Histopathology and immunohistochemistry of the patient's endomyocardial biopsy. Serial tissue sections of paraffin-embedded endomyocardial biopsies reveal perivascular fibrosis in absence of myocyte necrosis [Masson Trichrome.


Histopathology and immunohistochemistry of the patient's endomyocardial biopsy. HE. Stainings, see circle.


Histopathology and immunohistochemistry of the patient's endomyocardial biopsy. Severe infiltration of CD68+ macrophages.


Histopathology and immunohistochemistry of the patient's endomyocardial biopsy. CD3+ T cells. Primarily around intracardiac small vessels (see circle, magnification x200). HE, hematoxylin-eosin; CD, cluster of differentiation.


(a) A well-defined extra-axial lesion is identified anterior to the brainstem on this sagittal view, appearing hyper intense relative to brain parenchyma on the T2 weighted image (White arrows).


(b) Similar section noted one year later with reduction in mass of the cystic lesion identified in the image a.


(a) T1 weighted Brain MRI, this axial section identifies the lesion anterior to the brain stem appearing hyper intense relative to brain parenchyma (White arrows).


(a) T1 weighted image with contrast Brain MRI, this axial section identifies the lesion anterior to the brain stem appearing hyper intense relative to brain parenchyma with no enhancement noticed on contrast (White arrows).


Clinical photograph showing irregular, nodular, and discolored lesions on the forearm.


Clinical photograph showing erythematous, nodular, irregular lesions on the anterior chest wall, below the left nipple.


X-ray chest Posteroanterior view showing irregular diffuse deposition of mercury in the subcutaneous plane.


Gross photograph showing tissue bits with some shiny material on cut surface.


(a,b) Coronal and Saggital sections from CT Skeletal survey for paraproteinaemia. Single 3.2 x 1.5 cm medium low attenuation lesion with a thin sclerotic margin in the midshaft of the right femur causing mild scalloping of the adjacent inner aspect of the medial cortex.


MRI with standard multi-planar technique. (a, b) Coronal and sagittal T2 weighted MRI images of a 1.4 x 2.0 x 3.3 cm showed a hyperintense, well marginated, eccentrically located and marginally expansile lesion involving the mid right femoral shaft.


MRI with standard multi-planar technique. (c) Coronal T1-weighted image showed a well circumscribed cystic lesion of the right femoral shaft with a narrow zone of transition. It was fluid filled and has a relatively homogenous consistency with no cortical expansion. No other focal lesion seen.


(a,b) Femur XR post-operatively. The Intramedullary nail in situ in satisfactory position with evidence of excision biopsy site and cortical erosion.


(a) Low power image showed a fragmented spindle cell lesion and accellular necrotic bone.


(b) High power image showed biphasic appearance with hypercellular Antoni A areas and myxoid hypocellular Antoni B areas. There was evidence of nuclear pallisading around fibrillary processes (verocay bodies) and variable cellular spindle cell proliferation consistent with schwannoma. No atypical infiltrate or evidence of malignancy was seen.


(c) Cytoplasmic and nuclear immunohistochemical staining demontrated that the neoplastic cells are positive for S100.


The timeline showing the history of treatment and examinations for the patient under current study.


Family pedigrees case 1. The arrow point to the proband case who underwent whole-genome sequencing.


Summarizing scheme of disease progress.


Bone marrow smears of an acute myeloid leukemia without maturation case showing numerous blasts with round nuclei, fine nuclear chromatin, and dark blue cytoplasm (Leishman stain, oil immersion x 100).


GTG-banding in secondary AML-M6 revealed a tetraploid karyotype in 20% of the analyzed cells.


Ultrasound image of involved lymph nodes.


Fused positron emission tomography-fluorodeoxyglucose (PET-FDG) image before AVD treatment.


HE (magnification 400x).


HE (magnification 100x).


Immunohistochemical staining CD30 (magnification 400x). The stains included anti-CD20, CD3, CD30, CD15, PAX5, MUM-1, Ki-67.


HE immunohistochemical staining (magnification 400x). The stains included anti-CD20, CD3, CD30, CD15, PAX5, MUM-1, Ki-67.


Intraoral view showing the absence of 11.


Preoperative maxillary occlusal radiograph revealing impacted 11 and multiple supernumerary teeth.


Surgical area after removal of supernumerary teeth.


Surgically removed supernumerary teeth and soft tissue mass.


Panoramic radiograph showing Begg's bracket on 11 and traction with a ligature wire tied to a stainless steel base arch wire.


Intraoral view showing the alignment of 11 and a rectangular stainless steel wire.


Post- treatment intraoral view showing well aligned 11.


Preoperative panoramic radiograph showing impacted 11 and supernumerary tooth.


Panoramic radiograph showing mild eruption of 11.


Surgical exposure of 11.


Intraoral view showing the alignment of 11 with a NiTi wire.


Intraoral view showing the complete alignment of 11.


Left lower leg of case 1 on day 14 of hospitalization.


Left lower leg of case 1 on day 68 of hospitalization.


Female patient aged 45 years with POF in mandibular anterior region, displacing central, lateral and canine teeth.


Microscopic picture of biopsy slide showing- proliferated fibrous bands in the connective tissue with uniformly distributed chronic inflammatory cells.


Micro-photograph of another specimen of the same biopsy, showing thick fibrous whirls.


Multiple foci of osteoid tissue, surrounded by fibrous whirls.


Sam slide at further location showing multiple foci of osteoid tissue, surrounded by fibrous bands.


Molecular cytogenetic characterization of the marker chromosome. Arrows indicate the marker chromosome. (A) Spectral karyotyping.


Molecular cytogenetic characterization of the marker chromosome. Arrows indicate the marker chromosome. (B) Whole chromosome paint 18 green.


Molecular cytogenetic characterization of the marker chromosome. Arrows indicate the marker chromosome. (C) chromosome 18 arm-specific painting, 18p green/18q red.


Molecular cytogenetic characterization of the marker chromosome. Arrows indicate the marker chromosome. (D) Multicolor DNA Probe Kit CEP 18 aqua/X green/Y orange.


Electropherogram of the unbalanced marker D18S386 on chromosome 18.


(A) On admission.


(B) Two weeks after treatment.


(A) IgG staining.


(B) IgG4 staining.


PET-CT showed high glucose intake in salivary glands, lymph nodes, liver, and spleen.


Dynamic changes of laboratory examination. (A) WBC, NE underwent significant reduction after taking meropenem and TMP-SMX.


Dynamic changes of laboratory examination. (B) CRP, PCT underwent significant reduction after taking meropenem and TMP-SMX.


Dynamic changes of laboratory examination. (C) Renal glomerular function improved with lower urinary protein/24h urinary protein quantification.


Dynamic changes of laboratory examination. (D) Renal function retaining almost steady on the creatinine, eGFR, urea.


Routine bacterial culture result, identification of bronchoscopy specimens: Nocardia (Magnifications: 100x). (A) yellowish bacterial colony growing after bronchoscopy specimen inoculated on the culture medium.


Routine bacterial culture result, identification of bronchoscopy specimens: Nocardia (Magnifications: 100x). (B and C) Gram-positive, partial acid-fast positive, rod-shaped bacterium.


DWI: Patchy diffusion restricted lesions with high signal in the left frontal lobe, the corresponding ADC diagram shows uneven low signal changes.


The clinical course of this case.


Single-cell analysis of resected tissue from enhancing and non-enhancing lesions (A) Uniform Manifold Approximation and Projection (UMAP) representation of ten identified cell types in enhancing and non-enhancing samples from the resected tissue.


(B) Percentages of each cell type of all cell populations.


Subclustering analysis of T and NK cells. (A) UMAP plot showing three distinct T cell subpopulations, CD4+, CD8+, and Tregs (CD4+/FOXP3.


Subclustering analysis of T and NK cells. (B) UMAP representation of cytolytic score of T cells.


Subclustering analysis of T and NK cells. (C) Violin plots summarizing the cytolytic score of NK cells and T cells from enhancing and non-enhancing samples. The average cytolytic scores of T cells were 1.87 in enhancing and 2.50 in non-enhancing lesions (Wilcoxon test p = 3.084 x 10-6), and the average cytolytic scores of NK cells were 3.06 in enhancing and 4.66 in non-enhancing (Wilcoxon test p = 4.136 x 10-14).


Tumor cells arranged in papillary configuration (Pap, x200).


Papillary fragments revealing round to oval cells with hyper-chromatic nuclei and prominent nucleoli and abundant vacuolated cytoplasm (Pap, x400).


Clusters and papillary fragments of atypical cells containing abundant cytoplasm. (MGG, x200). Extracellular hyaline material (MGG, x100 [Inset]).


Changes of inflammatory markers during antibiotics treatment ( CRP.


Medical image.


WBC).


Computed tomography scan showing lytic lesion in mandible.


Fine-needle aspiration cytology smears showing many multinucleate giant cells (Leishman, x400).


Fine-needle aspiration cytology smears showing multinucleate giant cells amidst hemorrhagic background (Papanicolaou, x400).


Histopathology of parathyroid adenoma (x400).


Blue-gray colored eye lid with underlying tissue necrosis.


Intraoperative appearance of advancing wound.


Extraoral photograph of patient.


Clinical photograph showing. Gingival swelling on palatal aspect of 54.55.


64.65. Diffused.


Erythematous ulcerated gingival swelling covered with necrotic slough over buccal aspect of 64.65.


Gingival swelling with tiny bleeding spots over buccal aspect of 75 and 85.


(a and b) Intraoral radiograph showing radiolucent lesion surrounding root of 55, 74 and 75.


Orthopantomogram revealed multiple areas of bone loss in the left mandibular region.


(a and b) Axial and coronal computed tomography revealed multiple soft tissue density lesions with irregular and punched out bony destruction noted involving left mandibular, left side of occiput, right maxillary and right temporal bone.


Three-dimensional computed tomography revealed multiple osteolytic lesions in relation to maxillary alveolar process, body and ramus of left side of mandible.


Histopathological picture showing diffuse infiltrate of Langerhans cell with eosinophils (H&E stain, x40).


Trichoscopy presentation of hair roots.


Preoperative computerized tomography scan revealed an osteolytic multilocular radiolucency at posterior mandible associated with an impacted developing tooth.


A photomicrograph of Hematoxylin and eosin (H&E) stained sections showing primitive connective tissue stroma covered by columnar epithelium,. X100).


Follow up Computerized tomography scan revealed a new spongy bone formation at the site of preexisting lesion.


F; Computed tomography of the chest showing multiple random nodules diffusely distributed in both the lung fields.


MRI post-shunting (20 days). (A) MRI (T1-weighted image) shows a hypointensity signal periaqueductal area (red circle) with irregular profile suggesting the presence of the lesion.


MRI post-shunting (20 days). (B) MRI scan (T2-weighted image) shows a hyperintensity signal in the same area (red circle).


MRI post-shunting (20 days). (C) Gadolinium T1-weighted image shows a low focal contrast enhancement of the lesion in the periaqueductal area.


MRI post-shunting (20 days). (D) Proton magnetic resonance spectroscopy (MRS) reveals elevated cholin peaks (cholin/creatinine ratio at 1,9) in addition to reduced NAA (N-acetylaspartate).


MRI post-shunting (20 days). (E) Perfusion-weighted imaging (PWI) shows a low cerebral blood volume (CBV) in the area of interest.


