Thin Septa Research Articles

Ultrastructural Characterization of Testis in Non-descript Goat (Capra hircus)

Background: The proposed experiment was aimed at locating the spermatogonial stem cell niches inside the testis and to characterise the development of germ cells of testis in the non- descript goats at the different stages of pre and post natal life, which could be useful in selecting the goats for breeding at appropriate time and for other interventions related to reproductive developments in the goats. Methods: The present study was conducted on the testes of non-descript goats divided into three groups, viz. neonatal (within 1 month), prepubertal (from 1-18 months) and pubertal (above 18 months) with 10 healthy animals in each group. The collected samples of testis were processed for scanning electron microscopic study and subsequently, the samples were viewed and the photographs were taken in the facility available at Central Instrumentation Facility (CIF), OUAT, Bhubaneswar. Result: The present study revealed that the testis was surrounded by the tunica albuginea, a thin capsule of connective tissue, from which thin septum originated and extended into the inside of the organ. Among these septa, the seminiferous tubules were found. The seminiferous epithelium consisted of spermatogonial cells at different stages of development separated from each other by interstitial connective tissue. The interstitium was made up of randomly arranged collagen bundles. The intertubular vascular connective tissue contained Leydig cells mainly at wider locations where they were bounded by more than two seminiferous tubules. The mediastinal rete testis area contained many cavities of many intercommunicating channels supported by connective tissue pillars. The present study helped in developing a baseline data on the ultrastructural characteristics of seminiferous epithelium, rete restis, peritubular cells, Lyedig cells and other components of testis in non-descript goat at different post natal stages under study. The appearance of seprmatogonial cell lineage at the various post natal stages in non-descript goat would help in accessing the reproductive status of the animal.

Atypical arachnoid cyst with progression: a case report

A 26-year-old female patient applied to the outpatient clinic in 2018 due to pain that had been present for a long time (16 years) and had recently spread from the top of the head to the nape of the neck. It was learned from the patient's anamnesis that her pain was relieved with analgesics. Although no pathological findings were found in the neurological examination, brain MRI was requested to reveal possible intracranial pathological conditions. In the MRI images taken, a cystic mass with a lobulated contour and thin septa of 24x31x40 mm and similar intensity to CSF was detected in the right parasagittal area posteriorly at the vertex level. The patient's control brain MRI images 3 months later showed no increase in cyst size. However, the patient's anamnesis, which came for a control in 2022, showed that his current complaints and headaches had increased. The MR images showed that the existing cyst had reached a size of approximately 60x35 mm. Medical treatment was initially planned for the patient (Acetazolamide, 750 mg/day). The MR taken one month later showed that there was no reduction in the cyst size and the optic discs were slightly swollen in the fundus examination. Considering the cyst growth, the patient's failure to benefit from medical treatment and the swelling noted in the optic discs, the patient was fitted with a cystoperitoneal shunt. The patient's early postoperative tomography image showed a significant reduction in the cyst (50.15x25.66) and a slightly swollen optic disc image with blurred borders was detected in the fundus examination. The patient's complaints regressed, and in the radiological images it was determined that the cyst continued to shrink [(45.8x23.19 mm) and (41.1x20.3 mm)], the shunt was in place, and she had no clinical complaints. As a result, it was argued that patients with atypically located arachnoid cysts, as in this case, should be taken under close clinical and radiological follow-up, and surgical treatment methods should definitely be considered in patients who are found to have an increase in cyst size and clinical findings during this follow-up and who do not respond despite medical treatment.

The Predictive Power of Bosniak 3 and 4 Cystic Renal Lesion Categorization Using Contrast-Enhanced Ultrasound.

