Presenting Features Research Articles

A Study of Clinical, Radiological, and Etiological Profiles of Patients with Cavitary Lung Disease

Abstract Background: This study aims to find out the distribution pattern of cavitary lung disease across clinical, radiological, and etiological variables. Methods: This is an observational monocentric retrospective study conducted in Apollo Hospital, Greams Road, Chennai, between August 2022 and May 2023. After excluding cases lacking follow-up and no clinical data, 50 patients with cavitary lung disease who underwent bronchoscopy were included in this study. Data such as demographics, smoking status, clinical presentation, comorbidities, and radiological features were obtained. Results: Of the 50 participants, the majority had tuberculosis (TB), fungal, and bacterial infections. Fungal cavities were common in males with uniform age distribution and had cavities with air crescent signs. Bronchoscopy was inconclusive in most of them and required either computed tomography or video-assisted thoracic surgery (VATS)-guided biopsy to establish a diagnosis. The most common malignancy was squamous cell carcinoma, and autoimmune disease was granulomatous polyangiitis. Conclusion: Our study shows that the presence of cavities points more toward TB. One of the key measures in making TB treatment and control activities a success is identifying patients at high risk of transmission and poor outcomes like patients with cavities. However, it is important to exclude other diagnoses like malignancy where the prognosis can be fatal.

50302 Distinguishing features of presentation, clinical and histopathological features between indolent Primary Cutaneous B-Cell Lymphomas.

50302 Distinguishing features of presentation, clinical and histopathological features between indolent Primary Cutaneous B-Cell Lymphomas.

Renal Neoplasms with Concurrent Castleman-Like Regional Lymphadenopathy.

Renal cell neoplasms are known to be associated with paraneoplastic syndromes, and the association with Castleman-like regional lymphadenopathy has been rarely reported. We aim to characterize the association between renal neoplasms and Castleman-like lymphadenopathy. A search for renal neoplasms with concurrent Castleman-like lymphadenopathy in one single medical institution from 2000 to 2023 resulted in 4 specimens. A literature search for "Castleman" and "renal neoplasm" resulted in 8 reports. Patients' demographics, clinical presentation, gross and histologic features, results of ancillary studies, treatment, and follow-up were evaluated. Our patients included 3 men and 1 woman, with a mean age of 60 years. Four different subtypes of renal neoplasms were diagnosed, including clear cell renal cell carcinoma (RCC), papillary RCC, chromophobe RCC, and mucinous cystadenoma of the renal pelvis. For Castleman-like regional lymphadenopathy, 2 were plasma-cell predominant, and 2 were hyaline-vascular. After a median follow-up of 84 months, all patients were alive with no recurrence or progression of Castleman-like features following nephrectomies. Castleman-like regional lymphadenopathy should be considered in patients with renal tumors and lymphadenopathy. Although more prevalent in clear cell RCC, it can be also associated with other renal neoplasms. The concurrent lymphadenopathy was remitted following the renal tumor resections.

Powder-diffraction-based structural comparison for crystal structure prediction without prior indexing

The objective of crystal structure prediction (CSP) is to predict computationally the thermodynamically stable crystal structure of a compound from its stoichiometry or its molecular diagram. Crystal similarity indices measure the degree of similarity between two crystal structures and are essential in CSP because they are used to identify duplicates. Powder-based indices, which are based on comparing X-ray diffraction patterns, allow the use of experimental X-ray powder diffraction data to inform the CSP search. Powder-assisted CSP presents two unique difficulties: (i) the experimental and computational structures are not entirely comparable because the former is subject to thermal expansion from lattice vibrations, and (ii) experimental patterns present features (noise, background contribution, varying peak shapes etc.) that are not easily predictable computationally. This work presents a powder-based similarity index (GPWDF) based on a modification of the index introduced by de Gelder, Wehrens & Hageman [J. Comput. Chem. (2001), 22, 273–289] using cross-correlation functions that can be calculated analytically. Based on GPWDF, a variable-cell similarity index (VC-GPWDF) is also proposed that assigns a high similarity score to structures that differ only by a lattice deformation and which takes advantage of the analytical derivatives of GPWDF with respect to the lattice parameters. VC-GPWDF can be used to identify similarity between two computational structures generated using different methods, between a computational and an experimental structure, and between two experimental structures measured under different conditions (e.g. different temperature and pressure). VC-GPWDF can also be used to compare crystal structures with experimental patterns in combination with an automatic pre-processing step. The proposed similarity indices are simple, efficient and fully automatic. They do not require indexing of the experimental pattern or a guess of the space group, they account for deformations caused by varying experimental conditions, they give meaningful results even when the experimental pattern is of very poor quality, and their computational cost does not increase with the flexibility of the molecular motif.

