Careful Observation Research Articles

MATERNAL AND FETAL FACTORS ASSOCIATED WITH MISOPROSTOL USE IN MUBENDE REGIONAL REFERRAL HOSPITAL, UGANDA

There are numerous obstetric uses for misoprostol. It mimics the normal labour process by causing the uterus to contract strongly and by softening and dilating the cervix. This action makes it a uterotonic. The maternal uses include cervical ripening, initiating labour, treating incomplete abortions, preventing and treating postpartum haemorrhage, and causing abortions. This study sought to identify maternal and foetal risk factors related to misoprostol use among mothers who gave birth at the regional referral hospital in Mubende.
 A mixed method analytical cross-sectional design was used with mothers, their infants, and healthcare professionals. 385 respondents made up the sample. Interviews, observation, and the review of documents were used to gather the data.
 12.4% of mothers had ever used misoprostol. In comparison to mothers who lived in rural areas, urban mothers were two times more likely to have a positive history of misoprostol usage (COR=1.843, 95% CI (0.903-3.763)). Mothers with a parity of 2–4 had a 0.5x lower likelihood of using misoprostol [COR=0.514, 95% CI (0.166–1.595)]. Better APGAR scores of 4-7 (4 times) and 8-10 (2 times) in newborns were associated with a higher likelihood of a positive history of misoprostol use.
 In conclusion, misoprostol use poses dangers to both the mother and the foetus, necessitating careful observance.

Outcomes of Patients Treated With RCHOP With a PET-Adapted Approach for Consolidative Radiotherapy: A Retrospective Single-Center Study at the Royal Marsden Hospital

BackgroundTreatment with CHOP-based chemotherapy with consolidative radiotherapy (CRT) for primary mediastinal B cell lymphoma (PMBCL) has been the standard approach in the pre-rituximab era. Overtreatment with CRT for patients who may have already been cured by primary immunochemotherapy in the rituximab era is a significant concern due to the long-term toxicity associated with radiotherapy. Positron emission tomography (PET) may help to identify patients who may not benefit from further CRT. MethodsWe conducted a retrospective review of patients treated at the Royal Marsden Hospital between 2003 and 2020 for PMBCL to assess CRT use and survival outcomes. ResultsForty-three patients were identified, with 95% of the patients receiving R-CHOP. CRT was given in 5 patients. Five-year event-free survival was 79% (95% confidence interval: 64%-89%) and 5-year overall survival was 88% (95% confidence interval: 73%-95%). Seven of 9 patients with DS4 did not receive CRT and instead monitored with serial PET scans. None of these 7 patients relapsed in the mediastinum. ConclusionCRT may be omitted in patients with a negative end of treatment PET scans; however, careful observation may also obviate the need for CRT in PET positive patients.

Palliative care for people with long term neurological conditions: practices and reflections based on comprehensive care

The care for people with Long Term Neurological Conditions (LTNC) isn´t recognized as a major practice in Palliative Care (PC) scientific production; in daily basis, the assistance is focused on hygiene´s care and clinical observation. However, from the perspective of PC, the health professionals´ role is to promote the dignity of the human person. The concept of LTNC covers neurological diseases with a prognosis of long-time life with significant disabilities, end-of-life stage that is difficult to identify, with many symptoms and physical and cognitive impairments. In this paper, we considered the following situations: persistent vegetative state, minimal consciousness state and locked-in syndrome. This is a theoretical study of a qualitative nature, which aims to describe a new kind of PC practice with this population, based on first author PHD study. The concept of Comprehensive Care is the main theoretical framework for the paper. It is proposed a practice reconstruction based on the person´s biography occurs by several perspectives, especially through sensory stimuli related to prior patient´s occupational repertoire. Along with the detailed evaluation, the therapist does a careful and continuous monitoring, proposing activities, giving special attention to their reactions, being able to discriminate what pleases or not, and expanding the possibilities of encounter of people with LTNC and the environment which surround them. Therapist should also provide support and guidance to the family, which is in a vulnerable situation. Regardless of neurological reactions presented by the patients this practice helps reconstructing the meanings of the daily life of person with so severe disability. Sensory stimuli are shown as potential tools for a rehabilitation practice. Memory, history, identity, dignity, and subjectivity qualify the assistance for people with LTNC.