Contrast-enhanced ultrasound (CEUS) is increasingly utilized for the noninvasive assessment of renal cystic lesions, using the Bosniak grading system. Bosniak 3-4 lesions require surgical referral, which allows correlation with the histopathological outcome. In this single-center, retrospective study we evaluated renal CEUS exams conducted with SonoVue® with a diagnosis of a Bosniak 3 or 4 lesion between 2019 and 2022. A total of 49 patients and 50 lesions met the inclusion criteria, 31 lesions had available histopathological results. Patient demographics, cyst morphology, and dominant imaging features were registered. The histopathological diagnosis was considered a reference standard. Positive predictive power (PPV) for neoplastic lesions was comparable in the Bosniak 3 and 4 categories (75 vs 93.3%, P = .33), while PPV for histopathologically malignant lesion was considerably higher in the latter group (25 vs 93.33%, P = .0002). None of the lesions which had vividly enhancing thin septa as their dominant CEUS feature were malignant. Oncocytoma, multilocular cystic renal neoplasm of low malignant potential, and cystic nephroma were the major benign entities among Bosniak 3 lesions. Localized cystic kidney disease and hemorrhagic cysts were found to be the primary mimickers leading to false positive imaging findings. CEUS has a high predictive power for malignancy in the Bosniak 4 category, which is not maintained in the Bosniak 3 group due to the large proportion of benign lesions. Adherence to rigorous rule-in criteria and active surveillance strategies need to be considered for equivocal CEUS Bosniak 3 lesions.

CUTANEOUS DERMATOPHYTOSIS MIMICKING AUTOIMMUNE BLISTERING DISORDER

Some infectious diseases can clinically present as vesiculobullous disorders. A case of 33-year-old male patient presented with red, itchy skin lesions and few fluid filled lesions over both groins since 2 months. On clinical examination, multiple tense bullae with clear fluid over background of well defined erythematous plaques over both groins were noted.Histopathological examination showed subepidermal blister with abundant fibrin and numerous eosinophils in the blister cavity.Based on the diagnosis of biopsy proven bullous pemphigoid patient was started on steroids ( Inj. Dexamethasone 2cc IV OD in morning ) as treatment for 5 days. But on day 6 patient developed papular lesions over the original site where erythematous plaques were present.To rule out infectious etiology, KOH(10%) wet mount examination of the scales from the borders of the lesion showed numerous thin septate fungal hyphae and culture for fungus from skin scrappings showed growth for trichophyton mentagrophytes.So here, a case of 33 year-old male with cutaneous dermatophytosis having presentation mimicking bullous pemphigoid both clinically and histopathologically has been described.

Benign Multicystic Peritoneal Mesothelioma: A Case Report

Benign multicystic peritoneal mesothelioma (BMPM) is a rare tumor originating from peritoneal mesothelial cells. Here, we present a case of an 18-year-old male with right lower abdominal pain. Physical examination revealed a palpable mass with unclear boundaries. Laboratory tests showed elevated levels of monocytes and high-sensitivity C-reactive protein. CT scan revealed a cystic mass in the ileocecal region with multiple septations. Laparoscopic surgery confirmed a cystic solid mass resembling beads on the colon’s right side. Immunohistochemistry confirmed BMPM diagnosis. BMPM, especially in the ileocecal region, is uncommon and presents diagnostic challenges. Differential diagnosis includes lymphangioma, peritoneal metastasis, and malignant mesothelioma. CT findings, such as thin cyst walls and septations, aid in diagnosis. Recognition of BMPM’s imaging features improves diagnostic accuracy. Surgical resection remains the primary treatment. This case underscores the importance of considering BMPM in young male patients with abdominal pain and emphasizes the value of imaging modalities in accurate diagnosis and management.

Magnetic Field Analysis and Measurement of Pulsed Septum Magnet

Traditional off-axis injection becomes inadequate in diffraction limited storage ring (DLSR) for its small dynamic aperture (DA). On-axis injection with thin septum could solve the problem. This paper focuses on the theoretical calculation, field simulation, and measurement of thin septum magnets. The scheme of eddy-current type thin septum magnets (the thinnest portion is with the thickness of 0.9 mm) was adopted with laminated silicon steel sheets as the magnet core. The simulation of main field, stray field along the beam trajectory, the leakage field decayed over 1 millisecond time was carried out within Opera 2D/3D. Field measurement and analysis of thin septum magnets also has been conducted comprehensively. The results meet requirements, and the work laid a foundation for injection technology of an advanced light source.

