblastic neoplasms and a notable proportion of high-grade mature B- and T/NK-cell lymphomas. Recognizing both primary and secondary lesions and applying accurate histopathological classification are critical for timely diagnosis and to guide modern targeted therapies. This series expands the evidence base for a rare disease and underscores the importance of integrating ophthalmic assessment with contemporary World Health Organization diagnostic frameworks.

A Case of Extranodal NK/T-cell Lymphoma, Nasal Type That Required to be Differentiated from Hypertrophic Rhinitis

The human nose, crucial for respiratory function and facial aesthetics, exhibits diversity influenced by evolution, genetics, and environment. Tibetan populations, indigenous to the high-altitude Qinghai-Tibet Plateau, possess well-documented physiological adaptations to hypoxia. However, a comprehensive anthropometric analysis of their external nasal morphology, particularly regarding sexual dimorphism and regional variation, remains lacking. We conducted a cross-sectional study of 508 healthy Tibetan adults (233 men, 275 women) aged 18 to 25 years from 4 prefectures. Standard anthropometric instruments were used to measure nasal dimensions. Derived indices included the nasal index (NI), nasal tip projection width index (NTPWI), and nasal tip projection length index (NTPLI). Data were analyzed using non-parametric tests, general linear models (GLM) adjusting for age, correlation analyses, and χ2 tests. Men had significantly greater nasal width (median: 3.80 vs. 3.39cm), nasal depth, and NI (median: 76.92 vs. 61.51), whereas women had greater nasal height (median: 5.41 vs. 4.90cm) (all P <0.01). Regional heterogeneity was more pronounced in men. Those from Shigatse had significantly greater nasal height and depth. In women, limited regional variation was observed, and nasal morphology was influenced by age. Nasal type distribution differed significantly by sex (χ²=306.803, P <0.001): mesorrhine was most common in men (65.7%), whereas leptorrhine predominated in women (58.2%). Nasal morphology in young Tibetan adults exhibits significant sexual dimorphism and regional variation, particularly among men. These patterns likely reflect a complex interplay of high-altitude adaptation, developmental plasticity, and population history.

To investigate the diagnostic value of Interferon regulatory factor 8 (IRF8) in blastic plasmacytoid dendritic cell neoplasm (BPDCN) and extranodal NK/T-cell lymphoma, nasal type (ENKTL). Immunohistochemistry staining was used to detect IRF8 expression in 19 cases of BPDCN and 59 cases of ENKTL. In addition, 21 cases of myeloid sarcoma, 30 of B-lymphoblastic leukemia/lymphoma (B-ALL/LBL), 30 of T-lymphoblastic leukemia/lymphoma (T-ALL/LBL), 10 of histiocytic sarcoma, 10 of Langerhans cell histiocytosis, and 9 of follicular dendritic cell sarcoma were also included. DNA sequencing detected IRF8 genetic variation in 6 cases of BPDCN and 20 cases of ENKTL. IRF8 expression was detected in 100.00% (19/19) of BPDCN, exhibiting a strong and uniform staining pattern, and in 91.53% (54/59) of ENKTL, with varying degrees of staining intensity. Weak and focal staining was detected in 33.33% (7/21) of myeloid sarcoma, 13.33% (4/30) of B-ALL/LBL, and 11.11% (1/9) of follicular dendritic cell sarcoma. No expression was found in T-ALL/LBL, histiocytic sarcoma, or Langerhans cell histiocytosis. The proportion of IRF8 positive expression was higher in BPDCN and ENKTL than in other hematolymphoid neoplasms. In ENKTL, the average IRF8 expression was higher in nasal cases than in extranasal cases and in cases with mitosis figures of more than 4/10 high-power field (HPF). Predominantly large transformed cell morphology and extranasal involvement site might serve as independent prognostic factors of two-year survival in ENKTL. IRF8 genetic point mutations were found in 33.33% (2/6) of BPDCN and 10.00% (2/20) of ENKTL. The study demonstrated the promising value of IRF8 in the diagnosis of BPDCN and ENKTL.