Impact of Direct Acting Antiviral (DAA) Agents on Hematological and Hepatic Statuses of Patients with Chronic Hemolytic Anemias and Chronically Infected with Hepatitis C Virus (HCV)

Abstract Background Different combinations of Direct Antiviral Agents (DAAs) have been used against different Hepatitis C Virus (HCV) genotypes and in different types of patients. Aim and objectives To investigate the impact of DAA-based regimens on hematological and hepatic statuses of patients with chronic hemolytic anemias and chronically infected with HCV. Subjects and Methods This is a cross sectional study, was carried out at viral hepatitis research and treatment center of Ain Shams University Hospitals, on 50 patients with chronic hemolytic anemias and has HCV infection, from December 2019 till June 2020. Result There was high statistically significant difference before treatment, first month, third month and sixth month follow up in chronic liver disease group as regard HGB, statistically significant in Hemolytic anemia group (no splenectomy) as regard HGB and there was high statistically significant difference between the studied groups as regard HGB. Conclusion DAAs therapy is effective and tolerable in patients with chronic HCV patients. It improves liver necro-inflammatory changes in patients, evidenced by decreased liver enzymes' level, but still require careful observation during DAAs therapy for being more susceptible for hemolytic anemia.

Copper and Silver Catalysis in the (3 + 2) Cycloaddition of Neutral Three-Atom Components with Terminal Alkynes.

The introduction of the copper-catalyzed azide-alkyne coupling (CuAAC) to 1,3-dipolar cycloadditions was pivotal to their popularization in synthetic chemistry and to their application to multiple other domains of science. The reaction rate enhancement observed when coinage metal acetylide intermediates are involved in the cyclization process greatly expanded the structural and conditional range in which (3 + 2) cycloadditions may take place with terminal alkynes. Herein, we report that comparable rate enhancements, in nature and level, are induced by copper and silver catalysts in the intramolecular (3 + 2) cycloaddition of terminal alkynes with "neutral" three-atom components (TACs), specifically alkynyl sulfides. Through careful observations amidst reaction optimization, experimental, and DFT mechanistic studies, a pathway involving a proton-coupled cyclometallation key step is proposed. The sets of catalytic conditions that have been developed allow us to overcome several scope limitations previously presented by the thermally promoted (3 + 2) cycloaddition of "neutral" TACs, thus expanding their synthetic and applicative potential.

Augenblickdiagnose in neurology: Revisiting 'diagnosis in the blink of an eye'.

The art of diagnosis in clinical neurology requires attentive listening and careful observation. In certain situations, a fragment of the history or a physical sign may be so distinctive that it allows clinicians to evoke a specific diagnosis. This quick mental process was previously referred to as 'Augenblickdiagnose' ('diagnosis in the blink of an eye') in a seminal paper by Dr. William Campbell in 1998. We aimed to revisit this concept by providing additional clinical vignettes. The authors wrote clinical vignettes using examples from their own clinical practice and performed a non-systematic review of influential neurology textbooks using the words 'pathognomonic' and 'highly suggestive'. Twenty examples from various fields of neurology are presented in a table, stratified by major fields of neurology. A short educational reflection is provided for each diagnosis considered. 'Augenblickdiagnose' is an engaging teaching resource that also contributes to 'neurophilia', that is, a fascination for neurology, perhaps increasingly in today's modern neurology practice. However, multiple cognitive biases underlying mental shortcuts may lead to an incorrect diagnosis. It is important to stress that good clinical practice in neurology requires taking a thorough history and performing a careful neurological examination.

Acute liver failure due to herpes simplex viral hepatitis diagnosed by skin lesions and blood tests: a case report

BackgroundThe incidence of acute liver failure from herpes simplex virus is rare.Case presentationA 71-year-old Japanese man was diagnosed with acute liver failure and was transferred to our hospital. Steroid therapy, plasma exchange, and hemodiafiltration were started for liver failure, and antimicrobial therapy was initiated for pneumonia. Staphylococcus epidermidis was detected in blood culture. Skin rash appeared; a positive anti-herpes simplex virus result led to the diagnosis of acute liver failure from herpes simplex virus. Hence, acyclovir was started. After blood tests improved, treatments for acute liver failure were discontinued. Antimicrobial therapy was continued; however, he died. In this case, persistent bacteremia and drug-induced liver damage due to acyclovir may have contributed to his death.ConclusionsAcute liver failure can lead to complications and death. Thus, careful observation is crucial, even if the patient has shown some improvements.

Venous thoracic outlet syndrome, as a pitfall for cardiac implantable electronic device implantations.