P-80 A rare case of papillary thyroid carcinoma within a mature cystic ovarian teratoma

Abstract Introduction Mature teratoma is the most common ovarian germ cell neoplasm. Teratomas can contain various tissue groups, such as skin, hair, and thyroid tissue. Teratomas in which more than 50% of the tumor tissue is composed of thyroid tissue are defined as Struma Ovarii. Malignant transformation of Struma Ovarii has been reported at a rate of 0.5-5%, most commonly presenting as thyroid papillary and follicular carcinomas. Metastasis is observed in 5% of malignant cases. Clinical Case A 45-year-old female with a history of Hashimoto's thyroiditis presented in July 2022 with complaints of abdominal pain. Abdominal contrast-enhanced tomography revealed a hypo dense lesion 5 cm in diameter the right adnexal region, and in the magnetic resonance images 5 cm mass was observed in the right adnexal area. Serum Ca-125 level was 212 U/mL (0-35) at admission. Due to high suspicion of malignancy ovarian cystectomy has been performed. Pathology of specimen revealed a 0.5 cm thyroid papillary carcinoma with follicular variant in infiltrative features but no lymphovascular invasion. Subsequently, the patient underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy due to the unverifiable risk of malignancy. Pathological examination showed no malignancy. The patient presented to our clinic in June 2023, neck ultrasound revealed a 13×12 mm heterogeneous hypoechoic thyroid nodule with thick and thin septations and occasional internal vascularity in the left thyroid lobe. Fine-needle aspiration biopsy of the thyroid was performed, and cytology results were reported as benign. The serum thyroglobulin level was found to be 83.7 ng/mL. In terms of the treatment plan, BRAF and K-RAS gene analysis was planned based on the pathology preparations. The patient will be evaluated for total thyroidectomy/radioactive iodine ablation/no treatment based on the results. Follow-up is ongoing, and test results are awaited. Conclusion Malignant transformation of mature teratoma is rare and thyroid papillary carcinoma being the most frequently seen malignancy. There is no consensus on treatment and follow-up, but it is recommended to classify patients based on their risks and consider options such as total thyroidectomy/radioactive iodine ablation/no treatment for follow-up. Literature suggests the need for guidelines and treatment algorithms for the management of malignant struma ovarii. Some authors recommend whole-body iodine scanning in determining risk and follow-up, asserting that iodine-based treatment and follow-up methods would be meaningless without thyroidectomy. There is also an approach advocating for only salpingo-oophorectomy in low-risk patients and subsequent follow-up. Thus, a consensus on guidelines and treatment algorithms for malignant struma ovarii is needed.