Nasal deviation adversely impacts both airway function and facial aesthetics. The optimal surgical approach remains debated, particularly regarding how structural complexity modifies postoperative outcomes. The aims of the study were to evaluate the interaction between nasal deviation type and surgical method on functional and aesthetic results and to propose a structure-guided algorithm for surgical selection. We retrospectively analyzed 78 patients who underwent surgical correction of nasal deviation. Deformities were classified as Type I (linear), Type C (curved), or Type S (twisted) based on clinical examination and CT findings. Surgical techniques included septoplasty, rhinoplasty, septorhinoplasty, and comprehensive functional procedures. Outcomes were assessed using NOSE and ROE scores, CT-derived anatomical parameters, and complication rates. Generalized linear models were applied to examine the effects of deviation type, surgical method, and their interaction on postoperative improvements. Both deviation type and surgical method were significant predictors of NOSE and ROE improvement (P < 0.05). Generalized linear model analysis confirmed a significant interaction between deviation type and surgical method (P = 0.016 for NOSE; P = 0.049 for ROE). Complex deviations (Type C and Type S) achieved the greatest functional and aesthetic benefit from septorhinoplasty or comprehensive surgery. Mild, self-limited aesthetic complications occurred in 13.5% of cases, with no persistent functional impairments. Structural complexity significantly affects surgical outcomes in deviated nose correction. Matching surgical strategy to deviation type-especially employing combined or advanced techniques for complex deformities-optimizes both functional and aesthetic improvements. These findings support a structure-strategy matching model for individualized surgical planning in nasal deformity management.

Chronic rhinitis (CR) is currently recognized as a syndrome that manifests in different phenotypes. We aimed to establish an artificial intelligence system (quantitative assessment of nasal inflammatory cytology, QANIC) on the basis of whole-slide images (WSIs) to enable quantitative assessment of nasal inflammatory cells. During the development phase of QANIC, we screened nasal secretion smears from 145 CR patients for deep learning and obtaining a robust model. Subsequently, QANIC was applied to an internal cohort (N=881) and an independent external validation cohort comprising two clinical centers (N=234). Cluster analysis was employed to analyze two inflammatory variables (nasal and blood eosinophil [Eos] percentages) to investigate the clinical characteristics and inflammatory patterns of different clusters. Three clusters of inflammatory phenotypes were defined in CR patients: Cluster 1 (high nasal and high blood Eoss, accounted for 17.14% and 16.24% in the two cohorts, respectively), Cluster 2 (high nasal but low blood Eoss, 45.86% and 45.30%), and Cluster 3 (low nasal and low blood Eoss, 37.00% and 38.46%). Compared to Cluster 3, Clusters 1 and 2 demonstrated more severe clinical symptoms and nasal Type 2 inflammation, along with a diagnostic advantage in identifying seasonal allergic rhinitis. The QANIC marks the first time deep learning has been combined with WSIs for nasal cytology diagnosis. Subtyping rhinitis patients based on nasal cytology play an important role in monitoring inflammation dynamics and individualizing treatment.

Non-steroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD) is characterised by the clinical triad of hypersensitivity to NSAIDs, nasal polyposis, and asthma. The cells and mediators causing acute symptoms when driving the hypersensitivity reaction to acetylsalicylic acid (ASA) ingestion, remain poorly defined. To investigate the dynamics of nasal mediators during ASA provocation in N-ERD patients before and 24 weeks after therapy with the IL-4 receptor alpha-blocking antibody dupilumab (EudraCT (2019-004889-18) and ClinicalTrials.gov (NCT04442256)). Nasal mucosal lining fluids of patients with N-ERD, chronic rhinosinusitis patients with nasal polyp (CRSwNP) and healthy disease controls were collected at selected time points up to 2 h after ASA provocation. Analysis of thirty-three different inflammatory mediators as well as transcriptomic profiling was performed. In N-ERD patients, provocation was repeated after 24 weeks of dupilumab therapy. Sixty minutes after provocation with ASA, N-ERD patients showed a significant increase in type 2 associated cytokines (i.e., TSLP, IL-5 and eotaxin-3) as compared to the other patient groups. This effect was diminished after 24 weeks of dupilumab therapy and was independent of the development of ASA tolerance. Transcriptomics revealed dampened upregulation of type 2 associated pathway genes (i.e., AREG) as well as enhanced downregulation of lipid (i.e., ALOX15) and peroxisome metabolisms (i.e., NOS2) at ASA provocation after dupilumab therapy. Treatment with dupilumab leads to reduced nasal type 2 cytokine secretion and distinct changes in transcriptomic profile during ASA provocation, but changes in type 2 mediators show no association with tolerance development. EudraCT (2019-004889-18) and ClinicalTrials.gov (NCT04442256).