The subclavian vein is typically used in cardiovascular implantable electronic device (CIED) implantations. External stress on the subclavian vein can lead to lead-related complications. There are several causes of this stress, such as frequent upper extremity movements or external injury. Venous thoracic outlet syndrome (TOS) can also become the cause of external lead stress. However, the diagnosis of venous TOS can be challenging because subclavian venography can appear normal at first glance. We present a unique case of a device infection in a patient with venous TOS. A careful observation of the imaging studies is vital for diagnosing venous TOS and a leadless pacemaker implantation could be an alternative therapeutic option.

Outcome of initial lenvatinib treatment in patients with unresectable anaplastic thyroid cancer.

Anaplastic thyroid cancer (ATC) is a very rare disease with a poor prognosis and with no established effective drug therapy. The present study aimed to report the outcomes of lenvatinib single-agent therapy as an initial drug treatment in ATC, and to investigate its safety and efficacy. This retrospective cohort study included 56 patients with unresectable primary ATC, of whom 36 were treated with lenvatinib and 12 with weekly paclitaxel, and 8 patients who refused any drug treatment who received palliative care. The average survival in the lenvatinib group was 5.8 months, which was significantly longer than 2.0 months in the paclitaxel group (P=0.005). The efficacy of lenvatinib in the 36 patients with ATC, whose primary tumors were unresectable, was evaluated. The response rate was 33% and the median overall survival time was 5.0 months. A safety review indicated that lenvatinib should be used under the careful observation of local findings. Two patients, who showed a reduction with lenvatinib, underwent conversion surgery, which prolonged the prognosis in terms of avoiding events, such as asphyxia, fistula and hemorrhage due to tumor growth; however, the surgical margins were positive, indicating that complete remission was impossible even if surgical resection was performed. Therefore, starting with lenvatinib treatment and identifying a therapeutic drug based on genomic analysis is an acceptable treatment strategy for ATC while halting the disease progression.

The management of pain during pediatric hematopoietic stem cell transplantation: A qualitative study of contextual factors that influenced pain management practices.

Children hospitalized following hematopoietic stem cell transplantation (HSCT) experience complex and prolonged pain in response to the intensity of this treatment. To describe how pain was managed for children during HSCT therapy and how contextual factors related to the clinical environment influenced healthcare providers' and parents' pain management practices. A qualitative case study was conducted and involved semi-structured interviews at two time points following transplantation (30 and 90days) with parents (n=10) and naturalistic observations of pain-related care provided to children (n=29) during HSCT therapy by their healthcare providers (n=10). Semi-structured interviews were also conducted with healthcare providers (n=14). The effectiveness of pain management interventions was hindered by the multifactorial nature of pain children experienced, a gap in the provision of psychosocial interventions for pain and a lack of evidence-based guidelines for the sustained, and often long-term, administration of opioids and adjuvant medications. Misconceptions were demonstrated by healthcare providers about escalating pain management according to pain severity and differentiating between opioid tolerance and addiction. Parents were active in the management of pain for children, especially the provision of nonpharmacological interventions. Collaboration with external pain services and the impact of caring for children in protective isolation delayed timely management of pain. There is a pressing need to create evidence-based supportive care guidelines for managing pain post transplantation to optimize children's relief from pain. If parents and children are to be involved in managing pain, greater efforts must be directed toward building their capacity to make informed decisions.

Growth potential of small residual tumors after vestibular schwannoma surgery: comparison between remnants and the natural history of small tumors.