Machine Learning Model Reveals Determinators for Admission to Acute Mental Health Wards From Emergency Department Presentations.

This research addresses the critical issue of identifying factors contributing to admissions to acute mental health (MH) wards for individuals presenting to the emergency department (ED) with MH concerns as their primary issue, notably suicidality. This study aims to leverage machine learning (ML) models to assess the likelihood of admission to acute MH wards for this vulnerable population. Data collection for this study used existing ED data from 1 January 2016 to 31 December 2021. Data selection was based on specific criteria related to the presenting problem. Analysis was conducted using Python and the Interpretable Machine Learning (InterpretML) machine learning library. InterpretML calculates overall importance based on the mean absolute score, which was used to measure the impact of each feature on admission. A person's 'Age' and 'Triage category' are ranked significantly higher than 'Facility identifier', 'Presenting problem' and 'Active Client'. The contribution of other presentation features on admission shows a minimal effect. Aligning the models closely with service delivery will help services understand their service users and provide insight into financial and clinical variations. Suicidal ideation negatively correlates to admission yet represents the largest number of presentations. The nurse's role at triage is a critical factor in assessing the needs of the presenting individual. The gap that emerges in this context is significant; MH triage requires a complex understanding of MH and presents a significant challenge in the ED. Further research is required to explore the role that ML can provide in assisting clinicians in assessment.

Moderating Effects of Visual Order in Graphical Symbol Complexity: The Practical Implications for Design

In the field of visual graphic design, complexity plays a crucial role in visual information processing, and it is assumed to be an absolute quantity based on the number of the presenting features and components. However, it remains unclear whether the visual order of the constituent elements in graphical symbol complexity affects cognitive processing, especially memory processing. Our research innovatively generated four groups of novel, meaningless graphical symbols (complex and ordered, complex and disordered, simple and ordered, and simple and disordered) and experimentally manipulated the level of complexity and order in these stimuli. Before the formal experiment, a five-point scale was used to further rule out differences between objective and subjective definitions of these graphical symbols on ratings of complexity, order, concreteness, and familiarity. Then, we used a cue-recall task to compare subjects’ memory performance of those four graphical symbol groups. The analytical results showed a significant interaction between visual order and graphical symbol complexity, with the complexity effect appearing only when the stimuli were in disordered condition and disappearing once the stimuli were ordered. In addition, this study conducted a practical application validation to confirm that increasing the level of visual order is an effective way to improve user experience while maintaining the same level of complexity. The findings can serve as a reference for graphical symbol design, graphic design, and visual communication design.

Ischemic Stroke as a Presenting Feature of Promyelocytic Blast Phase in Chronic Myeloid Leukemia – an Uncommon Presentation of an Exceptionally Rare Blastic Transformation of Myeloproliferative Neoplasm

Ischemic Stroke as a Presenting Feature of Promyelocytic Blast Phase in Chronic Myeloid Leukemia – an Uncommon Presentation of an Exceptionally Rare Blastic Transformation of Myeloproliferative Neoplasm

Central Nervous System Disorders with Auto-Antibodies in People Living with HIV.

People living with HIV (PLWH) may present atypical neurological complications. Recently, autoimmune manifestations of the central nervous system (CNS) have been described. We retrospectively described the features of PLWH presenting with acute neurological symptoms with positive anti-CNS antibodies. We analyzed relevant CSF characteristics. Twelve patients were identified, with demyelinating, inflammatory, or no MRI lesions. We observed CSF inflammatory features. Aspecific CSF anti-CNS antibodies were found in all subjects and a specific antibody (second-level blotting panel) was found in one. The cases presented a slow resolution of symptoms with sequelae. More studies are needed to better describe the spectrum and prognosis of autoimmune CNS diseases in PLWH.

Complications of button battery ingestion or insertion in children: a systematic review and pooled analysis of individual patient-level data.