A 76-year-old male who presented with an enlarging right breast lump which proved to be an epidermoid cyst. Gray scale ultrasound of the right breast demonstrates an oval circumscribed mass with heterogeneous echogenicity at the 12 o'clock position 4 cm from the nipple. The mass is primarily located within the subcutaneous tissue. Contact with the deepest dermal layer forms an obtuse angle.


A 76-year-old male who presented with an enlarging right breast lump which proved to be an epidermoid cyst. Color Doppler ultrasound of the right breast mass demonstrates internal vascularity (arrow).


A 76-year-old male who presented with an enlarging right breast lump which proved to be an epidermoid cyst. Ultrasound- guided core biopsy of the right breast mass was performed with a 12-gauge needle.


A 76-year-old male who presented with an enlarging right breast lump which proved to be an epidermoid cyst. Post-biopsy ultrasound of the right breast mass 2-3 weeks later demonstrates a ruptured epidermoid cyst with surrounding inflammation and abscess formation. Note pus-filled tract extending to the skin (arrow).


Histopathological image shows sheets of odontogenic epithelium in the stroma arranged in cords and small islands (H&E,x100).


Histopathological image shows sheets of odontogenic cells with hyperchromatic nuclei and prominent intercellular bridges H&E x400).


Histopathological image shows nests of clear cells (H&E x400).


Histopathological image shows amyloid-like material admixed with epithelium (Congo red, x100).


2-Dimensional echocardiographic imaging (apical 4 chamber view) demonstrating dilated right side of the heart with most of the right ventricular cavity occupied by the tumor mass.


2D apical 4 chamber view showing forward tricuspid flow through the residual RV cavity.


Representative picture showing results from three independent endoscopic evaluations of the intestine of the patient obtained at different times before he was started on antibiotic therapy. There was no opportunity for further evaluations during treatment.


(A) Heavy shedding of typical MAP bacilli as seen in ZN staining: 4+ (positive).


(B) Negative for MAP bacilli at the end of 12 months of treatment.


Cat toy.


Granulomatous response to synthetic fibers.


Synthetic fibers with polarized light.


Clinical photographs. . Notes: (A) Patient's clinical presentation of herpes zoster ophthalmicus in 2002 (inset) with a slit-lamp photograph of his neurotrophic corneal ulcer in 2007.


Clinical photographs. (B) Cyanoacrylate glue had been applied for the management of a perforated corneal descemetocele in April 2011.


Clinical photographs. (C) Suspected vitreous prolapse from previous cataract surgery or accumulated fibrin that may have allowed passage of mycobacterial past the lens implant into the vitreous cavity (inset), and recurrent hypopyon.


Clinical photographs. (D) Clear corneal graft and anterior chamber 1 month after the pars plana vitrectomy, anterior chamber washout, and intravitreal injections of antimicrobial and fungal agents (amikacin, 400 mug/0.1 mL; vancomycin, 1 mg/0.1 mL; and amphotericin B, 5 mug/0.1 mL).


Squash smear showing tigroid background and dual population of cells; large polygonal tumor cells with vesicular chromatin, moderate amount of fragile vacuolated cytoplasm (arrow head) and mature lymphocytes in the background (arrow) (May Grundwald Giemsa X400).


Chest X-ray upon first admission. . Cardio-mediastinal silhouette is within normal limits with the heart being normal in size. . No pleural effusion / pneumothorax/consolidative patches identified.


Chest X-ray upon his most recent admission. . Mildly prominent hilar vascular markings identified (red arrows) with minimal blunting of the left costophrenic angle (blue arrows) and mild elevation of the left hemidiaphragm. But Cardio-mediastinal silhouette.


Chest CT upon recent admission. . Congestive pulmonary changes in the form of ground glass opacities and pleural effusion at the posterior inferior aspects of both lungs, more on the left. (Arrow heads) Circumferential pericardial effusion (red arrow).


Pleural and Pericardial Biopsy Histopathology report. . A. Light microscopic view showing well-defined epithelioid granuloma engulfing parasitic egg (H&E x400).


Pleural and Pericardial Biopsy Histopathology report. . B. The cuticle of the parasitic egg is polarizable (H&E x400 with polarizer/analyzer lens).


CT imaging of the maxillofacial region shows a heterogeneous mass over the left side of the nasal dorsum and frontal process of the left maxilla.


Photomicrograph showing acellular material arranged as nodules (Congo red, 20x).


Cytogenetic result of unstimulated bone marrow samples showing 47,XX, +4, t(8;21) in all metaphase plates.


(A) A metaphase cell following FISH with LSI AML-ETO (Abbott Molecular, USA).


(B) Whole chromosome paint probe 4 with spectrum Orange (Abbott Molecular, USA).


Magnetic resonance imaging (MRI) study of head and neck. A, Axial MRI scan showing a significantly increased signal of the bone marrow lesion (yellow arrow) when compared with left mandibular body (asterisk), with bone edema indicative of an inflammatory process taking place in the right mandibular body and gas tracking along the two pterygoid muscles (white arrows).


Magnetic resonance imaging (MRI) study of head and neck. B, A coronal T2-weighted image of the submandibular region showing a wide mass with very high signal intensity from the parapharyngeal space to the inferior cervical region with associated edema.


Gynecomastia.


Almond shaped eyes with esotropia.


Fluorescence in situ hybridization.


Autopsy findings. (A) Crescentic necrotizing glomerulonephritis. , x 400.


Autopsy findings. (B) Alveolar hemorrhage with neutrophil infiltration. , x200.


Autopsy findings. (C, D) DVT: neutrophils were abundant in the thrombus. Original magnification: x40.


Autopsy findings. (C, D) DVT: neutrophils were abundant in the thrombus. , x 400.


Autopsy findings. (E-G) NETs in the glomerulus. Blue: DNA stained by DAPI. Red: MPO. NETs were present in the crescent. , x 400.


Autopsy findings. (H-J) NETs in the thrombus. The detection of NETs was performed similar to the renal specimens. , x 400.


Mutational landscape of the three renal tumors in the patient's left kidney at first recurrence. We visualized the somatic mutation profiles of each tumor:angiomyolipoma (AML), clear cell renal cell carcinoma (RCC), and papillary RCC:as heat maps (black-colored genes indicate driver gene mutations in many cancer types). CDH11, Cadherin 11; CDK12, Cyclin Dependent Kinase 12; DICER1, Dicer 1; PABPC1, Poly(A) Binding Protein Cytoplasmic 1; PARP4, Poly(ADP-Ribose) Polymerase Family Member 4; PBRM1, Polybromo 1; POLQ, DNA Polymerase Theta; PTPN13, Protein Tyrosine Phosphatase Non-Receptor Type 13; PTPRK, Protein Tyrosine Phosphatase Receptor Type K; RET, Ret Proto-Oncogene; RPS3A, Ribosomal Protein S3A; SAMD3, Sterile Alpha Motif Domain Containing 3; SMARCA1, SWI/SNF Related, Matrix Associated, Actin Dependent Regulator Of Chromatin, Subfamily A, Member 1; SUSD2, Sushi Domain Containing 2; TSC1, TSC Complex Subunit 1; ZNF208, Zinc Finger Protein 208; ZNF721, Zinc Finger Protein 721.


(a) Photomicrograph of normocellular bone marrow trephine biopsy (H and E, x40). (b) Numerous histiocytes replacing the other normal bone marrow cell constituents (H and E, x100).


Photomicrographs of immunohistochemistry revealing (a) Positive cytoplasmic immunoexpression of CD68 in histiocytes (CD68, x200).


(b) CD1a-negative histiocytes (CD1a, x200).


(c) Negative immunoexpression of histiocytes for S100 (S100, x200).


(d) CD3 immunopositive expression of the lymphocytes (CD3, x200).


(a) Periodic acid-Schiff stain negative histiocytes (PAS, x200).


(b) Perl's Prussian blue staining showing unstained brown pigment in the histiocytes (Perl's stain, x200).


(a) Schizont of P. Vivax (encircled) on peripheral blood smear examination (Leishman stain, x200). (b) Bleaching of the brown-colored pigment in the histiocytes with the alcoholic ammonium hydroxide (H and E, x200).


A set of antibiotic-loaded articulate spacers that were implanted.


T1-weighted sagittal image of a 2-year-old girl. Note the hypoplastic pons and cerebellum with normal appearance of the corpus callosum.


Healthy donor) blood CD8- TCRgammadelta- T-cells, monocytes, and dendritic cells (B). Panel (B) shows CD4 surface membrane expression levels for CD8- TCRgammadelta- T-cells, monocytes, and dendritic cells for the different anti-CD4 antibody clones tested in the patient (black histogram) compared to a representative healthy donor (gray histogram) and an isotype control (red dash line), and the staining for a negative population (CD8+ T-cells) in the patient (green line) and the healthy control (blue line). DCs, dendritic cells.


Thorax CT, It is observed that the lesion shows spiculation into the lung parenchyma in the coronal reformatted images and parenchymal window.


Torax CT, Lesion with irregular borders and containing milimetric calcified focuses in the axial mediastinal window in the right apical region of the lung.


Appearance of the lesion with a moderate FDG uptake in fusion images in PET-CT.


Specimen material of the lesion after wedge resection. Red-looking lung tissue in the lesion and its surrounding area monitored off-white-yellow in colour in total.


Clinical course of the patient. . Abbreviations: HD, high dose; DEX, dexamethsone; Cy, cyclophosphamide; FLC, free light chain; IgG, Immunoglobulin G.


Axial.


Coronal T1-contrast. Image shows contrast enhancement dural-based tumor with cystic component size 7 x 5 cm resulting in midline shift of approximately 1.6 cm and third ventricular obliteration.


Axial T2 image showing hypointense cystic component (c).


Microscopic examination revealed the proliferation of neoplastic meningothelial cells with pale eosinophilic cytoplasm forming solid nests, associated with a dense chronic inflammatory infiltrate rich in lymphocytes and some plasma cells (a) (H&E, x20).


Both tumor cells and lymphocytes are positive with vimentin (b) (x20).


Negative glial fibrillary acidic protein in tumor cells excludes the diagnosis of glioma with xanthomatous changes (c) (x40).


CD3 staining in lymphocytes dispersed between tumor cells (d) (x20).


Immediate postoperative computed tomography scan showing total removal of tumor with some certain extent of midline shift (a).


Magnetic resonance imaging axial T1-contrast scan 6 months after operation showing no recurrence (b).


Bronchial washing cytology shows bronchial epithelial cells and mixed acute and chronic inflammatory infiltrate, including numerous histiocytes. Most histiocytes were packed with many yeast-like organisms (Pap, x400) with inset showing oval to oblong in shape with central transverse septum (GMS, x1000).


Bronchoscopic biopsy shows diffuse histiocytic proliferation with organisms in submucosa. (H&E, x400).


A 53-year-old female patient with emphysematous pyelonephritis with necrotizing fasciitis presented with breathlessness, pain in left lower hemithorax and in the left lumbar region. Noncontrast axial computed tomography thorax in mediastinal window showing bilateral pleural effusion (white arrow).


A 53-year-old female patient with emphysematous pyelonephritis with necrotizing fasciitis presented with breathlessness, pain in left lower hemithorax and in the left lumbar region. Coronal high-resolution computed tomography window showing necrotizing fasciitis in the left lateral chest wall (black arrow).


A 53-year-old female patient with emphysematous pyelonephritis with necrotizing fasciitis presented with breathlessness, pain in left lower hemithorax and in the left lumbar region. Axial noncontrast computed tomography abdomen showing retroperitoneal abscess extending anterolateral to left psoas, anterior to left iliacus, extending up to left inguinal region with multiple air foci (white arrows). Multiple air foci just beneath anterior abdominal wall on either side, in intermuscular fat planes of abdominal wall muscles and in subcutaneous fat in anterior abdominal wall on the left side (curved white arrows).