Due to the heterogeneous definitions of tumor regrowth and various tumor volume distributions, the nature of small remnants after vestibular schwannoma (VS) surgery and the appropriate timing of adjuvant stereotactic radiosurgery for these remnants remain unclear. In this study, the growth potential of small remnants (< 1 cm3) after VS surgery was compared with that of treatment-naïve (TN) small VSs. This retrospective single-center study included 44 patients with VS remnants following subtotal resection (STR) of a large VS (remnant group) and 75 patients with TN VS (< 1 cm3; TN group). A 20% change in tumor volume over the imaging interval indicated radiographic progression or regression. Tumor progression-free survival (TPFS) rates were estimated using the Kaplan-Meier method. In the remnant group, the mean preoperative tumor volume was 13.8 ± 9.0 cm3 and the mean tumor resection rate was 95% ± 5%. The mean tumor volume at the start of the observation period did not differ significantly between the two groups (remnant vs TN: 0.41 ± 0.29 vs 0.34 ± 0.28 cm3, p = 0.171). The median periods until tumor progression was detected were 15.1 (range 4.9-76.2) months and 44.7 (range 12.6-93.2) months in the TN and remnant groups, respectively. In the remnant group, the TPFS rates were 74% and 70% at 3 and 5 years after the surgery, respectively, compared with 59% and 47% in the TN group. The log-rank test demonstrated a significant difference (p = 0.008) in the TPFS rates between the two groups. Furthermore, 42 patients each from the remnant and TN groups were matched based on tumor volume. TPFS was significantly longer in the remnant group than in the TN group (3-year rates, 77% vs 62%; 5-year rates, 73% vs 51%; p = 0.02). In the remnant group, 18% of the tumor remnants demonstrated regression during follow-up, compared with 9% in the TN group, but this intergroup difference was not significant (p = 0.25). This study demonstrated that the growth potential of small VS remnants was lower than that of TN tumors. Observing for small remnants may be appropriate after STR of a large VS. Given the risk of tumor regrowth, careful observation using MRI should be mandatory during follow-up.

Retrospective Review of 181 Patients with Pathologic Vertebral Compression Fractures

Background: Compression fractures are often associated with lower energy trauma and may occur in the setting of abnormal bone health associated with genetic disorders and endocrine disorders, neoplastic disease, infection, and inflammatory disorders. There is no significant series in the literature describing the prevalence or etiology of pathologic pediatric compression fractures.Methods: IRB-approved retrospective study was performed at a tertiary children's hospital from 2012-2022. Patients <18 years old diagnosed with atraumatic vertebral compression fractures were included and reviewed for demographics, underlying diagnosis/comorbidity, presentation, mobility, deformities, imaging data, treatments, and outcomes.Results: 181 patients (54% Male) were included with mean age 14.17 years and follow-up of 20 months. A compression fracture was the presenting symptom of an underlying diagnosis in 32% of patients, and 21% of patients received an MRI to distinguish between metastatic disease and benign fractures. Primary osteoporosis was the cause in 15% and secondary osteoporosis was in 65% of patients; most commonly due to immunosuppressants (46%) and acute lymphoblastic leukemia (ALL) (10%). Primary lesions were the etiology in 20% of patients. There was a median of 3 fractures per patient, mostly of the midthoracic (82%) and thoracolumbar spine (51%). Radiographs revealed wedge fractures in 82%, biconcave fractures in 22%, and vertebra plana in 12%. Patients were managed with observation (46%), bracing (31%), bisphosphonates (31%), and fusions (4%). By last follow-up, there was a higher proportion of patients who developed scoliosis or became wheelchair-bound. Overall, there was a 16% mortality rate which was mostly associated with cancer.Conclusion: Overall, 32% of patients presented with a compression fracture as the presenting symptom of an underlying disease. Pathologic vertebral compression fractures in children frequently occurred due to immunosuppressants, ALL, and metastatic disease. The fractures were most often wedge morphology in the thoracolumbar and mid-thoracic regions of the spine. MRIs may be useful for distinguishing between benign fractures and malignancy.Levels of Evidence: Level IV Key Concepts•Pathologic Vertebral Compression Fractures occur commonly in children with primary or secondary osteoporosis or due to primary site lesions, such as metastases.•Patients often have multiple fractures about the thoracolumbar and mid-thoracic regions of the spine.•Wedge and biconcave fractures were the most common fracture type at presentation and indicated an underlying disease not previously known in one-third of patients.•MRI is useful for distinguishing between benign fractures and malignancy as the etiology of the fracture.

Intraguild scavenging on carnivore carcasses is delayed enough to allow successful dispersal of maggots for pupation