Facility type and survival outcomes in extranodal NK/T-cell lymphoma, nasal type: A national cancer database analysis

Development of a machine learning model to predict overall survival in patients with peripheral T-cell lymphoma in a minority enriched population

Hematopoietic stem cell transplantation in T-cell lymphomas: A promising strategy challenging poor prognosis

Abstract Introduction/Objective Extranodal NK/T cell lymphoma, nasal type (ENKTL-NT), is a rare EBV-associated lymphoproliferative disorder. Although typically associated with nasal obstruction, epistaxis, and destructive lesions of the upper aero-digestive tract, widespread dissemination can occur. Diagnosis is often challenging due to small biopsies, heterogeneous admixture of neoplastic cells, inflammatory cells, and necrosis. We share our experience in the work up of a series of cases from our institution. Methods/Case Report: Results A total of 4 male patient, ages 30 to 45, were identified. In 3 of the 4 cases (75%), an initial biopsy demonstrated either ulceration, necrosis, or oropharyngeal microbiota as the principal finding. In 2 out of 4 cases (50%) a repeat biopsy was performed with frozen section analysis to identify invasive fungal sinusitis. Only 1 case was identified to have atypical lymphoid cells that prompted flow cytometry analysis. At diagnosis, biopsy proven systemic disease was identified in 2 of the 4 cases (50%). Conclusion Our findings demonstrate the diagnostic and clinical challenges encountered by both clinical providers and surgical pathologists in the identification of this rare entity.

ObjectiveTo evaluate whether nasal septum deviation type is associated with intraoperative mucoperichondrial perforation during septoplasty.MethodsIn this prospective observational cohort at Bağcılar Training and Research Hospital (Istanbul, Türkiye), 133 adults undergoing septoplasty for nasal obstruction were classified by the Mladina system. The primary outcome was the occurrence of mucoperichondrial perforation during surgery; secondary outcomes were laterality and the largest tear dimension. Group differences across deviation types were analyzed with appropriate comparative statistics; two-sided P < 0.05 was considered significant.ResultsPerforation occurred in 63 of 133 patients (47.4%). Most tears were unilateral (98.4%); one patient (0.8%) had bilateral tears constituting a septal perforation. Perforation incidence differed by deviation type (P < 0.001): Type I, 5.9%; Type II, 31.3%; Type III, 37.8%; Type IV, 78.6%; Type V, 65.2%; Type VI, 60.0%; and Type VII, 83.3%. Mean tear size increased with deviation complexity, measuring ∼2–5 mm in Types I–III versus 6–8 mm in Types IV–VII (P < 0.05). Perforation frequency and size did not differ between surgeons.ConclusionNasal septum deviation morphology is strongly associated with the risk and extent of mucoperichondrial perforation during septoplasty. Patients with complex deviation patterns (Types IV–VII) have a substantially higher risk; recognizing these patterns preoperatively may inform counseling and encourage meticulous dissection strategies to reduce mucosal injury and the likelihood of septal perforation.