A 53-year-old female patient with emphysematous pyelonephritis with necrotizing fasciitis presented with breathlessness, pain in left lower hemithorax and in the left lumbar region. Noncontrast computed tomography abdomen and pelvis. Coronal.


A 53-year-old female patient with emphysematous pyelonephritis with necrotizing fasciitis presented with breathlessness, pain in left lower hemithorax and in the left lumbar region. . Sagittal) showing left renal (white arrow) and retroperitoneal abscess with air foci (curved white arrow).


A 53-year-old female patient with emphysematous pyelonephritis with necrotizing fasciitis presented with breathlessness, pain in left lower hemithorax and in the left lumbar region. Noncontrast computed tomography thorax and abdomen with pelvis. Mediastinal window - axial.


A 53-year-old female patient with emphysematous pyelonephritis with necrotizing fasciitis presented with breathlessness, pain in left lower hemithorax and in the left lumbar region. . Coronal) showing necrotizing fasciitis in the left lateral chest wall up to left axilla (black arrow), along left lateral abdominal wall (white arrow) reaching up to perivesical fat (curved white arrow).


A 53-year-old female patient with emphysematous pyelonephritis with necrotizing fasciitis presented with breathlessness, pain in left lower hemithorax and in the left lumbar region. Noncontrast computed tomography abdomen and pelvis showing pigtail catheterization in a retroperitoneal abscess (white arrow).


MRI scan of suprapatellar aspect in January 2013.


May 2017.


Histological image showing highly vascular soft tissue mass, diagnosed histologically as capillary hemangioma.


Case 2. A; FISH analysis on metaphase and interphase with an LSI ETV6/RUNX1 ES Dual Color Translocation Probe Set (Vysis).


Case 2. B; SNP array revealed the highest level of amplification located within the RUNX1 locus.


Pretreatment study models.


Right buccal occlusion.


Left buccal occlusion.


Maxillary occlusal view. Mandibular occlusal view.


Chest CT scan reveals right lower lobe cavity.


Transaxial, coronal, and sagittal statistical parametric mapping results (p=0.05 false discovery rate) confirming the hypometabolism in the cerebellar lobes.


Magnetic resonance imaging, T1 sequences with gadolinium, sagittal view. Imaging after two previous resections. Note strong dorsal (C7/Th1 to Th5) and ventral (C6 to Th3/Th4) enhancement in the spinal canal. Artifacts due to laminoplasty material.


Chest CT results on day 1, day 7, and day 14 after admission. (A) Chest CT findings on the first day of admission revealed diffuse pneumonitis throughout the lungs.


Chest CT results on day 1, day 7, and day 14 after admission. (B) The patient's chest CT on day 7 showed a worsening of the infection (due to the severity of the disease, the patient could not hold her breath well, so the images were not clear).


Chest CT results on day 1, day 7, and day 14 after admission. (C) On the 14th day of admission, the patient's chest CT results showed slight improvement after treatment.


Dynamic changes in infection indexes and platelet counts in the patient after admission. (A, B) The neutrophil and leucocyte counts decreased significantly 7 days after admission.


Dynamic changes in infection indexes and platelet counts in the patient after admission. (C) The serum procalcitonin level continued to decline.


Dynamic changes in infection indexes and platelet counts in the patient after admission. (D) The platelet count continued to increase. Eventually, the patient's indicators returned to normal (different colors represent different medications, and the length of the lines represents the duration of treatment with the medication).


Dynamic changes in liver and kidney function in the patient after admission. After appropriate treatment, the aspartate aminotransferase.


Dynamic changes in liver and kidney function in the patient after admission. Alanine aminotransferase.


Dynamic changes in liver and kidney function in the patient after admission. Lactate dehydrogenase.


Dynamic changes in liver and kidney function in the patient after admission. Creatinine. Levels of the patient gradually returned to normal (different colors represent different medications, and the length of the lines represents the duration of treatment with the medication).


The anteroposterior pelvis graphy, determined multilobular dense nodular components in the periarticular soft tissue around the pelvis joint.


Radiographs of the right knee reveal calcified masses with lucent areas in the popliteal cavity of the knee joint.


Ultrasound of the right axillary area showing a mass with cystic degeneration.


MRI of the right axillary area involved, showing a lesion in the right axilla measuring 3.0 x 3.8 x 2.3 cm, with primary cystic component and irregular thickened wall.


Anterior segment photograph of the patient's right eye.


Cataract, a retrolental vascularized mass extending from the optic disc to the posterior lens capsule, and depression and enlargement of the optic disc in the right eye by Doppler ultrasonography.


The elongation of ciliary processes was demonstrated.


A. Calcified nodule with "egg-shell" pattern.


B. Microcalcification spots in the same nodule.


A. Macroscopically complete calcified nodule.


B. Calcified rim when cut.


Erythema rash on the front of the chest.


Swelling on the palmar aspect of the index finger.


Soft tissue swelling on the palmar aspect of the finger without any bony changes.


Cut section of the well-defined tumor with fibrofatty tissue.


Histopathological appearance showing multiple multinucleated giant cells interspersed in a stroma of histiocytes and fibrous tissue.


MRI images. MRI images (1.5 tesla): (A,B) Sagittal sections in the T1-weighted MRI images: global cerebellar atrophy with a marked enlargement of the subarachnoid space, thinning of cerebellar folds and vermis (arrow) related to diffuse cerebellar atrophy.


MRI images. (C) Axial section in the T1 sequence: cerebral white matter and ventricles without alterations.


NSD1 gene sequencing. Exon 2 sequence of the NSD1 gene (superior: normal; inferior: patient sequence) showing the deletion of adenine (blue arrow) at position 247 (c.247delA), which has an effect on the protein and generates a premature stop codon at amino acid 87 (red box).


(A) Contrast-enhanced computed tomography (CECT) shows pleural-based heterogenous hypodense mass.


(B) Baseline positron emission tomography-computed tomography shows local disease.


(C) CECT shows large abdominopelvic mass.


(D) CECT shows presacral deposit.


(A) Pleomorphic liposarcoma tumor deposit shows admixture of pleomorphic lipoblasts with epithelioid cells (hematoxylin and eosin, x100).


(B) Pleomorphic liposarcoma tumor deposit shows multivacuolated lipoblasts with indented pleomorphic nuclei (hematoxylin and eosin, x200).


(C) Pleomorphic liposarcoma cells are positive for S-100 (immunohistochemistry, x200).


(D) Pleomorphic liposarcoma cells show diffuse p53 expression (immunohistochemistry, x200).


Clinial photograph showing papulovescicular lesions over the anterior chest wall (arrow).


Complete ptosis and ophthalmoplegia in the left eye.


T1 and T2-weighted MRI with gadolinium contrast of the brain and orbits. . Notes: Coronal T2-weighted MRI disclosing a 5x9x10 mm abnormal enhancing of the soft tissue in the left superior orbital fissure with mild extension along the anterior aspect of the left cavernous sinus (red arrow).


T1 and T2-weighted MRI with gadolinium contrast of the brain and orbits.an axial T1-weighted MRI disclosing mild edema of the left lateral rectus (red arrow) . Abbreviations: MRI, magnetic resonance imaging. T1, spin-lattice relaxation time; T2, spin-spin relaxation time.


Lemierre syndrome patient with neck stiffness, cervical lymphadenopathy and tenderness along the course of external jugular vein.


X-ray AP and lateral view of the neck showing increase in prevertebral shadow at 4th cervical vertebral region. Cervical lordosis is lost. Diffuse pulmonary infiltrates present.


CECT neck showing peripheral enhancing hypodense area in the prevertebral space compressing trachea and oesophagus.


Axial CECT lung window showing well-defined subpleural nodules with central cavity and feeding vessel. Minimal bilateral pleural effusion noted.


Thyroid-stimulating hormone timeline.


Bone chambers massively invaded by grayish-colored oxalate crystals deposited in stars or rosettes (hematoxylin and eosin stain, original magnification x 40).


Grayish-colored oxalate crystals deposited in stars or rosettes surrounded by a macrophage reaction against foreign bodies (hematoxylin and eosin stain, original magnification x 200).


Medullar fibrosis (special trichrome stain, original magnification x 200).


A very intense pale green birefringence of crystals of oxalate showed in polarized light (hematoxylin and eosin stain, original magnification x 400).


First CT scans at admission. Acute pancreatic necrosis and edema of pancreatic tail and surrounding adipose tissue are visible (arrows).


A-d CT scans after VARD. After transgastric necrosectomy, VARD, and percutaneous drainage, all the retroperitoneal necrotic collections dramatically reduced (arrows).


The axial T1.


T2 W/FLAIR. Image shows cerebellar vermis lesion that was hypointense on T1WI and heterogeneous on T2WI, vith perilesional edema, and triventricular hydrocephalus.


H&E x100 specimen of pancreatic tail displaying multifocal high-grade intraductal papillary mucinous neoplasia. H&E, hematoxylin and eosin.


Magnetic resonance cholangiopancreatography demonstrating a new development of enhancement of a branch duct cystic lesion most distally.


H&E x100 specimen of pancreatic tail displaying multifocal high-grade dysplasia pancreatic intraepithelial neoplasia-3.


Composite oral cavity defect. Through-and-through defect following composite mandibular resection and resection of the entire chin pad.


Simultaneous harvest of anterior tibial perforator free flap and fibular osteocutaneous free flap. Anterior tibial perforator supplying the anterior border of skin paddle.


Fibular free flap plated into a reconstruction plate, shown with attached anterior tibial perforator flap (ie, flow-through free flap). Anterior tibial perforator sewn to the distal end of the peroneal artery, microvascular anastomosis for flow-through free flap performed in the leg (short arrow). Vasculature of fibula anastomosed to the right facial artery, the external jugular vein, and a large common facial vein (long arrow).


Inset of fibular flow-through free flap. Reconstruction of composite defect. Blue stitch located at the site of anterior tibial perforator.


Lactophenol Cotton Blue mount of slide culture showing funnel shaped sporangia and sporangiospores of Apophysomyces elegans.


Extensive anterior abdominal wall necrosis, blackened edge of the lesion.


Intraoral photograph after the bite opening with orthodontic appliance.


Intra-operative photograph of surgical technique;. After flap reflection.


After bone splitting, and ,bone fill.


After suturing.


Posttreatment photograph of the patient;. After 1 week.


After 2 weeks frontal, and ,maxillary occlusal view.


With prosthesis.


Representation of the patient phenotype. (a,b) The patient showed distal tremors, hypertonia, trunk hyperextension, spasticity, microcephaly, craniofacial disproportion, and a decreased vertical skull size.


Representation of the patient phenotype. (c) Multiple dimples and arthrogryposis.


Representation of the patient phenotype. (d) Feet contractures and prominent calcaneus.


Representation of the patient phenotype. (e) Clenched fists, hand contractures, and camptodactyly.


Representation of the patient phenotype. (f) Strabismus.


Representation of the patient phenotype. (g) Excess skin over the entire scalp and forehead and occipital and nuchal skin folds, generating the appearance of a short neck.


Representation of the patient phenotype. (h) Sloping of the forehead and prominence of supraorbital ridges, which creates an appearance of proptosis and oversized facial features, epicanthal folds, and retrognathia. Bilateral depressions were present on the forehead.