AbstractVertebrate carcasses are a valuable resource for a wide range of organisms, although their consumption rates can vary greatly by the type of carcasses. Studies have indicated that mammalian carnivores rarely consume carnivore carcasses, particularly in the early stages of decay, and thus these carcasses may potentially serve as a reproductive resource for necrophagous arthropods such as blowflies. However, it is unknown whether delays in consumption by carnivores are sufficient for necrophagous arthropods to complete their life cycle in the carcasses. This study addressed this question by monitoring 69 raccoon carcasses using camera traps in Yakumo, southern Hokkaido, Japan, during the summer seasons of 2016–2019. The decay stages of the carcasses were categorized by carefully observing the videos captured by the camera traps, and the timing of maggot dispersion was estimated. The first visitation and first consumption of vertebrate scavengers were also modelled, and the proportion of carcasses visited or consumed by vertebrate scavengers prior to maggot dispersion was determined each year. The proportion of carcasses visited by vertebrate scavengers before maggot dispersal ranged between c. 50% in 2017 and c. 30% in other years. However, only c. 20% of carcasses in each year were consumed before maggot dispersal, and consumption was only partial. The first species to scavenge at carcasses were red foxes and raccoon dogs, with the exception of two carcasses that were first scavenged by large‐billed crows. These results suggest that while delayed visitation of carcasses may partly explain delayed consumption, active avoidance of phylogenetically related species may increase the chances of successful maggot dispersal. Our approach of using careful video observations and statistical modelling may apply to a wide range of habitats and could improve our understanding of the ecological consequences of the taboo against cannibalism.

Strategi Rumah Yatim Ar-Rahman Kota Medan Dalam Pengoptimalisasian Dana Zakat, Infaq dan Shadaqh

This research is about strategies and optimizing the management of zakat, infaq and shadaqah at the Ar Rahman Orphanage in Medan City. This study started from the author's observations of social care embodied by zakat, infaq and sadaqah as a form of a Muslim's faith to help ease the burden of Muslims, thus making the Muslims prosperous. The purpose of this research is to find out the constraints and efforts as well as strategies in optimizing ZIS funds. The method used in this study uses a descriptive method, namely by collecting interview data, observation, and documentation studies. The results of the study show that the Ar-Rahman Orphanage in Medan City in the strategy of increasing fundraising has 3 strategies, namely the first program strategy which consists of 7 main programs, namely humanitarian programs, orphans and poor self-reliance programs, da'wah programs, educational programs, economic programs, utilization programs, and health programs. In addition to these programs in the Infaq Sadaqah program there is one program called Ifsoh bound. . The obstacles faced in implementing the marketing strategy of the Ar-Rahman Orphans House in Medan City, are the lack of knowledge about zakat in the community, then many people do not understand zakat, infaq, alms through the Orphans and Dhuafa Institutions.&#x0D; Keyword : Dhuafa Orphanage, Strategy, ZIS

Phenomenon of Early Marriage on Girls in The Cintapuri Village in Banjarmasin City (Phenomenological Study)

In this modern era, child marriage still remains a practice in some regions. This phenomenon damages the normal life of families and negatively affects the human capitals of Indonesia. Higher number of child marriages would lead to increase in the divorce rates than normal, as those involved in this marriage have not developed the necessary emotional control for solving problems that might arise during these marriages. This led many to the path of divorce. The goal of this research is to understand the factors that led to child marriage in Cintapuri Village, Banjar Regency, Banjarmasin. This research uses the qualitative descriptive method with phenomenological model. Subjects in this research were teenage girls married in the age of 14-16 with Junior High School (SMP) being their last education level, parents, and village governance apparatus in Cintapuri Village, Banjar Regency, Banjarmasin. The data from this research was collected through careful observations and interviews with people related to the research’s objective. The result of this research shows there are several factors leading to the rampant cases of child marriage, such as economical, educational, and cultural factors. Looked through from an economical point-of-view, many parents are marrying their children off to alleviate their economic burden. From an educational point-of-view, many parents are not aware of the adverse effects of child marriage and the laws that regulate the minimum age of marriage, because of the lack of education. From a cultural point-of-view, parents are feeling nervous and ashamed for the fact that their daughter do not have a partner yet, leading them in search of a suitable partner for their daughter even though their daughter do not always approve of the parent’s suitable partner.&#x0D; Keywords: child marriage, divorce, economy, education, culture

Cytological features of oral malignant lymphoma in scraping liquid-based cytology: Cases of plasmablastic lymphoma and anaplastic lymphoma kinase-positive anaplastic large cell lymphoma