Allergic rhinitis (AR), an immunoglobulin E (IgE)-mediated inflammatory disease, is frequently associated with house dust mites (HDMs), particularly Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f). While serum allergen-specific IgE (sIgE) is widely used, the diagnostic value of local sIgE and its interplay with systemic IgE and nasal cytokines remains unclear. This study evaluated local sIgE performance, nasal cytokine profiles, and nonlinear local-serum sIgE dynamics for AR patients. This prospective study enrolled 60 HDM-sensitized AR patients and 143 healthy controls from February 2023 to September 2024. Serum and local Der p/Der f sIgE and total IgE were quantified; and nasal cytokines were analyzed by Luminex. Logistic regression, ROC analysis, and Spearman correlation assessed diagnostic performance and associations.Restricted cubic spline (RCS) modeling explored nonlinear local-serum sIgE relationships. AR patients exhibited elevated local Der p and Der f sIgE logistic regression confirmed their associations with AR, supported by strong diagnostic accuracy. Local sIgE demonstrated stronger correlations with type 2 cytokines (IL-4, IL-5, CCL5, CCL11) than serum sIgE. RCS analysis identified inflection points for Der p and Der f, revealing threshold-dependent nonlinear dynamics between local and serum sIgE. Local sIgE demonstrates high diagnostic accuracy for HDM-sensitized AR and better reflects local Th2-driven inflammation. The nonlinear local-serum sIgE relationship advocates dual-compartment profiling, advancing precision diagnostics in AR.

Using Positron Emission Tomography/Computed Tomography to Diagnose Atypically Located Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type, Mimicking Necrotising Soft Tissue Infection

Extranodal natural killer/T-cell lymphoma (ENKTCL), nasal type, is a rare and aggressive subtype of non-Hodgkin's lymphoma that often presents with extranodal involvement. While relapse patterns commonly involve the nasal cavity, lungs or skin, cardiac involvement is rare. We report a late 50-year-old patient with ENKTCL, nasal type, who achieved complete remission following chemotherapy and autologous stem cell transplantation. He remained disease-free for 6 years before presenting with abdominal pain and haematuria. Imaging revealed an isolated right adrenal mass, confirmed as relapsed ENKTCL on biopsy. Shortly after, an incidental cardiac mass was detected, involving the right atrium, right ventricle and pericardium. Though not amenable to biopsy, imaging exhibited the classic coronary vessel floating sign, characteristic of cardiac lymphomas. The patient passed away despite multiple therapeutic and palliative efforts due to a very poor prognosis after cardiac involvement. This case represents the first documented case of relapsed ENKTCL presenting with cardiac involvement.

Peripheral blood and nasal swabs Type I and III IFNs signature in RSV positive infant with bronchiolitis.

To investigate the clinical impact of the proposed morphological typing of the anterior process of the calcaneus using frontal and lateral radiographs. We consecutively included lateral radiographs of the foot bones of 294 patients with normal ankle joint development from 1 January 2018 to 30 April 2024 at our general hospital for use in this retrospective observational cross-sectional study. The geometric parameters of Bohler Angle and Gissane Angle were measured according to morphological classification, and the length, height, and angle of the anterior process of the calcaneus were measured. The anterior process of the calcaneus was classified into 3 types, nasal (145 cases), angular (74 cases), and square (75 cases). In terms of morphological features, the nasal type had a statistically significant (p < 0.05) difference in the angle and length of the anterior process of the calcaneus compared to the angular type, andthese parameters were greaterthan those in the square type. Meanwhile, between square, angular and nasal, there was a statistically significant difference in the height of the calcaneus' anterior process. Furthermore, it was shown that the left and right sides showed no significant differences in any morphological characteristics of the calcaneus except length. Additionally male patients tended to have a higher anterior process height than female patients. Bifurcate ligament damage and morphological type may be linked to variations in the calcaneus' anterior process, and the classification may also be useful in making treatment decisions for fractures of this structure. IV.

Extranodal NK/T-cell lymphoma, nasal type (ENKTCL-NT) is a type of primary nasal peripheral T-cell lymphoma, which is a rare type of non-Hodgkin's lymphoma, especially with hemophagocytic syndrome (HPS), and can easily lead to clinical misdiagnosis. The disease is dangerous, it progresses rapidly, and the treatment is ineffective. This article reports a case of ENKTCL-NT with HPS, which involves the primary nasal cavity invading the oral cavity. Patients attain improved remission outcomes with autologous hematopoietic stem cell transplantation (ASCT) in combination with chemotherapy. This paper reviews current domestic and international research and summarizes diagnostic and therapeutic approaches to enhance clinicians' comprehension of the disease.