CECT showing the heterogeneously enhancing mass arising from the pancreas.


Operative and postoperative image.


Specimen with tumour and spleen.


Hematoxylin and eosin staining.


S100 staining.


PET scan.


Gangrenous digits of the patient.


Ulcerated jugulodigastric node.


Histological specimen of jugulodigastric lymph node. Notes: (A) Biopsy from the ulcerated jugulodigastric node showing spindle cell carcinoma.


Histological specimen of jugulodigastric lymph node. (B) Cytology smear from the ulcerated jugulodigastric node showing spindle cell carcinoma.


Lymphangitis carcinomatosis involving the right lobe and mediastinal adenopathy.


Computed tomography scan of abdomen.


Pathology demonstrating small bowel inflammation.


Pathology demonstrating ulceration of the small bowel.


Imprint from bone marrow biopsy. Giemsa stain. x1,000.


Bone marrow trephine biopsy. A; Intertrabecular space completely filled by angiosarcoma. The lesion shows multiple anastomosing vascular channels (HE. X100).


Bone marrow trephine biopsy. B; Vascular spaces lined by endothelial cells with mild to moderate atypia, surrounded by spindled neoplastic cells (HE. X400).


Immunohistochemical staining of the bone marrow biopsy. A CD31 positivity in neoplastic cells (x400). B; Factor VIII positivity in neoplastic cells (x400).


Confirmation of novel IL-10RA variants. (A) c.395T>G variant (red arrow) confirmed by Sanger sequencing.


Confirmation of novel IL-10RA variants. (B) Validation of the ex.1del (p. ?) variant by quantitative PCR. Genomic DNA was extracted from peripheral blood from the patient, her parents and healthy controls. Reactions were set up using one set of primers upstream and downstream of exon 1 in triplicate. The beta-actin gene served as a reference gene. The 2-DeltaDeltaCT method was used to calculate the copy number. Samples with normalized ratios (NRs) <0.1 denote individuals with homozygous deletion, samples with NRs of about 0.5 denote individuals with heterozygous deletion, sample with NRs of ~1 denote healthy individuals (two copies), and samples with NRs of ~1.5 or more denote individuals with copy number gain.


Brain stem degeneration presents in brain MRI. Sagittal.


Brain stem degeneration presents in brain MRI. Transversal. T2-weighted brain MRI indicates gliotic neurodegeneration in the medulla oblongata with predominant loss of pyramidal tracts.


Brain stem degeneration presents in brain MRI. Magnification of inlay (c) uncovers pathologic brain stem formation reminiscent of 'kissing swans.


Brain stem degeneration presents in brain MRI. D; Transversal T1-weighted sectioning of the brain stem (arrow) after Gadolinium administration. No contrast enhancement is detectable.


Brain stem degeneration presents in brain MRI. E; Sagittal T2-weighted cervical spine MRI shows atrophy of the upper cervical spinal cord in addition to medulla oblongata atrophy.


Brain stem degeneration presents in brain MRI. F; Transversal T2-weighted brain MRI indicates putative periventricular rim-sign and global brain atrophy.


Brain stem degeneration presents in brain MRI. G; Brain MRI-angiography reveals normal intracranial vascular status without indication of stenosis.


CT of abdomen and pelvis. Multiple bilateral renal stones measuring between 1 and 4 mm. Bilateral pelvocaliectasis. No discrete renal lesions although renal fungal ball cannot be excluded.


Renal ultrasonography. Seven millimeter, left sided interpolar nonshadowing hyperechoic foci in the renal collecting system.


Liquid-based cytology smear shows an uncoiled, eosinophilic, shrunken, thin organism in a background of superficial and intermediate cells (pap, x40).


Peripheral blood smear showing the presence of a microfilaria which appeared as coiled basophilic thick organism with nuclei (pap, x100).


Liquid-based cytology smear shows an eosinophilic, shrunken, thin elongated organism in a background of superficial and intermediate cells (pap, x40).


Liquid-based cytology on higher magnification revealing nuclei not extending up to the tail (pap, x100).


Multiparametric flow cytometry shows two distinct clones (CD19pos and CD19neg) of cells both of which are positive for CD45, CD22, CD10, CD25, CD103, CD11c, CD123 and surface Igkappa in similar intensities. The plasma cells do not show clonal restriction.


Clinical course of a patient.


White membrane adherent to the pharynx noted on oropharyngeal examination on presentation in a 14-month-old incompletely vaccinated infant with respiratory distress.


Chest computed tomography (CT) showed multiple space-occupying lesions. The arrows indicate the lesions.


Clinical photograph showing close-up view of skin abscess on the volar aspect of the patient's right wrist.


Photograph of skin abscess surrounded by skin erythema taken 2 days later.


Photograph of completely healed wrist wound taken 2 months later.


The CT scan of this patient showed lung metastases from synovial sarcoma at the baseline in February 2015 (A).


At the first radiological evaluation in April 2015 there was a partial response (B).


The patient was on drug holiday from June 2016 to April 2018 when the same lesion started to grow again (C).


It then showed a good response to Trabectedin re-challenge in July 2018 (D).


Lung metastases from uterine leiomyosarcoma right before starting Trabectedin in November 2015.


Showing an almost complete response after treatment in February 2016 Systemic therapy was then suspended for a drug holiday.


During this period the lesion began to grow again in December 2017 (C).


However, in March 2018 after Trabectedin re-challenge a new partial response was observed (D).


This patient showed hypervascular liver metastases from retroperitoneal leiomyosarcoma at the baseline CT scan in April 2015 (A).


The lesions were reduced in both size and vascularisation after treatment with Trabectedin, which was stopped in December 2016 (B) for a drug holiday.


This patient experienced in June 2016 disease progression with multiple peritoneal lesions at MRI (A) after being treated with Trabectedin and surgery.


However, Trabectedin showed to be effective again, achieving a partial response in February 2018 (B).


Clinical findings and MRI images. (A) A reddish mass of 4-mm diameter is seen under the nail plate (area surrounded by the triangle mark). Distal nail splitting is observed in the left thumb.


Clinical findings and MRI images. (B) T1-weighed magnetic resonance image shows tumor with normal intensity.


Clinical findings and MRI images. (C) T2-weighed magnetic resonance image shows high-intensity lesion. Flow void is indicated by an arrow. MRI: magnetic resonance imaging.


Surgical findings. (A) A reddish mass is seen under the nail plate. The excision line after the nail claw is indicated in blue.


Surgical findings. (B) After excision, skin grafting was performed from the thenar eminence.


Histopathological findings. (A) A loupe image. An incompletely encapsulated tumor.


Histopathological findings. (B) A middle-power view. The tumor is composed of fine collagen fibers pointed in every direction.


Histopathological findings. (C) A high-power view. Nuclei of the proliferating cells are spindle- or comma-shaped. Among the tumor cells, capillaries and a small number of mast cells are dispersed (indicated by arrows).


Histopathological findings. (D) Appearance of new thumb nail six months postoperatively. This observation is natural.


A; Oral ulcer contained and surrounded by polymorphonuclear cells and confined cell debris; outside this zone and extending diffusely throughout the lamina propria, a large number of infiltrating lymphocytes and macrophage-like cells were seen (x40).


B; Inflammatory cell infiltrate (CD8+ stained; antibody CONFIRM anti-CD8, SP57) associated with oral mucosa ulceration (x10).


A; G banded karyogram was completed in 1997. The unidentified SMC is indicated by the arrow. Karyotype: 47,XY,+r /46,XY.


Magnetic resonance imaging scans from first clinic encounter. Sagittal T1 postcontrast image, showing prepontine cystic lesion (red arrow).


Magnetic resonance imaging scans from first clinic encounter. Axial T1 postcontrast image.


Magnetic resonance imaging scans from first clinic encounter. Axial T2 image.


Magnetic resonance imaging scans from follow-up after 3 months. Sagittal T1 postcontrast image showing decrease in size of cyst (red arrow).


Magnetic resonance imaging scans from follow-up after 3 months. Axial T1 postcontrast image.


Magnetic resonance imaging scans from follow-up after 3 months. Axial T2 image.


Magnetic resonance imaging scans from most recent follow-up. Sagittal T1 postcontrast image, note the normal contour of brainstem.


Magnetic resonance imaging scans from most recent follow-up. Axial T1 postcontrast image.


Magnetic resonance imaging scans from most recent follow-up. Axial T2 image.


Testicle without fixation, extensively infiltrated by cream-colored neoplasia (*) and with areas of necrosis.


Immunohistochemical analysis showing a positive reaction for myeloperoxidase, labeling the neoplastic cells (brown) with preservation of the seminiferous duct (negative) on the right side of the image (magnification 400X).


Electron microscopic findings at the first renal biopsy. Several microspheres are shown in the GBM of a capillary loop (arrowheads).


Visual field tests using a Goldmann perimeter. . Notes: (A) Central and paracentral scotomas were observed in the left eye at the initial ocular examination.


Visual field tests using a Goldmann perimeter. (B) Regression of visual field defect was observed in the left eye at 2-month follow-up after pulse steroid therapy.


(a) Computed tomography revealing diffuse subarachnoid hemorrhage.


(b) 3D-reconstruction of digital subtraction revealing a broad base small aneurysm of the basilar tip.


(c) Digital subtraction angiography revealing quite high basilar tip in relation to the dorsum sella.


(d) Postoperative digital subtraction angiography revealing the total obliteration of the aneurysm.


Preoperative computed tomography-angiography.


Digital subtraction angiography. Revealing right posterior communicating artery-posterior cerebral artery and left P1 segment aneurysms.


Postoperative intravenous-digital subtraction angiography (c, d) revealing the total obliteration of the aneurysm with presentation of the P1 perforating branch.


Cycle threshold value of SARS-CoV-2. Blue: Nasopharyngeal swab. Red: Sputum.


mNGS detection and anti HHV-1 therapy. Acyclovir: 0.5 g intravenous every 8 h from Day 19 to Day 35.


A and b, H&E stained pictures showing parakeratinized stratified squamous epithelium overlying the connective tissue components and clusters of eosinophilic toto bodies in the upper spinous cell layer (10x).


H&E picture showing the presence of nonkeratinized stratified squamous epithelium showing areas of eosinophilic Toto bodies (10x).


H&E-stained picture showing hyperplastic epithelium and superficially confined Toto bodies with few focal areas showing a break in the continuity of the basement membrane (black arrow). Subepithelial connective tissue is composed of severe inflammatory cell response mainly composed of lymphocytes and plasma cells (4x).


H&E-stained picture showing that the deeper connective tissue is composed of moderately differentiated epithelial cell population arranged in the form of sheets and cords and presenting dysplastic epithelial cells with nuclear and cellular pleomorphism (black arrow) and nuclear hyperchromatism (arrowhead) (20x).


(a) MRI brain with contrast demonstrated 4.7 cm multiloculated rim enhancing cystic lesion with additional smaller projections invading the right frontal lobe with associated vasogenic edema and midline shift.


(b) MRI brain with contrast demonstrating resection of right frontal mass with expected postoperative changes.


(c) MRI brain with contrast demonstrating enhancing foci within left frontal lobe adjacent to prior surgical cavity.


(d) MRI brain with contrast demonstrating resection of left frontal foci with expected postoperative changes.


MRI with contrast.


MRI T2WI.


Medical image.


ADC. MRI Head demonstrating right frontoparietal subdural collection with associated vasogenic edema and restriction on DWI and ADC maps.