The main purpose of cytological examination in the oral region is to screen for squamous cell carcinoma or intraepithelial neoplasms; thus, the background tends to be considered a deterrent for microscopy. From this perspective, liquid-based cytology (LBC) is favorable for preparing clear samples with few backgrounds. However, background hemocytes are sometimes of critical importance in the diagnosis. We report two cases of oral malignant lymphoma, plasmablastic lymphoma, and anaplastic large cell lymphoma in which careful observation of the background in scraping LBC sample contributed to the early diagnosis. Atypical lymphoid cells were observed only in a very small part of the LBC samples from the presented patients; however, cytological findings, such as large lymphoid cells with outstanding nucleoli, large mitotic cells, or intermediate-to-large lymphoid cells with pleomorphic nuclei were sufficient for obtaining a cytological diagnosis of malignant lymphoma. Although the number and cell size of leukocytes in LBC with Papanicolaou staining were significantly different from those in air-dried conventional smears with Romanovsky staining, which are commonly preferred for the discrimination of hemocytes, the corresponding cytological features could be observed. Therefore, attention should be paid to the background as well as squamous epithelium to prepare for such unexpected cases. The LBC examination with Papanicolaou staining alone can suggest the possibility of malignant lymphoma.

المقارنة فى الوصف بين ثقافة الكشمير والهند فى رحلات محمد بن ناصر العبودي دراسة تحليلية مقارنة

Travel literature is one of the most important geographical, historical and social sources in which the writer or historian takes information and facts from live scenes, visualization, and careful observations to make the reader enjoy artistic pleasure. The travelogue carries with it new information and special personal experiences, and the best travelogue is the one in which there is a deep observation of the things where a traveller analyzes the two different cultures and civilizations. Travel literature is a branch of comparative literature, and there is a close connection between comparative literature and travel literature, which is one of the most important literary exchanges. Muhammad Bin Nasir al-ʿabūdī an Arab traveler traveled to the Indian subcontinent and Kashmir, and in his Travelogue, he described the Indian and Kashmiri customs, traditions, and cultures. In this research, I did a comparison between the Indian and Kashmiri customs, traditions, and cultures, and the researcher tried to analyze how al-ʿabūdī described the Indian and Kashmiri customs. What is al-ʿabūdī's method of describing these two cultures?

Disrespectful and inadequate palliative care to lesbian, gay, and bisexual patients.

The study aims to describe inadequate, disrespectful, and abusive palliative and hospice care received by lesbian, gay, and bisexual (LGB) patients and their spouses/partners due to their sexual orientation or gender identity. A national sample of 865 healthcare professionals recruited from palliative and hospice care professional organizations completed an online survey. Respondents were asked to describe their observations of inadequate, disrespectful, or abusive care to LGB patients and their spouses/partners. There were 15.6% who reported observing disrespectful care to LGB patients, 7.3% observed inadequate care, and 1.6% observed abusive care; 43% reported discriminatory care toward the spouses/partners. Disrespectful care to LGB patients included insensitive and judgmental attitudes and behaviors, gossip and ridicule, and disrespect of the spouse/partner. Inadequate care included denial of care; care that was delayed incomplete, or rushed; dismissive or antagonistic treatment; privacy and confidentiality violations; and dismissive treatment of the spouse/partner. These findings provide evidence of discrimination faced by LGB patients and partners while receiving care for serious illness. Hospice and palliative care programs should promote respectful, inclusive, and affirming care for the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community, including policies and practices that are welcoming and supportive to both employees and patients. Staff at all levels should be trained to create safe and respectful environments for LGBTQ patients and their families.

Significant tortuosity of the internal carotid artery encountered during neck dissection

AbstractBackgroundThe internal carotid artery (ICA) is one of the vital structures of the head and neck region to be preserved during neck dissection. It may present several unusual forms of tortuousness, and surgeons should be mindful of these variations while performing surgeries.Case presentationThe patient is an 80‐year‐old woman presented with a T2N0M0 squamous cell carcinoma affecting the left side of the tongue. During neck dissection, significant tortuosity of the ICA was observed. With careful surgical manipulation, the surgery was a success, avoiding any potential damage.ConclusionSurgeons must avoid the potentially fatal complication through a detailed preoperative imaging evaluation and careful intraoperative observation.

Nasal-Type Extranodal Natural Killer/T-Cell Lymphoma Recurrence at Penile Glans Masquerading Urinary Contamination on 18F-FDG PET/CT.

A 69-year-old man with a history of extranodal NK/T-Cell lymphoma, nasal type (ENKTL-NT) performed an interim 18F-FDG PET/CT for response evaluation. It showed an intense focal uptake at his penile glans, which was suspected as urinary contamination initially. However, he complained with redness and swelling of his penis during further history inquiry. After careful observation, the diagnosis of ENKTL-NT recurrence at penile glans was highly suspected. It was confirmed by percutaneous biopsy of the penile glans finally.