Button battery (BB) exposures are common in children and can have devastating consequences. We reviewed current evidence on the complications associated with BB exposure and identified predictors of outcomes using individual patient-level data. We carried out a systematic review and pooled analysis by searching MEDLINE, Embase, and Scopus up to May 19, 2023. Included studies describe complications following BB exposures in children (aged < 18years). Odds ratios (ORs) were calculated using binary logistic regression to measure associations between predictive factors and different outcomes. Two-hundred seventeen studies (439 children) were included. The median age at presentation was 1.75 [interquartile range (IQR) 1.00-3.00] years and 399 (90.9%) exposures were ingestions. Of the 380 cases reporting sex, 162 (42.6%) were female. Feeding (192, 48.1%) and respiratory difficulties (138, 34.6%) were common presenting features for ingestions, while symptomatology was site-specific for insertions. Common complications included oesophageal mucosal damage alone (105, 26.3%) and tracheooesophageal fistula (93, 23.3%) for ingestions, and nasal septal perforation (22, 55.0%) and mucosal damage alone (13, 32.5%) for insertions. Intestinal perforation occurred in 2.5% of ingestion cases, including perforation of Meckel's diverticulum, peritonitis, and jejunocolic fistula. Vascular complications were common among children who died. Age (≤ 2years), battery exposure duration (> 6hours), and battery diameter (≥ 20mm) were associated with common and severe complications of ingestions. BB injuries are time-critical, with severe sequelae predominantly affecting young children. Diagnosis is challenging. Preventative work through regulation and safer battery design are required to eliminate this problem.

X[formula omitted]CoH[formula omitted] (X = Ca, Sr) for hydrogen storage: First-principles computations

The structural, electronic, elastic, optical, phonon, and thermo-physical properties of the tetragonal X2CoH5 (X = Ca, Sr) hydrogen storage compounds were thoroughly examined using first-principles calculations. The negative formation enthalpies (−76.03 kJ/mol.H2 for Ca2CoH5 and −72.55 kJ/mol.H2 for Sr2CoH5) highlight the structural stability of these materials. Phonon calculations revealed no imaginary frequency modes, confirming the dynamic stability of X2CoH5. The mechanical stability of Ca2CoH5 and Sr2CoH5 was evidenced by the compliance of the elastic constants with Born stability criteria. The electronic band structure indicates that Ca2CoH5 and Sr2CoH5 are direct bandgap semiconductors with narrow bandgaps of ∼0.27 and 0.34 eV, respectively. The appraisal of Poisson’s ratio (ν = 0.22 for X = Ca and 0.23 for Sr) and Pugh’s ratio (B/G = 1.47 for X = Ca and 1.56 for Sr) suggests that both metal hydrides exhibit brittle mechanical behavior. Moreover, 3D plots of Young’s modulus (E), shear modulus (G), linear compressibility (β), and Poisson’s ratio (ν) uncover anisotropy within X2CoH5. The hydrogen storage capabilities were scrutinized, and the present materials feature excellent volumetric hydrogen density (95.65 gH2l−1 for Ca2CoH5 and 80.24 gH2l−1 for Sr2CoH5), moderate gravimetric hydrogen density (3.38 wt% for Ca2CoH5 and 2.06 wt% for Sr2CoH5) and high hydrogen desorption temperature (584 K for Ca2CoH5 and 558 K for Sr2CoH5). Notably, the obtained volumetric hydrogen densities are in line with the volumetric capacity criteria set by the U.S. Department of Energy (DOE) for 2025. Finally, the optical and thermo-physical characteristics of X2CoH5 compounds were also investigated in this work.

Natural history and outcome of nonketotic hyperglycinemia in China.