(a) MRI T1W with contrast four-weeks post-surgical evacuation of subdural collection and initiation of platinum-based chemotherapy demonstrating marked improvement.


(b) MRI T1W with contrast eight-weeks following initiation platinum-based chemotherapy demonstrating marked progression of invasive tumor in the right parietal and posterior frontal lobes, extensive vasogenic edema extending to the atrium of the right lateral ventricle and midline shift.


Exophytic growth in relation to 42, 43, 44, and 45.


Multilocular radiolucency with many radiopaque spots of driven snow appearance.


Computed tomography reconstructed image of the lesion.


Epithelial cells with prominent intercellular bridge and amyloid-like material.


Leisegang ring calcifications and amyloid-like material in connective tissue stroma.


Fused coronal PET-CT image of our patient before the axillary lymph node biopsy shows a lobulated FDG-avid mass (star) in the right axilla, which represents the patient's known axillary invasive ductal carcinoma. An adjacent small FDG-avid round structure (arrow) was suspicious for metastatic axillary lymphadenopathy.


A; Abdominal CT shows marked dilation of the transverse and descending colon with localized high-density areas.


B; Barium enema examination shows irregular mucosal contours and barium flecks in the transverse and descending colon.


Response to treatment in Case 1. Calcium levels in relationship to denosumab administration, and ,PRRT cycles in case 1.


Response to treatment in Case 1. Anterior view of 177Lu-LUTATHERA scintigraphy after I, II, and ,IV cycles of PRRT.


Response to treatment in Case 1. Posterior view of 177Lu-LUTATHERA scintigraphy after I, II, and IV cycles of PRRT.


Histopathology findings.


Maximum intensity projection image 18F-FDG PET-CT shows multiple distant metastasis in the lung, liver and bones. . Abbreviations: CT, computed tomography; FDG, fluorodeoxyglucose; PET, positron emission tomography; dm, mean decimeter.


Cutaneous nodule.


Diffuse esophageal ulceration.


Fine needle aspiration cytology from cutaneous lesion.


Specimen of spleen with a cyst measuring 8 cm x 8 cm, with cyst wall showing trabeculations.


Intra-operative visualisation of the diverticulum and gangrenous perforation of the diverticulum with impending obstructive symptoms. Blue arrow indicates the visualization of gastric mucosa in MD on a Meckel's scan ; green arrow indicates the CT observation of MD; yellow arrow indicates the post-operative specimen of MD with the distal gangrenous perforation.


Initial CT head showed subarachnoid haemorrhage (SAH) present in the frontal horn of the left lateral ventricle, third ventricle and fourth ventricle, and the foramen magnum; yellow arrows indicate blood component in the scans.


A diagram of timeline for this case.


A) Demonstrates conglomerate of para-aortic retroperitoneal lymphadenopathy at diagnosis of primitive neuroectodermal tumor. Patient went on to receive cheomtherapy with VAC/IE.


B) Demonstrates parital response to chemotherapy prior to potentially curative surgical resection.


Primitive neuroectodermal tumor (Case 1) consisting of a large confluent aggregate of immature neuroepithelium that forms tubules lined by stratified cells (inset picture) was identified in the orchiectomy sample.


Clinical course of the patient (schematic). BDG, (1,3)-b-D-glucan; PCT, procalcitonin; CRP, c-reactive protein; CT, computed tomography; MRI, magnetic resonance imaging; MRA, magnetic resonance angiography; VRC, voriconazole; IPI, Imipenem; VAN, Vancomycin; TEC, teicoplanin; AmBL, liposome-associated amphotericin B; mNGS, metagenomics next-generation sequencing; PB, peripheral blood; CSF, cerebral spinal fluid; BAL, bronchoalveolar lavage fluid.


Daily course of the patient's treatment. Horizontal thick blue lines show the medications administered; VRC, voriconazole; AmBL, Liposome-associated amphotericin B; TZP, piperacillin-tazobactanm; IPI, Imipenem; PCT, procalcitonin; CRP, C-reactive protein.


Frontal view of patient showing dark brown papules having linear distribution, limited on the right side of the face.


Intraoral photograph showing desquamative gingivitis and enamel hypoplasia in relation to 13 and 42.


Radiograph of the lumbar spine showing mild scoliosis with congenital Schmorl's node at D-12,. 3,. . 4,. . 5 (red arrow), and spina bifida (yellow arrow).


Retinography of the LE showing multiple, round and yellowish lesions in the macula and nasal to the optic nerve (left).


OCT with detachment of the neuroepithelium and a slight RPE detachment.


FA revealing hyperfluorescent lesions. At presentation.


Retinography of the LE performed 1 year later, revealing a chorioretinal scar.


Patient with Crouzon Syndrome, with cranio-cervico-facial involvement after a surgical procedure of cervicofacial advancement whit septic shock and acute and chronic osteomyelitis. A) Bilateral areas of ecchymosis were observed in the cervico-maxillary region.


Patient with Crouzon Syndrome, with cranio-cervico-facial involvement after a surgical procedure of cervicofacial advancement whit septic shock and acute and chronic osteomyelitis. B) Necrotic areas in the cervical, frontal, temporal and occipital regions.


Patient with Crouzon Syndrome, with cranio-cervico-facial involvement after a surgical procedure of cervicofacial advancement whit septic shock and acute and chronic osteomyelitis. C) Infected area with Pseudomonas aeruginosa.


Patient with Crouzon Syndrome, with cranio-cervico-facial involvement after a surgical procedure of cervicofacial advancement whit septic shock and acute and chronic osteomyelitis. D) Once the infection was controlled after multiple surgical lavages and debridation, broad spectrum antibiotics, VAC and hyperbaric oxygen the skin grafts were placed.


Patient with Crouzon Syndrome, with cranio-cervico-facial involvement after a surgical procedure of cervicofacial advancement whit septic shock and acute and chronic osteomyelitis. E) The patient was discharged from the hospital.


Patient with Crouzon Syndrome, with cranio-cervico-facial involvement after a surgical procedure of cervicofacial advancement whit septic shock and acute and chronic osteomyelitis. F) Bone scintigraphy. - the bone scan images showed abnormal increased uptake of 111In in the right temporal region.


HTT (superior) juxtaposed with uninvolved thyroid parenchyma (inferior) with intervening fibrous capsule (H&E, 200X).


(A) Clinical observations according to the canine inflammatory bowel disease activity index score. A score of 3 or less was considered normal. * indicates the date of each fecal microbiota transplantation (FMT) procedure conducted. Of note, the patient with inflammatory bowel disease (IBD) achieved a normal score from day 42 of FMT throughout the remainder of the observation period.


(B) Clinical observations according to the WalthamTM Feces Scoring System. A score of 3.5 or less was considered normal. *indicates the date of each FMT procedure conducted. Of note, the patient with IBD achieved a normal score from day 42 throughout the remainder of the observation period.


Patch of woolly hair over the vertex.


Linear epidermal nevus over chin.


Light microscopy showing twisting and breakage of hair.


Trichoscopy showing irregularity of hair shaft.


Black arrow showing tumor cells with cytoplasmic PSA positivity (x 100).


T2 sagittal MRI of the thoracic spine showing both fractures.


T2 sagittal and coronal magnetic resonance imaging just above the T3-T4 levels on top of conus.


Microphotograph showing closely placed small capillary sized vascular channels along with a few dilated ones x200. Note the prominent endothelial cells and fibrin thrombus (*).


CD31 immunohistochemistry highlighting the endothelial cell line capillary channels (x200).


Preoperative contrast-enhanced abdominal computed tomography (CT) scan, axial arterial phase. The images reveal a low-density mass (red arrow head) measuring about 8.2 x 7.6 cm in diameter and prominently involving the uncinate process of the pancreas. The pancreatic head and neck are displaced and splayed around the anterior aspect of the tumor, certainly abutting the superior mesenteric artery (SMA; red arrow).


Histopathological photomicrographs of a solid pseudopapillary tumor (SPT). The image shows that the small round cells arranged and formed into nests, pseudopapillae, and microcysts. Note the tumor cells are traversed by a delicate vascular network. (Hematoxylin and eosin, original magnification, x20).


(A, B) Contrast-enhanced abdominal CT scan on postoperative day 1. A = axial. B = coronal. The images reveal an intraluminal thrombus (red arrow) in the proximal SMA ~1.5 cm from its aortic origin, causing near complete occlusion of the SMA.


Clinical course. beta-hCG = human beta subunit of chorionic gonadotropin; Cre = creatinine; im = intramuscular injection; MTX = methotrexate; PSL = prednisolone; RB = renal biopsy; UP = urinary protein.


Light microscopy of initial renal biopsy specimens shows thickening of the glomerular capillary walls, thrombus-like structures within the glomerular capillary lumina, and a double-contour appearance along the glomerular capillary walls. Masson's trichrome stain x 400.


Light microscopy of initial renal biopsy specimens shows thickening of the glomerular capillary walls, thrombus-like structures within the glomerular capillary lumina, and a double-contour appearance along the glomerular capillary walls. Periodic acid-methenamine-silver stain x 400).


C: Immunofluorescence microscopy shows positive staining for IgM along the glomerular capillary walls.


D: Electron microscopy shows the expansion of the glomerular subendothelial space with electron-dense aggregates.


Light microscopy of follow-up renal biopsy specimens shows normal glomerular structures. Masson's trichrome stain x 400.


Light microscopy of follow-up renal biopsy specimens shows normal glomerular structures. Periodic acid-methenamine-silver stain x 400).


GCTTS presenting in a young child. (A) Presence of a soft tissue mass along the third digit of left hand.


GCTTS presenting in a young child. (B) Hematoxylin and Eosin (H&E) staining of resected finger mass consistent with a diagnosis of GCTTS. Arrowheads indicate multinucleated giant cells.


CT scan of right lower extremity. . Extensive air is shown tracking superiorly within the anterior and posterior compartments of the thigh (notated by white arrows).


Intra-operative photo of right lower extremity. . Taken during initial AKA revision and soft tissue debridement for extensive necrotizing infection.


Right lower extremity wound. . Integra graft over viable muscle of anterior, lateral, and posterior compartments of right thigh. Photo taken post-operative day #19 after AKA revision procedure.


(a) Positron emission tomography-computed tomography scan showing fluorodeoxyglucose uptake in distal ileum, (b) ileal biopsy showing confluent granulomas with epithelioid cells and multinucleated Langhans giant cells (H and E, x20), (c) Ziehl-Neelsen stain of the ileal tissue showing acid-fast bacilli.


(a) Orthopantomograph showing multilocular radiolucency in the mandibular body-ramus area on the left side.


(b) Cone beam computed tomography image showing buccal expansion due to the lesion.


(a) Photomicrograph demonstrating follicles of ameloblastoma in mature fibrous stroma (H&E, x10).


(b) Foreign body and associated granulomas (H&E, x10).


(c) Multinucleated giant cells phagocytosing hyaline ring-like foreign particles (H&E, x40).


(d) The foreign body demonstrating periodic acid-Schiff positivity (periodic acid-Schiff, x10).


(a) Foreign body showing peripheral smaller rectangular cells (demonstrated by arrowhead) and arrow pointing larger more angular cells in the center enclosing amorphous eosinophilic material (H&E, x40).


(b) Processed pulse showing structure similar to the foreign body (H&E, x40).


Microscopic: sections show dense spindle cell proliferation with storiform growth pattern associated with patchy infiltration of lymphoplasma cells.


Positive reaction of tumor cells with SMA.