P-66 Primary Thyroid Lymphoma mimicking Riedel Thyroiditis

Abstract Introduction Although Riedel's thyroiditis and primary thyroid lymphoma are rare diseases of the thyroid, they should be considered in the differential diagnosis of patients presenting with a neck mass. We report here the case who was followed up with the diagnosis of Riedel's thyroiditis and later diagnosed with lymphoma. Clinical Case A 67-year-old female presented with swelling in the neck, pain and shortness of breath. Thyroid ultrasound demonstrated enlarged thyroid gland, heterogeneous parenchyma, irregular contours, thin septations and pseudonodule formations. Laboratory tests revealed, TSH 4.17 mIU/L, fT4 1.37 ng/dl, anti TPO 147 IU/mL, sedimentation 13mm/h, and CRP of 5.5 mg/dl. In neck CT, an 8*4 cm hypodense mass infiltrating both thyroid lobes, extending anteriorly and superiorly, surrounding the trachea by 270 degrees, was detected. Follicle cells were seen in the fine needle aspiration biopsy, but no neoplasm was found. In PET-CT, increased FDG uptake was detected in the thyroid parenchyma (SUVmax: 22.89) and in one subcentimetric lymph node (SUVmax: 3.5) in the right cervical region. No neoplasm was found in the tru-cut biopsy and the biopsy was reported as granulomatous thyroiditis. When her current complaints and physical examination findings were evaluated together, methylprednisolone was started, considering Riedel's thyroiditis. In the follow-up examination, the thyroid size of the patient decreased significantly and the steroid dose was reduced. The patient, who could not be followed up for a while, developed swelling and pain in the neck again, and was followed up in the ICU with acute respiratory failure, a tracheal stent was applied to the patient. The patient was then followed in the ward, with dyspnea, dysphagia and hoarseness continued, was admitted to our polyclinic again and was hospitalized. The patient stated that her oral intake decreased due to dysphagia and there was a loss of 40 kg. She had no fever or night sweats. She was not smoking. Physical examination revealed a hard, fixed mass that completely filled the right neck and reached the midline. In the endoscopic examination, the vocal cords were paralytic, the air passage was inadequate, and the mass was invading the trachea. Tracheostomy was applied to the patient. Trucut biopsy was taken from the thyroid tissue. In addition, PET-CT was taken. On PET-CT, right thyroid dimensions showed significant morphological progression compared to the previous study, very dense at similar levels (previous SUVmax: 22.89,current SUVmax: 22.76);intense FDG uptake was detected in 8 mm lymph nodes in the left cervical and 19×20 mm lymph nodes in the right supraclavicular (SUVmax 22.17) region.Diffuse Large B-Cell Lymphoma was detected as a result of thyroid biopsy and R-CHOP treatment was started on the patient. She was discharged after 2 cycles of chemotherapy (Figure). The diagnosis of both Riedel's thyroiditis and primary thyroid lymphoma are histopathological. The importance of open surgical biopsy and cooperation with an endocrine-specific pathologist was emphasized through our case.Figure.Photos of the patient at her initial and last state

New species of Ontocetus (Pinnipedia: Odobenidae) from the Lower Pleistocene of the North Atlantic shows similar feeding adaptation independent to the extant walrus (Odobenus rosmarus).

Ontocetus is one of the most notable extinct odobenines owing to its global distribution in the Northern Hemisphere. Originating in the Late Miocene of the western North Pacific, this lineage quickly spread to the Atlantic Ocean during the Pliocene, with notable occurrences in England, Belgium, The Netherlands, Morocco and the eastern seaboard of the United States. Reassessment of a pair of mandibles from the Lower Pleistocene of Norwich (United Kingdom) and a mandible from the Upper Pliocene of Antwerp (Belgium) that were referred to as Ontocetus emmonsi reveals existences of features of both Ontocetus and Odobenus. The presence of four post-canine teeth, a lower canine larger than the cheek-teeth and a lower incisor confirms the assignment to Ontocetus; simultaneously, characteristics such as a fused and short mandibular symphysis, a well-curved mandibular arch and thin septa between teeth align with traits usually found in Odobenus. Based on a combination of these characters, we describe Ontocetus posti, sp. nov. Its mandibular anatomy suggests, a better adaptation to suction-feeding than what was previously described in the genus suggesting that Ontocetus posti sp. nov. likely occupied a similar ecological niche to the extant walrus Odobenus rosmarus. Originating from the North Pacific Ocean, Ontocetus most likely dispersed via the Central American Seaway. Although initially discovered in the Lower Pliocene deposits of the western North Atlantic, Ontocetus also left its imprint in the North Sea basin and Moroccan Plio-Pleistocene deposits. The closure of the Isthmus of Panama during the Mio-Pliocene boundary significantly impacted the contemporary climate, inducing global cooling. This event constrained Ontocetus posti in the North Sea basin leaving the taxon unable to endure the abrupt climate changes of the Early Pleistocene, ultimately going extinct before the arrival of the extant counterpart, Odobenus rosmarus.