Nonketotic hyperglycinemia (NKH) is a rare, life-threatening genetic disorder. The patients usually show heterogeneous and nonspecific symptoms, resulting in diagnosis challenges using conventional approaches. Here, the clinical presentation and genetic features of 20 Chinese patients were examined and reported in order to clarify the natural history and prognosis of NKH in China. The Human Gene Mutation Database and literature regarding NKH in China were reviewed. Age of onset, clinical characteristics, genetic analysis, cranial magnetic resonance imaging (MRI) and electroencephalography (EEG) examinations, and outcome of the patients were analyzed. Natural history experiences and follow-up assays for five patients who were followed in our center were described. Among all 20 NKH patients, 17 (85%) had the neonatal type and 3 (15%) had the infantile type, no late-onset cases were detected. Patients showed up for admission with a history of seizures (15/20), lethargy (14/20), hypotonia (11/20), apnea (9/20), and feeble sobbing (4/20). Brain MRI findings included abnormal signals in the internal capsule, cerebellum, or brainstem (6/14), dysplasia of the corpus callosum (5/14), and white matter abnormalities (3/14). EEG evaluations showed anomalies such as burst suppression (4/8) and hypsarrhythmia and/or epileptic activity (6/8). Median values of cerebrospinal fluid (CSF) glycine levels, plasma glycine levels and CSF/plasma glycine ratios were135.2 (range, 6.3-546.3) μmol/L, 998.2 (range,75-3,084) μmol/L, 0.16 (range, 0.03-0.60) respectively. Genetic analyses revealed four new variations and GLDC, AMT gene abnormalities in 13 (65%), 7 (35%) case, respectively. Prognosis information was available for 18 cases: nine patients died, eight in the neonatal period. Among the nine survivors, varying developmental disorders were observed. Different disease processes and outcomes were found in Chinese NKH patients, according to this study. The initial clinical presentations, CSF glycine levels and CSF to plasma glycine ratios do not reliably predict prognosis, while MRI and EEG abnormalities may indicate a poor outlook. NKH diagnosis should be considered for neonates presenting specific symptoms. The present survey provides clinical data that support the development of a standardized protocol for diagnosing and treating NKH in China.

Heart involvement in systemic sclerosis: emerging concepts.

Systemic sclerosis (SSc)-associated heart involvement (SHI) is a significant cause of both morbidity and mortality in individuals with SSc. SHI can take many different forms, and likely is a spectrum of fibroinflammatory cardiac disease. Presenting features include arrhythmia, ventricular systolic or diastolic dysfunction, pericardial disease, and exercise intolerance. Risk of sudden cardiac death in SSc is likely 10-30-fold greater than general population estimates. In this review, we explore what is known about the pathogenesis of SHI, its prevention and management, and discuss available strategies for screening for SHI in light of new recommendations for the routine screening of SHI in all SSc patients. We describe the spectrum, clinical features, and pathogenesis of SHI. Furthermore, we review the new recommendations for screening for SHI in individuals with SSc. There is a large, under-recognized burden of SHI in people living with SSc, which likely contributes to the significant increase in sudden cardiac death observed in SSc. However, a broad-based screening approach, including asymptomatic, low-risk patients should be viewed with caution given the lack of evidence-based treatments and interventions for SHI particularly in this group.

Do textbooks provide opportunities to develop meaningful botanical literacy? A case study of the scientific model of plant nutrition

ABSTRACT Botanical literacy is a crucial component of science education, particularly in light of the contemporary socio-ecological challenges. However, the literature reports that, due to the phenomenon known as Plant Awareness Disparity (PAD), average botanical literacy is scant. Multiple factors influence the effectiveness of botanical education, including the quality of instructional materials teachers employ to support their instruction. Therefore, this study assesses the treatment of the Scientific Model of Plant Nutrition (SMPN) in seven commonly used Spanish Biology textbooks for secondary education to determine whether they foster a meaningful botanical literacy and empower students with the scientific competence needed to understand and make informed decisions regarding plant-related global challenges. The investigation evaluates four fundamental aspects: structure, conceptual content, images, and activities. Findings reveal that the analysed textbooks present PAD features; promote reproductive and superficial learning that fails to foster the construction of interrelated and scientifically accurate mental models of plant nutrition; include visual representations that do not always enhance learning; and propose tasks which are insufficient to develop the scientific skills and competence pursued by current science teaching-learning. The implications of this research on botanical literacy and teaching-learning of the SMPN are discussed, and measures to enhance educational materials are proposed.

Biomarker Landscape in RASopathies.