A single, dome-shaped, swelling is seen at the left index figure without significant changes of the overlying skin. Tumor nodule measures 2.0 x 2.3 cm in size.


Electron microscopy of liver biopsy. (A) Hepatocytes are irregular in shape and size, and the nucleus is eccentric (3,000 x, scale bar: 10 mum).


Electron microscopy of liver biopsy. (B) Part of the capillary bile duct is dilated; a large number of microvillous and lysosomes are visible (9,000 x, scale bar: 5 mum).


Electron microscopy of liver biopsy. (C) Hyperplasia of collagen fibers can be seen in liver cells, with cross-sections (*). The picture also presents with an increased number of mitochondria with abnormal morphology ( ) and an increased density of rough endoplasmic reticulum ( ) (9,000 x, scale bar: 5 mum).


Optic pathway gliomas and computed tomography of Case 1.


Intraoperative photograph with excised lesion and histopathological photographs of Case 1.


Optic pathway gliomas and computed tomography of Case 2.


Intraoperative photograph with excised lesion and histopathological photographs of Case 2.


Nests of monomorphic cuboidal poroid cells with prominent nucleoli (hematoxylin & eosin stain).


Eccrine porocarcinoma composed of basaloid cells with focal infiltration into the dermis (hematoxylin & eosin stain).


Low-power photomicrograph depicting granular layer with associated keratinization consistent with epidermoid-infundibular cyst. HE staining.


Medium-power view showing atypical squamous epithelium with focal infiltration and associated stromal response. HE staining.


Medium-power view demonstrating keratinizing tumor cells with mitotic figure. HE staining.


Array-CGH profile of the patient showing a 2.8 Mb loss at 15q26.3 and 496 kb gain at 15q26.3 ie arr[GRCh37] 15q26.3(99550797_102429040)x1,15q26.3(99049746_99546177)x3.


Specimen radiographic appearance of the jaw eliciting the multilocular radiolucency with root resorption postero-anteriorly.


Radiographic appearance of the jaw eliciting the multilocular radiolucency with root resorption.


The microscopic appearance exhibiting fibrous connective tissue exhibiting numerous odontogenic epithelial islands with peripheral tall columnar cells showing reversal of polarity. The center of the island shows stellate reticulum like cells which is replaced by granular cells (inset) (under x10 magnification).


The microscopic appearance shows central stellate cells replaced by large eosinophilic rounded or polyhedral granular cells (under x10 magnification).


The microscopic appearance of granular cell (under x40 magnification).


Coronal.


Sagittal. CT images showing a loculated cystic lesion in the tail of the pancreas closely involving the spleen.


Three biopsy pathological diagnosis results of the patient.


Chest CT scan evolution of the tumors.


Pedigree analysis: Pedigree analysis of the proband up to the previous three generations. White symbol (square or circle) - a healthy person, white symbol (square or circle stroked through diagonally) - death of that individual, triangle - miscarriage, white symbol (blue colored and stroked diagonally) - proband.


Preoperative clinical presentation of the lesion.


Proliferating keratinizing stratified squamous epithelium into underlying connective tissue (4x).


Islands of odontogenic epithelium within a cellular fibrous stroma (10x).


Islands of odontogenic epithelium within a cellular fibrous stroma (40x).


Postoperative view.


Hip, thigh, and lower calf MRIs of the proband (II-3) with PRX mutation. A: Coronal scan of lower limbs. T1-weighted images demonstrated no definite fatty or atrophic changes in hip and thigh muscles.


Hip, thigh, and lower calf MRIs of the proband (II-3) with PRX mutation. B-E: Axial scans of lower limbs. B and C: At the thigh levels, MR images were normal.


Hip, thigh, and lower calf MRIs of the proband (II-3) with PRX mutation. B-E: Axial scans of lower limbs. D and E: On the lower calf levels, we found mild fatty changes in distal peronei muscles (arrows), but, the tibialis anterior and soleus muscles were not involved.


Preoperative magnetic resonance images. Axial unenhanced T2 weighted magnetic resonance imaging showing right-sided lesion (white arrow) and hyperdense areas which extends to the left cerebellum (hemorrhage) and there is no edema round the lesion.


(b) Axial postcontrast T1 image, showing bilateral vermian lesions in which the right-sided mass is enhancing gadolinium peripherally.


(c) Postcontrast sagittal image, demonstrating partly attachment of the mass to the tentorium.


(d) Postcontrast coronal image demonstrates bilateral lesions close to the tentorium in mixt intensity.


(a-d) Intraoperative images. (a) Initial surgical view of the tumor, originating from the tentorium (white arrow) after retraction of cerebellum inferiorly.


(a-d) Intraoperative images. (b) Bipolar coagulation of the tumor feeders and detachment of the tumor from the tentorium.


(a-d) Intraoperative images. (c) Surgical view of the tumor (white arrow) after total detachment.


(a-d) Intraoperative images. (d) Removal of the tumor in a single piece (white arrow) fashion.


(a-c) Postoperative magnetic resonance images demonstrating no residual tumor. (a) Axial enhanced T1 imaging.


(a-c) Postoperative magnetic resonance images demonstrating no residual tumor. (b) Sagittal enhanced T1 imaging.


(a-c) Postoperative magnetic resonance images demonstrating no residual tumor. (c) Coronal T2 imaging.


CECT of brain showing right parietal parasagittal metastatic tumor.


MRI of cervico-dorsal spine demonstrating C6-D2 spinal tumor with dumbbell like extension into upper thorax.


MRI axial images demonstrating spinal tumor at D-1 extending outside.


Histopathology showing densely cellular tumor arranged in sheets, and ,lobules with minimal intervening stroma.


Immunohistochemistry showing membranous positivity for CD99.


Post-operative CECT brain at nine months after surgery showing no evidence of tumor.


Axial view magnetic resonance images show a mass at the T11 and T12 level, pushing the conus medullaris superiorly and to the right.


Intraoperative picture, post-laminectomy at T11 and T12 level.


Intraoperative picture, the tumor was excised along with the involved nerve root.


Sagittal view magnetic resonance images showing an intramedullary mass adjacent to the conus medullaris at T11 and T12 level.


Axial view magnetic resonance images show a mass at the T11 and T12 level, abutting on the conus medullaris.


Intraoperative picture post-laminectomy of T11 and T12 reveals the mass.


Intraoperative picture, the mass was completely removed without having to sacrifice the nerve root.


Sagittal view magnetic resonance image reveals an intradural mass at T11 level.


Axial view magnetic resonance image shows a well-defined intradural extramedullary mass at T11 level, compressing the conus medullaris.


Intraoperative picture post-laminectomy T10 and T11 reveals the mass.


Intraoperative picture, the mass was completely without sacrificing the affected nerve root.


Skin manifestation after bagatelle injury on day 11 after admission.


Intraoperative appearance after initial radical debridement on day 11 after admission.


Areactive necrosis of subcutaneous fat and fascia without detection of bacteria (H&E, 200x).


Diagram of the course of disease.


Photograph of patient on postembolization day 4, demonstrating hyperpigmented plaque on her left nasal ala and cheek with surrounding erythema.


Case 1. 58-year-old male with difficulty in swallowing was diagnosed with squamous cell carcinoma of right tonsil. A) Maximum Intensity Projection (MIP) image shows tonsillar SCC infiltration in both lobes of the thyroid gland (arrows).


Case 1. 58-year-old male with difficulty in swallowing was diagnosed with squamous cell carcinoma of right tonsil. B) Axial CT image for attenuation correction and anatomic localization.


Case 1. 58-year-old male with difficulty in swallowing was diagnosed with squamous cell carcinoma of right tonsil. C) Axial PET image shows diffuse tracer uptake in both lobes of the thyroid gland (arrows).


Case 1. 58-year-old male with difficulty in swallowing was diagnosed with squamous cell carcinoma of right tonsil. D) Axial PET/CT fusion image reveals SUVmax of the right and left thyroid lobes was 7.5 and 5.9, respectively (arrows).


Case 2. 66-year-old male complaining of a mass in the neck was diagnosed with supraglottic squamous cell carcinoma. A) Maximum Intensity Projection (MIP) image shows supraglottic SCC metastasis in both lobes of the thyroid gland (arrows).


Case 2. 66-year-old male complaining of a mass in the neck was diagnosed with supraglottic squamous cell carcinoma. B) CT image for attenuation correction and anatomic localization.


Case 2. 66-year-old male complaining of a mass in the neck was diagnosed with supraglottic squamous cell carcinoma. C) Axial PET image shows intense metabolic activity in both lobes (arrows).


Case 2. 66-year-old male complaining of a mass in the neck was diagnosed with supraglottic squamous cell carcinoma. D) Axial PET/CT fusion image reveals SUVmax of the right thyroid lobe was 20.3 and SUVmax of the left lobe was 7 (arrows).


Left: Preoperative abdominal CT. Solid hepatic lesion at segments VI and VII (arrows) and calcified lesion at the tail of the pancreas (circle). Right: Postoperative abdominal CT. Subcapsular hepatic fluid collection without recurrence of the HCC (circle). . Abbreviations: CT, computed tomography; HCC, hepatocellular carcinoma.


Left: Intraoperative photo. Microwave tissue coagulator marking the margins for hepatic segmentectomy. Right: Gross specimen photo. Hepatic segments VI and VII containing the HCC. . Abbreviation: HCC, hepatocellular carcinoma.


The intraoperative photographs and schematic renderings show details of the operation. . Notes:. A sizable segment of IVC around the lesion was freed, and ,detached, where two Satinsky's clamps were placed at the proximal part to occlude the IVC without affecting the left renal vein.


The intraoperative photographs and schematic renderings show details of the operation. The granuloma (blue arrow) was exposed and detached from posterior tissue after the proximal IVC segment was ligated, cut off, and stretched caudally.


The intraoperative photographs and schematic renderings show details of the operation. (C and D) The sketch illustrations explain the key steps straightforward. (C) The granuloma was attached posterior to the IVC (arrow).


The intraoperative photographs and schematic renderings show details of the operation. (C and D) The sketch illustrations explain the key steps straightforward. (D) The IVC was ligated and sutured after the granuloma was removed (arrow). . Abbreviation: IVC, inferior vena cava.


The photographs and microscopic pathological presentation of the surgical specimen. . Notes:. Grossly, the granuloma sized 2.6x3 cm is covered by a fragment of inferior vena cava.


The photographs and microscopic pathological presentation of the surgical specimen. The arrowheads indicate the surgical suture.


The photographs and microscopic pathological presentation of the surgical specimen. Numerous epithelioid histiocytes, multinucleated giant cells, and the amorphous necrotic fat are present.


Anterioposterior digital subtraction angiogram of the celiac artery: (a) early arterial phase shows arterial feeders which supply the hypervascular tumor.


(b) Mid-arterial phase, revealing marked coarse neovascularity and significant arterio-venous shunting, as demonstrated by early visualization of the left and right portal veins (arrows), typical for hepatocellular carcinoma.


(c) Late arterial phase, tumor blush and delayed contrast washout with persistent opacification of the portal system (arrows).


Computed tomography angiogram, axial and coronal images (a and b) indicating the site of the hepatocellular carcinoma in segments 7/8 (arrows).


Corresponding axial and coronal SPECT/ CT images (c and d). Note only minimal accumulation of MAA in segment 7/8 tumor, while more intense tracer uptake is noted in the surrounding normal hepatic parenchyma.


Pre-operative.


Excised tissue.


Post-operative.


Pre-operative (lateral view).


After excision.


Periodontal dressing.


Histopathologic slide.