Diagnosis and treatment of angiographically unclear coronary lesions.

Although selective coronary angiography is the gold standard diagnostic technique for coronary lesions, this method does not provide all information regarding pathophysiologic mechanisms. We herein describe a patient in their early 60s with a 3-month history of pronounced angina. Coronary angiography revealed a central line of illumination in the proximomedial segment of the right coronary artery, suggesting a chronic coronary dissection/recanalized thrombus, along with positive remodeling and TIMI grade 2 flow. Optical coherence tomography showed a recanalized thrombus and multiple lumens separated by thin septa. Because of the significantly reduced flow and signs of ischemia in the right coronary artery irrigation territory, we decided to perform percutaneous coronary intervention. Post-treatment optical coherence tomography indicated optimal apposition and expansion of the stents with positive remodeling of the blood vessel. We believe that decisions regarding treatment modalities should be guided by the presence or absence of ischemia. Lesions that are causing myocardial ischemia should be revascularized; otherwise, medical treatment can be utilized.

MORPHOLOGICAL CHARACTERISTICS OF THE UTERUS OF WHITE OUTBRED RATS

Using light microscopy methods, the histological structure of the uterus of white outbred rats at the level of the body and cervix was clarified. It has been established that the walls of the right and left uterine horns grow together, forming a double body and neck. Whose cavities remain separated from each other by a thin septum and open into the vagina with two separate openings. The area of fusion of the medial walls is characterized by the union of the perimeter and the supravascular layer of the myometrium. The data obtained can be used to illuminate the relevant sections of reference and educational literature when writing sections on evolutionary, functional, comparative species morphology and reproductive biology. Based on the histological study, it was established thatin rats, despite the general type of uterine structure, there are significant differences that mainly affect their lower segment at the borders.

Failure of Left Bundle Branch Pacing Owing to Iterative Septal Perforation: A Word of Caution for Thin Septum and Highly Dilated Cardiomyopathy

Failure of Left Bundle Branch Pacing Owing to Iterative Septal Perforation: A Word of Caution for Thin Septum and Highly Dilated Cardiomyopathy

A Large Recurrent Retroperitoneal Lymphangioma in a Previously Healthy Adolescent Male: A Case Report

Lymphangiomas are uncommon benign lymphatic vessel tumors that can affect any area of the body served with the lymphatic system. Intra-abdominal lymphangiomas are considered rare, accounting for less than 5 percent of all lymphangioma cases. In this case report, we present a recurrent large retroperitoneal lymphangioma in a previously healthy 15-year-old boy. The patient presented to the Emergency Department with abdominal pain lasting for one week. The pain, described as diffuse, crampy, and non-radiating, gradually increased with time and was aggravated by movement. A large retroperitoneal fluid collection was found on the Computed Tomography (CT) scan. Subsequently, the patient underwent CT-guided drainage, at which 700ml of bloody fluid was extracted. After three months, the patient was readmitted to the hospital for a similar presentation of abdominal fullness and pain. Complete blood count analysis indicated an unremarkable profile, except for a left shift of 82.2% neutrophils and a white blood cell count of 11,300/mcl. A CT scan of the abdomen reported a large, thin-walled cystic lesion in the right hemi-abdomen with minimal thin internal septations, resulting in moderate right hydronephrosis/hydroureter.

First report of Fusarium clavum causing garlic bulb rot in Mexico.