RASopathies are a group of related genetic disorders caused by mutations in genes within the RAS/MAPK signaling pathway. This pathway is crucial for cell division, growth, and differentiation, and its disruption can lead to a variety of developmental and health issues. RASopathies present diverse clinical features and pose significant diagnostic and therapeutic challenges. Studying the landscape of biomarkers in RASopathies has the potential to improve both clinical practices and the understanding of these disorders. This review provides an overview of recent discoveries in RASopathy molecular profiling, which extend beyond traditional gene mutation analysis. mRNAs, non-coding RNAs, protein expression patterns, and post-translational modifications characteristic of RASopathy patients within pivotal signaling pathways such as the RAS/MAPK, PI3K/AKT/mTOR, and Rho/ROCK/LIMK2/cofilin pathways are summarized. Additionally, the field of metabolomics holds potential for uncovering metabolic signatures associated with specific RASopathies, which are crucial for developing precision medicine. Beyond molecular markers, we also examine the role of histological characteristics and non-invasive physiological assessments in identifying potential biomarkers, as they provide evidence of the disease's effects on various systems. Here, we synthesize key findings and illuminate promising avenues for future research in RASopathy biomarker discovery, underscoring rigorous validation and clinical translation.

Generalized lymphadenopathy as an initial presentation of systemic lupus erythematosus: case report and review of the literature

BackgroundSystemic lupus erythematosus (SLE) is a chronic multisystemic autoimmune disorder with a wide array of clinical manifestations. Lymphadenopathy is occasionally observed in patients with SLE, and although it is sometimes a feature of active disease, it is rarely the initial presenting feature at the time of diagnosis.Case presentationWe report the case of a 35-year-old woman with clinical features of generalized lymphadenopathy, fatigue, fever, and malaise of approximately 3 months duration with no other constitutional disorders or systemic involvement suggestive of SLE.Despite extensive laboratory, radiological, and histological evaluations for malignancies and infectious causes of generalized lymphadenopathy, all results returned normal. About a month later, she developed inflammatory polyarthritis, with a markedly elevated erythrocyte sedimentation rate (ESR) of 120 mm/h, and a subsequent serologic workup confirmed the diagnosis of SLE.Autoimmune serology testing revealed positive results for various antibodies, including antinuclear antibody (ANA) at a titre of 1:5120, homogenous and speckled pattern, anti-Sm, anti-dsDNA, U1-snRNP, Ku, SSA-AntiRo, SSB-AntiLa, anti-SM/RNP, anti-Histone, ribosomal-p protein, and anti-nucleosome antibodies. The diagnosis of SLE was established using the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ ACR) criteria.She was on oral prednisolone, hydroxychloroquine, and calcium/vitamin D3 tablets. The patient improved remarkably, all swollen lymph nodes regressed spontaneously and she had no further need for a hematology review.ConclusionWhile similar cases have been reported in Europe and some parts of Asia, in Africa, a careful search of the literature revealed that such cases have been reported only from Egypt in North Africa and not from other parts of the continent; hence, this case report highlights the importance of recognizing atypical presentations of SLE to improve awareness and diagnosis in different regions.

Benign bone tumors in North East Indian population – A hospital-based study

Background: Primary bone tumors are relatively uncommon and constitute only 0.2–0.5% of all tumors in all ages in most series reported worldwide. Benign bone tumors are more common than the malignant bone tumors. Not many studies on benign bone tumors in the North Eastern Indian population are published in the available literature. Aims and Objectives: The current study was done with the aim to find out the epidemiological data on benign bone tumors in patients of the North-East Indian population who were admitted to the orthopedic department of a teaching institute. Materials and Methods: A hospital-based retrospective study with prospective effect was conducted on benign bone tumors in patients admitted to the Department of Orthopedics at our teaching institute from 2016 to 2020. Patients of all ages and both sexes with suspicion of bone tumors based on history and clinical examination were subjected to roentgenographic evaluation, including computed tomography (CT) scan and/or magnetic resonance imaging. Pre-operative core needle biopsy under C-arm/CT guidance or incisional biopsy was done for histological diagnosis, followed by appropriate intervention. Soft-tissue tumors and malignant bone tumors were excluded. Patients were followed up for recurrence, complications, and functional recovery. Results: Forty patients of bone tumors were treated out of 2288 patients admitted to the department (incidence of 1.75%). 29 were benign bone tumors with an incidence of 1.27%. Of 10–20 years age group was most commonly affected. Male preponderance with M: F=6.25:1. Femur (n=16) was the most commonly affected bone. Presenting features were swelling (n=18), pain (n=11), and pathological fracture (n=5). osteochondroma (n=15) was most common followed by giant cell tumor of bone (n=6). Treatment ranged from intralesional steroid to wide marginal excision based on histopathological diagnosis, the extent of tumor, anatomical location, and presenting symptoms. All patients were rehabilitated to activities of daily living at the final follow-up. No recurrence or any long-term complications were reported. Conclusion: This study gives epidemiological data on benign bone tumors, which can be used for setting up or upgrading dedicated oncological or oncosurgery institutes. A multicentric study on a large population in the future is suggested to obtain a larger data bank.