Clinical presentation of NEC and SCC. Esophagogastroduodenoscopy and CT findings in NEC (A,B). (A) A large ulcerated mass was found in the esophagogastric junction.


Clinical presentation of NEC and SCC. Esophagogastroduodenoscopy and CT findings in NEC (A,B). (B) CT imaging reveals para-aortic lymph node swelling (yellow arrow).


Clinical presentation of NEC and SCC. Esophagogastroduodenoscopy and CT findings in SCC (C,D). (C) A tiny, red-colored mucosal area in the center of the cicatrized lesion (white arrow).


Clinical presentation of NEC and SCC. Esophagogastroduodenoscopy and CT findings in SCC (C,D). (D) CT imaging shows no distant metastasis after the chemotherapy for NEC.


Clinical presentation of NEC and SCC. (E) Macroscopic findings for the resected specimen. No other regional/distant metastasis can be seen in the resected specimen.


Clinical presentation of NEC and SCC. (F) An ulcerated mass at the esophagogastric junction can be observed in the resected specimen (white arrow). NEC, neuroendocrine carcinoma; SCC, squamous cell carcinoma; CT, computed tomography.


Histological evaluation of NEC and SCC. Hematoxylin and eosin, and immunohistochemical staining of the biopsy (NEC;. E staining.


Histological evaluation of NEC and SCC. Hematoxylin and eosin, and immunohistochemical staining of the biopsy (NEC;. Synaptophysin.


Histological evaluation of NEC and SCC. Hematoxylin and eosin, and immunohistochemical staining of the biopsy (NEC;. CD56.


Histological evaluation of NEC and SCC. Hematoxylin and eosin, and immunohistochemical staining of the biopsy (NEC;. MIB-1.


Histological evaluation of NEC and SCC. Hematoxylin and eosin, and immunohistochemical staining of the biopsy (NEC;. P53. NEC, neuroendocrine carcinoma; SCC, squamous cell carcinoma; H-E, hematoxylin and eosin.


Histological evaluation of NEC and SCC. And surgically resected specimen (SCC.


Histological evaluation of NEC and SCC. And surgically resected specimen (SCC;. Synaptophysin.


Histological evaluation of NEC and SCC. And surgically resected specimen (SCC;. CD56. NEC, neuroendocrine carcinoma; SCC, squamous cell carcinoma; H-E, hematoxylin and eosin.


Histological evaluation of NEC and SCC. And surgically resected specimen (SCC;. P53.


Histological evaluation of NEC and SCC. CK5/6. Scale bars; 50 mum.


Transverse view on CT of the bilateral iliopsoas abscesses.


CT demonstrated Sagittal View of Abdomen and Pelvis demonstrating gas locules in Right Iliopsoas Region.


>50% occlusive right internal jugular vein thrombus on ultrasonography.


CECT showing eccentric thickening of gall bladder wall.


MRCP showing dilated bile duct with multiple sites of narrowing.


Smear shows cluster of malignant cells displaying round to oval hyperchromatic nuclei, condensed chromatin, prominent nucleoli, and moderate amount of cytoplasm (MGG, x40 magnification).


Side viewing endoscopy showing ampullary growth.


Metal stent in the bile duct.


Gadolinium-enhanced T1 MRI shows left medullary enhancement (arrow.


As extensive nodular circumferential leptomeningeal enhancement (arrows.


Findings correlate with axial T2 FLAIR images also showing lateral brainstem hyperintensity (arrows.


As well as a patchy involvement of the bilateral midbrain (arrows,. And the pituitary infundibulum (arrowhead.


Intraoperative photograph shows the direct swab of a mycotic-appearing mass which resulted in negative smear and culture. Also seen are a number of small colonies (arrowheads), one of which resulted in the positive identification of blastomyces dermatitidis on culture.


Nontender subungual, nodular lesion in the right toe.


After excision of the lesion.


Immunohistochemical (IHC) study; low power view of neoplastic spindle cells which show IHC positive staining with vimentin.


Focal reaction with smooth muscle actin.


Negative reaction with CD34.


Positive staining pattern with CD99 (IHC x40).


MRI or CT scan images of the patient. Indicated partial enhancement of pia mater in brain enhanced MRI.


MRI or CT scan images of the patient. Revealed an area of abnormal attenuation measuring 67 mm x 62 mm in the right lobe of the liver, indicative of a single large multi-loculated abscess in abdominal enhanced CT.


MRI or CT scan images of the patient. Displayed the abscess reduced to 51 mm x 37 mm 3 days after emergency CT-guided percutaneous drainage of the liver abscess in abdominal plain CT.


MRI or CT scan images of the patient. Showed no lesions in liver in the reexamination of abdominal CT after full recovery.


Swelling on left side of face extending from zygomatic arch to lower border of mandible superoinferiorly. Swelling was covering the whole ramus of the mandible anteroposteriorly.


Intraoral examination shows obliteration of buccal sulcus and displacement of first and second deciduous molar and first permanent molar.


Cytological smears show spindle-shaped stroma with giant cells (40x).


Postoperative follow-up after two months.


Extraoral. Intraoral.


Computed tomography of neck; lymphadenomegalies in various dimensions.


Karyorrhectic debris and cellular infiltration of histiocytes and immunoblasts in the absence of polymorphonuclear leukocytes (hematoxylin and eosin stain x200).


Histiocytes and activated B-cells (hematoxylin and eosin stain x200).


(A) SS-OCT imaging confirms the diagnosis as the lesion can clearly be seen coming up from the sclera and compressing the overlying choroid and choriocapillaris. The lesion is inactive as there is no sign of yellow intraretinal exudation, localized subretinal fluid or focal retinal hemorrhages and the posterior border (arrows) of the lesion is well defined.


(B) Cross-sectional composite OCT angiogram. The lesion is avascular. Overlying choroidal vasculature is thinned. Flow signals are color coded: purple, choroid; red, neuroretina.


OCT angiography: resulted in fewer choriocapillaris flow voids (between arrows).


Computed tomography at the first presentation showing a 5-cm massive pulmonary tumor in the left upper lobe and multiple nodules in both lung fields. Mediastinal window.


Computed tomography at the first presentation showing a 5-cm massive pulmonary tumor in the left upper lobe and multiple nodules in both lung fields. Pulmonary window.


(A) Histological examination of lung biopsy specimens obtained from the left pulmonary mass revealing proliferation of polyhedral and spindle atypical cells.


(B) PD-L1 tumor proportion score was detected by Burning Rock Dx.


Chest CT images obtained after one course of chemotherapy.


Chest CT images obtained after 2 weeks.


6 weeks.


10 weeks. In a patient who received single camrelizumab (PD1 monoclonal antibody) treatment.


The expression of EGFR2 was detected by IHC before.


After. Apatinib treatment. (100x).


Macroscopic features of the colon at autopsy. The serosal membrane showed patchy fibrous thickening, and the intestinal wall was edematous.


Preoperative neuroradiological assessment. Computed tomography scan (a) demonstrating the presence of a densely calcified left temporal and insular lesion.


Preoperative neuroradiological assessment. FLAIR sequences of magnetic resonance (MR) scan confirmed the presence of the calcified tumor (b).


Preoperative neuroradiological assessment. Postoperative MR confirmed the complete resection of the lesion (c).


Large expansile tumor mass with thinned out cortex in the anterior end of fourth rib noted on computed tomography scan.


Clinical photograph of patient before treatment (left-side view).


Clinical photograph of patient 6 weeks after treatment.


Computerized tomography scans before and after immunotherapy in Case #1 Initial CT scan showing large left sided renal mass in April of 2019.


Compared to CT scan in March of 2020. Showing substantially decreased mass.


Representative pathologic images from Case #1 Hematoxylin and eosin (H&E) stained slides at low-power.


High-power. Magnification showing extensive hyalinized fibrosis with scattered chronic inflammation and hemosiderin laden macrophages in the area of tumor regression.


The fibrosis extends into the adjacent fibroadipose tissue (C).


Chronic tubulointerstitial nephritis and globally sclerosed glomeruli are present in the adjacent residual benign renal parenchyma (D).


Computerized tomography scans before and after immunotherapy in Case #2 Initial CT scan in July of 2018 showing large right renal mass.


Pulmonary metastases.


Compared to CT scan in December of 2019 showing substantially decreased mass.


Resolution of pulmonary metastases.


Representative pathologic images from Case #2 H&E stained slides at low-power.


High-power. Magnification showing a massive infiltration of chronic inflammatory cells and foamy macrophages in the area of tumor regression.


Areas of tumor regression also showed necrotizing granulomatous inflammation (C).


Chronic tubulointerstitial nephritis, globally sclerosed glomeruli, and hemosiderin laden macrophages are present in the adjacent residual benign renal parenchyma (D).


Preoperative magnetic resonance imaging brain T2-weighted images.


(a and b) Postoperative computed tomography brain with contrast showing complete exision of lesion.


(a) Rhabdoid cells with vesicular nuclei, prominent nucleoli, and spherical cytoplasmic filamentous inclusions (H and E, x200). (b) Small hyperchromatic cells similar to PNET showing dense nuclei, dispersed chromatin, small to inconspicuous nucleoli, with scant cytoplasm and indistinct cell borders, arranged in a solid pattern (H and E).


(Buccal view): Buccal fistula.


(palatal view): Accentuated lingual pit of the right maxillary lateral incisor.


Intraoral periapical radiograph.


The gutta-percha cone inserted in oral fistula.


Fistulography.


Identification of the dens invaginatus invagination orifice.


Dens invaginatus with a rounded shape surrounded by vital pulp of maxillary lateral incisor.


Entrance of the dental root canal.


Seal of the peri-malformation space and of the canal tract of dental malformation.


Periapical radiography at the end of endodontic treatment.


Periapical radiography after 6 months of endodontic treatment.


Cervical gingivoplasty.


Lithium silicate ceramic veneers on 1.2 and a reductive odontoplasty of the right maxillary central incisor.


Mean fluorescence intensity values of untreated and acid-treated single antigen bead assay from a control sample.


Mean fluorescence intensity values of untreated and acid-treated single antigen bead assay from the test sample.


Gray-scale ultrasound image shows a well-circumscribed nodule.


Axial T1 -weighted MR image at the level of the nipple demonstrates a small, well circumscribed nodule lateral to left nipple of intermediate signal.


Dynamic, fat saturated magnetic resonance performed immediately after intravenous contrast administration at the same level as Figure 2 demonstrates avid enhancement of the lesion lateral to the left nipple.


Hematoxylin and Eosin stained tissue at x40 low power view shows hemangioma (black arrows) and breast ducts and lobules (gray arrows).


Hematoxylin and Eosin stained tissue at x400 high power view reveals abnormal vascular spaces in the hemangioma (arrows).


This is a dynamic enhancement curve mapping lesion enhancement with time following contrast administration. It shows rapid initial enhancement, a peak, minor washout and then a plateau formation. This is an intermediate type of curve - malignant lesions have the rapid enhancement but also tend to washout rapidly as well - ie there is steeper curve drop as compared to what is seen in this image.


Chest X-ray showing right-sided moderate effusion with thickening.


Medical thoracoscopy view, showing inflamed parietal pleura with few adhesions.


Microscopic view showing acute fibrinous exudate (H&E x 200).


Microscopic view revealing dense fibroblastic reaction characterized by fascicles of spindle cells mixed with fewer numbers of lymphocytes, plasma cells, and eosinophils associated with deposits of dense collagen (H&E x 200).