In Mexico, the main states for garlic (Allium sativum L.) production are Zacatecas, Guanajuato, and Puebla. In the 2020 crop season, garlic cultivation encompassed 6,794 ha, yielding 85,505 tons (SIAP, 2021). In February 2020, 35 garlic samples showing basal rot symptoms were collected from the garlic-growing regions in the states of Zacatecas and Aguascalientes in the municipalities of San Antonio Tepezala 22°13'13.5''N, 102°15'55.3''W, Rincón de Romos 22°17'44.9''N, 102°13'06.8''W, and Calera 22°58'39.4''N and 102°41'29.9W, respectively. The sampling carried out was random sampling by conglomerates, dividing each field in groups with plants that showed similar symptoms. The infected plants were stunted in growth, with reddish dying leaves. The stalks and bulbs were soft, and their root system was poorly developed. The collected samples were placed in polyethylene bags and taken to laboratory. The roots and bulbs of 35 plants were cleaned, portions of the diseased tissue was cut into 0.5 cm pieces and disinfected in 1% sodium hypochlorite for 3 minutes. The samples were rinsed twice with sterile distilled water and dried on sterile paper towels. The tissues were cultured on Potato Dextrose Agar (PDA) medium and incubated in the dark at 25°C. Seven days after incubation, pure cultures were obtained using monoconidial cultures technique on Spezieller Nährstoffmmarmer agar (SNA) and subcultured on carnation leaf agar (CLA). Ten isolates were obtained that grew slowly, showing a white coloration, then turning yellow with abundant aerial mycelia. Microscopic traits of 30 characterized spores included slender macroconidia that were curved dorsiventrally, tapering towards both ends, with five to seven thin septa, measuring 36.4-56.6 µm × 4.0-4.9 µm in size and chlamydospores that were abundant, globose to oval, subhyaline and terminal or intercalary in chains measuring 8.8-4.5 µm in diameter. Microconidia, were single-celled, hyaline, nonseptate, and ovoid. The morphological traits matched the description of Fusarium clavum (Xia et al. 2019). To confirm the strain's identity, DNA was extracted from six monoconidial cultures and used as template to amplify translation elongation factor (TEF) gene 1α, RNA polymerase largest subunit (RPB1), and RNA polymerase second largest subunit (RPB2) (O'Donnell et al. 2010). The products were sequenced and deposited in GenBank as ON209360, OM640008 and OM640009, the homology analysis using BLASTn was similar to F. clavum with 99.46%, 99.49% and 98.82% respectively with E VALUE 0.0 in all cases with access numbers OP48709, HM347171 and OP486686. Koch postulate was performed to confirm the pathogenicity of the six isolates. Variegated garlic cloves were planted after being disinfected with sodium hypochlorite at 3% w/v in 2-kg pots under the greenhouse conditions. When the garlic plants developed 4 or 5 true leaves, their basal stalks were inoculated by pouring uniformly with 1 mL of a spore suspension at 108 conidia/mL prepared from 1-week-old colonies (Lai et al. 2020). Twenty-four plants were inoculated with six isolates (four plants per isolate), and four control plants were treated with sterile distilled water. Symptoms appeared 20 days post-inoculation. The leaves were reddish, and the stalks were soft. The leaves eventually developed foliar dieback disease symptoms, their root system showed brown lesions and rot, and all water-inoculated controls remained asymptomatic. Isolations were made on the diseased plants, and the inoculated pathogen was recovered and confirmed morphologically and molecularly by DNA extraction and PCR reactions. Koch's postulate was repeated twice, obtaining the same results. To our best knowledge, this is the first report of F. clavum infecting Allium sativum L. in Mexico. bulb rot caused by F. clavum is a severe threat to garlic cultivation, and identification of this pathogen is important for effective disease management and control.

Papillary Thyroid Carcinoma within a Thyroglossal Cyst: A Rare Case Report with Review of Literature.