Features of artistic presentation of images of people's leaders in the context of the development of the system of realistic painting in China in the XX – early XXI century

Features of artistic presentation of images of people's leaders in the context of the development of the system of realistic painting in China in the XX – early XXI century

Pulmonary artery aneurysm: computed tomography (CT) imaging findings and diagnosis.

Pulmonary artery aneurysm (PAA) is a rare pulmonary vascular disease with nonspecific symptoms and various etiologies. As the disease progresses, in addition to the dilation of the pulmonary arteries, it may be accompanied by remodeling of the cardiac structure and changes in the morphology of the aorta. Recognizing the cause of PAA is therefore a clinically challenging task. In this review article, we provide an overview of various causes of PAA with the support of corresponding imaging findings on computed tomography pulmonary angiography (CTPA) examination. Firstly, from the perspective of hemodynamics, a logical diagnosis is provided according to whether the main pulmonary artery (MPA) is dilated, and whether the PA is dilated locally or diffusely. Secondly, for the imaging examination of vascular wall lesions, due to the limitations of ultrasound examination and interventional procedures, the irreplaceability of dual-phase CTPA examination in disease assessment is especially emphasized. Finally, for highly suspected disorders, it is necessary to comprehensively check with the patient whether there is a family history or past medical history. For patients with PAA, especially those with Marfan syndrome (MFS) or arteritis, adequate preoperative imaging evaluation, regular postoperative radiographic follow-up, and concurrent treatment of the underlying disease (if necessary) are crucial, which are related to the prognosis and long-term quality of life of such patients. Despite the nonspecific features of PAA presentation, a thorough examination of the patient's clinical history and imaging characteristics will play an important role in diagnosing PAA and planning patient management strategies.

Primary hepatic diffuse large B- cell lymphoma mimicking cholangiocarcinoma

Primary lymphoma of liver is a rare malignancy with non-specific clinical features and tumor markers. The presentation and imaging features may be indistinguishable from other hepatic malignant lesions. Pathological diagnosis is the gold standard, and early detection is essential to choose the treatment modality. Here, we share an interesting case of Primary Diffuse Large B cell lymphoma of liver and its imaging findings on Computed tomography (CT), Magnetic Resonance Imaging (MRI) and F-18 FDG PET/CT.

Clinicopathological features of hepatoid adenocarcinoma and non-hepatoid adenocarcinoma of the stomach: A systematic review and meta-analysis.

Hepatoid adenocarcinoma of the stomach (HAS) is an extremely rare and unique malignant gastric tumor with a significantly worse prognosis than non-hepatoid adenocarcinoma of the stomach (non-HAS). The present study explored the clinicopathological features of HAS and non-HAS patients to provide insights into HAS treatment strategies. From December 26, 2023, we performed a comprehensive search of the PubMed, Web of Science, Cochrane Library, and Embase.com databases for relevant studies. Two authors independently screened the studies, evaluated their quality, extracted data, and performed the analyses. This study was registered with PROSPERO on January 2, 2024. Nine retrospective studies were included for analysis after screening 833 articles. A total of 350 and 924 patients were enrolled in the HAS and non-HAS groups, respectively. While no significant differences were observed in age, sex, tumor size, T3 or T4 stage, and N2 or N3 stage between the two groups, the HAS group exhibited higher rates of lymph node metastasis (OR = 1.93, 95% CI: 1.19-3.13, p = 0.007), liver metastasis (OR = 3.45, 95% CI: 2.26-5.28, p < 0.001), and vascular invasion (OR = 2.76, 95% CI: 2.05-3.71, p < 0.001). Additionally, the HAS group had lower 3-year survival rates (HR = 2.35, 95% CI: 1.70-3.25, p < 0.001) and 5-year survival rates (HR = 3.63, 95% CI: 1.49-8.88, p = 0.005), but lower rates of lymphatic permeation (OR = 0.68, 95% CI: 0.47-0.99, p = 0.040). Based on the current clinical evidence, patients with HAS present distinct clinicopathological features, greater invasiveness, and poorer prognosis than non-HAS patients. Further research is warranted to develop optimal treatment strategies for HAS.