Thyroglossal cyst (TGC) is the most common congenital anomaly of the thyroid gland and is found in approximately 7% of general population. It represents cystic degeneration of a remnant of the thyroglossal duct that failed to involute during gestation. Malignancy occurring in TGC is rare entity, accounting only for 1% of all thyroglossal cysts. We are presenting such a rare case of papillary thyroid carcinoma arising in a thyroglossal cyst.30-year-old female presented with a painless, gradually progressive swelling below the chin extending to left side. On examination, swelling was noted in submental region and measuring 4 × 3 × 1cm, firm in consistency and moves with deglutition and movement of tongue.On radiological investigations, lobulated cystic lesion in midline with thin septations was seen, suggestive of thyroglossal cyst. The thyroid of the patient was normal. Patient underwent Sistrunk procedure. On histopathology, papillary thyroid carcinoma in thyroglossal cyst was seen and it was invading cyst wall and superficial skeletal muscle.The 1st case of thyroglossal duct carcinoma was reported by Brentano in 1911. Till now 300 cases have been reported in literature. Carcinomas occurring in thyroglossal cyst are extremely rare, (< 1% cases). The most frequent histological type is papillary pattern followed by mixed(papillary and follicular), squamous cell, Hürthle cell, follicular and anaplastic variety. The etiology of thyroglossal duct carcinoma is unknown and neither good clinical history nor examination can lead to a preoperative diagnosis. Diagnosis is often incidental on histopathology as in present case.Thyroglossal duct carcinoma is a rare condition that comes as a surprise to both the patient and surgeon and should be considered in patients presenting with cystic midline neck masses.

Multilocular cystic renal neoplasm of low malignant potential in a patient with chronic pyelonephritis and end-stage renal disease: A rare case report

Multilocular cystic renal neoplasm of low malignant potential (MCNLMP) is a rare subtype of clear cell carcinoma having an excellent prognosis. These tumors exhibit distinct morphology and consist of multiple cysts separated by thin septa lined by clear cells with no expansile growth. These cysts, though rare in a setting of chronic pyelonephritis and end-stage renal disease, are usually diagnosed on radiography using the Bosniak classification. But in certain situations where cysts are not visible radiologically, a final diagnosis is made with the help of histopathology and immuno- histochemistry only. We, hereby, report such a rare incidental case of MCNLMP diagnosed on histopathology in a nephrectomy specimen of an elderly male with chronic pyelonephritis and end-stage renal disease.

The Role of Extracellular Signal-Regulated Kinase Pathways in Different Models of Cardiac Hypertrophy in Rats.

Cardiac hypertrophy develops following different triggers of pressure or volume overload. In several previous studies, different hypertrophy types were demonstrated following alterations in extracellular signal-regulated kinase (ERK) pathway activation. In the current study, we studied two types of cardiac hypertrophy models in rats: eccentric and concentric hypertrophy. For the eccentric hypertrophy model, iron deficiency anemia caused by a low-iron diet was implemented, while surgical aortic constriction was used to induce aortic stenosis (AS) and concentric cardiac hypertrophy. The hearts were evaluated using echocardiography, histological sections, and scanning electron microscopy. The expression of ERK1/2 was analyzed using Western blot. During the study period, anemic rats developed eccentric hypertrophy characterized by an enlarged left ventricle (LV) cavity cross-sectional area (CSA) (59.9 ± 5.1 mm2 vs. 47 ± 8.1 mm2, p = 0.002), thinner septum (2.1 ± 0.3 mm vs. 2.5 ± 0.2 mm, p < 0.05), and reduced left ventricular ejection fraction (LVEF) (52.6% + 4.7 vs. 60.3% + 2.8, p < 0.05). Rats with AS developed concentric hypertrophy with a thicker septum (2.8 ± 0.6 vs. 2.4 ± 0.1 p < 0.05), increased LV muscle cross-sectional area (79.5 ± 9.33 mm2 vs. 57.9 ± 5.0 mm2, p < 0.001), and increased LVEF (70.3% + 2.8 vs. 60.0% + 2.1, p < 0.05). ERK1/2 expression decreased in the anemic rats and increased in the rats with AS. Nevertheless, the p-ERK and the p-MEK did not change significantly in all the examined models. We concluded that ERK1/2 expression was altered by the type of hypertrophy and the change in LVEF.

Ovarian mucinous adenocarcinoma and false negative frozen pathology: A case report and review of the literature

Introduction: In this case report we discuss the presentation and management of a woman with a large adnexal mass. Case Report: This report describes a 32-year-old year healthy woman who presented with four months of increasing abdominal fullness. Computed tomography (CT) imaging showed a 34 cm fluid-filled left adnexal mass with few thin septations. Tumor markers were within normal limits. She strongly desired minimally invasive surgery in the setting of low concern for malignancy. A mini-laparotomy was performed, purse string sutures were placed through the cyst wall, and fluid was aspirated with minimal spillage. Her left tube and ovary were resected laparoscopically. Intraoperative frozen pathology returned as mucinous cystadenoma with some areas of atypia. Final pathology resulted with Grade 2 mucinous adenocarcinoma and she was taken back to the operating room for a surgical staging procedure. Pathology from her laparoscopic staging surgery was benign. She underwent chemotherapy with carboplatin/paclitaxel for Stage 1C1, Grade 2 mucinous adenocarcinoma of the ovary based on intra-operative spillage. Conclusion: Despite reassuring imaging and tumor markers, particularly in the setting of frozen pathology with low concern for malignancy, final pathology may indicate carcinoma. Although the accuracy of intra-operative frozen pathology is generally high, both gynecologic oncologists and non-oncologic gynecologists should be aware of the limitations of the test and counsel patients that the final pathology may be discordant. Appropriate counseling about the risk of intra-operative spillage and subsequent upstaging is of particular importance.

CLINICAL PATHOLOGIC CONFERENCE CASE 1: A MULTILOCULAR RADIOLUCENCY OF THE RIGHT MANDIBLE

CLINICAL PATHOLOGIC CONFERENCE CASE 1: A MULTILOCULAR RADIOLUCENCY OF THE RIGHT MANDIBLE

Novel method to biopsy aneurysmal bone cysts in children.

The thin and friable septations composing aneurysmal bone cysts (ABC) may be challenging to target for percutaneous biopsy. The purpose of this study was to describe and evaluate a novel method of ABC biopsy using endomyocardial biopsy forceps as an attempt to capture larger fragments of tissue for diagnosis. This was a retrospective study performed over a 17-year period. Patients <18 years old who underwent percutaneous biopsy for a presumed ABC, based on pre-procedure imaging, were included. Medical records were reviewed to identify age, sex, lesion location, biopsy procedure details, complications, and pathology results. A diagnostic biopsy was defined as conclusive histologic confirmation. Inconclusive findings or findings suggestive of but not diagnostic of an ABC were treated as non-diagnostic, even if imaging and clinical findings were characteristic. Biopsy device selection and quantity of tissue obtained was at the discretion of the pediatric interventional radiologist. Fisher's exact test was used to compare the diagnostic yield of standard biopsies to those employing biopsy forceps. Twenty-three biopsies were performed in 18 patients (11 female) with a median age of 14.7 years (IQR 10.6-15.6). Lesions were located in the extremities (7, 30.4%), chest (6, 26.1%), pelvis (5, 21.7%), spine (4, 17.4%), and mandible (1, 4.3%). Specimens were obtained using a 13- or 15-gauge bone coring needle (11, 47.8%); 14-, 16-, or 18-gauge soft tissue needle (6, 26.1%); or a combination of bone and soft tissue (4, 17.4%) needles. Endomyocardial biopsy forceps were utilized in 7 cases (30.4%), 2 in which it was the only device used. Overall, a conclusive pathologic diagnosis was made in 13/23 (56.5%) biopsies. Of the diagnostic biopsies, 1 was a unicameral bone cyst and all others were ABCs. No malignancy was identified. Compared to the standard approach, the use of forceps was more likely to result in a diagnostic biopsy (40.0% vs 100.0%, p = 0.008). There were no complications. Endomyocardial biopsy forceps offer an additional, novel technique to biopsy presumed ABCs and may improve diagnostic yield.