Axial CT scan of the abdomen in case 1 with intravenous contrast revealing a complex 2.3 cm pancreatic head lesion (arrow). CT, computed tomography.


H&E-stained sections of UCOGC. (A) Low-power view demonstrating a fairly well-circumscribed tumor nodule surrounded by a rim of desmoplastic stroma (arrow), which abuts adjacent benign pancreas. Hemorrhage is observed within the tumor (arrow), 20x.


H&E-stained sections of UCOGC. (B) Central hemorrhage and necrosis give the appearance of a condensation of hyperchromatic nuclei toward the periphery of the nodule, 100x.


H&E-stained sections of UCOGC. (C) Multiple mitotic figures, including one bizarre pentapolar mitosis (arrow), are observed within a background of multinucleated giant cells and microscopic hemorrhage. Malignant cells demonstrate marked nuclear pleomorphism and hyperchromasia, 200x.


H&E-stained sections of UCOGC. (D) High-power view demonstrating an additional atypical mitotic figure surrounded by multinucleated giant cells (arrows) with a dense cytoplasm. Over 20 distinct nuclei can be observed within a single cell, 400x. H&E, hematoxylin and eosin; UCOGC, undifferentiated carcinoma with osteoclast-like giant cells.


Axial CT scan of the abdomen in case 2 with intravenous contrast showing an ill-defined pancreatic head mass (arrow) that measures 3.6 x 3.6 cm. There is associated pancreatic ductal dilatation with abrupt cutoff at the level of the mass. The mass abuts the superior mesenteric vein and there is attenuation of the main portal vein and SMV at the confluence related to the mass. SMV, superior mesenteric vein.


H&E-stained sections demonstrating clear cell features. (A) Low-power view demonstrating irregular malignant glands with surrounding desmoplastic tumor stroma. The normal lobular architecture of the pancreas is lost, 5x.


H&E-stained sections demonstrating clear cell features. (B) Angulated malignant glands are lined by epithelial cells with hyperchromatic basal to central nuclei of varying sizes and variable amounts of foamy to clear cytoplasm (arrows). Single malignant cells are present within the stroma, 100x.


H&E-stained sections demonstrating clear cell features. (C) Malignant cells are seen invading between an arteriole (black arrow), a nerve (white arrow), and adjacent benign pancreas (asterisk), 100x.


H&E-stained sections demonstrating clear cell features. (D) Similar histopathologic findings are observed in metastatic tumor glands seen in the subcapsular sinus of a peripancreatic lymph node (arrow), 100x.


Plain radiograph of wrist showing lytic lesion in Capitate.


CT Scan wrist showing lytic lesion in Capitate.


Intra operative picture showing cavity in Capitate after extended curettage of the lesion.


Histopathalogical photomicrograph showing multinucleated giant cell (arrow).


1 year follow up radiograph showing no recurrence.


Frond-like structures with a vascular core making pseudopapillary pattern of growth Follicle-like spaces with variability in size and content, Distinct cytologic features; polygonal cells with clear cytoplasm and round to angulated nuclei with prominent 1-2 nucleoli.


Immunoreactivity with CD117, PLAP and CK AE1/AE3.


Noncontrast computed tomography scan of the chest showing a 2 cm round soft tissue mass with smooth regular margin in the left lower lobe.


Fibrotic stromal fragment with papillary features in a background of abundant blood (Papanicolaou stain, x100).


Fibrovascular fragment associated with round cells (Diff-Quik stain, x200).


Cohesive sheets of surface cells arranged in pavement-like fashion (Diff-Quik stain, x400).


Dense collagenous stromal tissue associated with bland appearing round cells (x200).


Both surface and round cells are positive for thyroid transcription factor-1 immunostain (x200).


AE1/AE3 immunoreactivity is present in the surface cells but not the round cells (x200).


Progesterone receptor immunoreactivity is present in the round cells but not the surface cells (x200).


Bosselated irregular non-tender skin colored swelling over the occipital region extending toward the nape of the neck.


Coronal view T1 DIXON FS post gadolinium, slice thickness 3 mm. Arrow: Cavernous sinus, Triangle: Pars cavernosa of the internal carotid artery. Initial MRI: Thrombosis of the cavernous sinus and involvement of the internal carotid artery with hyperemia of the vasa vasorum (A).


Coronal view T1 DIXON FS post gadolinium, slice thickness 3 mm. Arrow: Cavernous sinus, Triangle: Pars cavernosa of the internal carotid artery. MRI 7 days post-admission: Increasing inflammation of the internal carotid artery with further reduction in lumen size (B).


Coronal view T1 DIXON FS post gadolinium, slice thickness 3 mm. Arrow: Cavernous sinus, Triangle: Pars cavernosa of the internal carotid artery. MRI 14 days post-admission: Improvement of internal carotid artery involvement with a partial recovery in size (C).


Coronal view T1 DIXON FS post gadolinium, slice thickness 3 mm. Arrow: Cavernous sinus, Triangle: Pars cavernosa of the internal carotid artery. MRI 3 months post-admission: Complete recanalization of the left cavernous sinus and normal size of the left internal carotid artery (D).


Neuroradiological findings on presentation. Brain CT showing enlarged lateral ventricles with slit ventricle.


Neuroradiological findings on presentation.abdominal and pelvic CT demonstrating the course of the ventriculo-peritoneal shunt catheter (arrows) and the massive cerebrospinal pseudocyst surrounding the peritoneal end.


CT after insertion of the ventriculo-pleural shunt. Brain CT showing decreased lateral ventricle volume (a, b).


T1W Magnetic resonance imaging showing a predominantly isointense intramedullary tumor.


Sagittal.


Axial. Contrast enhanced Magnetic resonance imaging showing the homogenously enhancing intramedullary tumor with interspersed cystic/necrotic areas.


Microphotograph showing a highly cellular tumor, consisting mainly of small round to oval cells with hyperchromatic nuclei and remarkably scanty cytoplasm along with the presence of Homer-Wright pseudorosettes; the tumor cells being immunopositive for CD 99 (inset).


Photograph showing a nodular swelling over right lower eyelid.


Photomicrograph showing cellular smear with tumor cells arranged in groups as well as singly scattered (MGG, x100).


Pleomorphic tumor cells with vacuolated cytoplasm (MGG, x400).


An extensive erosive erythema with a red, easy-to-bleed nodule on the scrotum (a).


Atypical cells mainly proliferated in the dermis forming solid pattern nests (b).


Paraffin-embedded tissue samples from the right shoulder were deparaffinized and stained with anti-RANKL antibody (c).


T1-weighted MRI before the treatment (a).


Physical examination revealed that all primary tumors had disappeared (b).


T1-weighted MRI after the treatment (c).


Lymphocyte count, cytomegalovirus (CMV) blood and cerebrospinal fluid (CSF) viral load, and the progression of symptoms and events over one year, in a 10-year-old girl who underwent allogeneic HSCT. Colour bars represent the timeline graph of antiviral treatments and their corresponding duration. After discontinuing the immune-suppressive regimen, the patient first experienced headaches with high blood CMV load, despite therapy with valganciclovir and foscarnet. Her symptoms then worsened until overt immune reconstitution inflammatory syndrome (IRIS) occurred, with high CSF CMV load, despite CMV clearance from the blood, together with an increase in lymphocyte count and severe bone marrow and renal toxicity. After the initiation of anti-CMV-specific immune globulins, the CSF viral load dropped rapidly, and symptoms improved. HSCT, hematopoietic stem cell transplantation; IST, immunosuppressive therapy; IRIS, immune reconstitution inflammatory syndrome; CMV, cytomegalovirus; CSF, cerebrospinal fluid.


Serum and cerebrospinal fluid (CSF) cytomegalovirus (CMV)-IgG antibodies (Ab) titre evaluation in CMV-IgG-positive patients undergoing the Cytotect CP treatment (Cytotect group, n = 15) and those not so treated (Control group, n = 15). In the Cytotect group, the CSF CMV Ab levels were significantly higher than serum Ab levels (P < 0.001) and CSF Ab levels of the Control group (P < 0.0001). CMV serum and CSF Ab evaluations were performed in triplicates, and their results are shown as mean +- SD. Statistical analysis was performed using the Mann-Whitney U-test.


First visit occlusal view.


After 6-month placement of calcium hydroxide.


After 20 months of calcium hydroxide placement.


CBCT view;. First visit.


After 6 months, Significant shrinkage in the size of the lesion was observed.


After 20 months of follow-up.


Initial evaluation of mixed friction burn to anterior abdomen of a 30-year old female pedestrain struck by a motor vehicle. Total burn surface area (TBSA) estimated to be 13% (4% full-thickness 3rd degree, 9% partial thickness 2nd degree).


Morel-Lavallee lesion discovery during of a 30-year old female pedestrain struck by a motor vehicle tangential burn wound excision revealed full-thickness abdominal wall ischemia (approximately 12 cm diameter), extensive fascial-cutaneous separation, and traumatic dissection. Over 1.5 L of fluid were removed from this region at index operation requiring drain placement for weeks post-operation.


Post-repair day 5 of abdominal wall Morel-Lavallee lesion with excision and autografting with split-thickness skin graft of a 30-year old female pedestrain struck by a motor vehicle.


Clinical course of the present case before HBV reactivation.


Clinical course of the present case after anti-virus therapy started. GCAP = Granulocytapheresis.


Microtia with preauricular tag.


Facial asymmetry with left preaxial polydactyly.


Fundus photography of the right and left eyes. Extensive choroidal coloboma is seen in the right eye.


Fundus photography of the right and left eyes. , markedly different from the left eye.


Fluorescein fundus angiography of the right and left eyes. A; The right eye shows no changes of DR.


Fluorescein fundus angiography of the right and left eyes. B; The left eye displays a wide area of retinal nonperfusion.


Imaging of hepatic PEComa. (A) Contrast-enhanced phase of CT reveals a poorly-defined mass with a significantly high intensity in segment VII of the liver.


Immunohistochemical results of hepatic PEComa (x200). (A) Tumor cells showing strong and diffuse positive staining for HMB-45.


Immunohistochemical results of hepatic PEComa (x200). (B) Tumor cells showing strong and diffuse positive staining for SMA (+++). PEComa, perivascular epithelioid cell tumor; HMB-45, human melanoma black-45; SMA, smooth muscle actin.


Dissection of the tumor.


Distal pancreatectomy using a stapler.


The spherical tumor after complete separation.


Operative bed with pancreatic stump.


Preoperative extraoral profile.


Preoperative intraoral image.


Computed tomography scan (axial cut).


Computed tomography scan (coronal cut).


Intraoperative image.


Postoperative extraoral profile.


Microscopic view showing dense proliferation of fibro-collagenous tissue among which are seen areas of bony trabeculae lined by plump osteoblasts.


Proliferating fibroblastic tissue with blood vessels and osteoid showing plump osteoblastic rimming.


High-power view showing focus of proliferating fibroblastic cells with few specs of calcification (psammamatoid type).


Fundus images at presentation (2a), after 1 month (2b), and at 4 months (2c). Faint discolored peripapillary fundus lesions typical of multiple evanescent white dot syndrome (MEWDS) were seen at presentation (2a) and still present after one month (2b); corresponding to fluorescein angiography (FA) hyperfluorescent areas and hyperautofluorescent areas. At 4 months (2c), these lesions take the aspect of chorioretinal scars while FA and hyperautofluorescent lesions are no longer present.


Fundus autofluorescence pictures at presentation (5a), after 1 month (5b), and at 4 months (5c). On the right column (left eye), hyper-autofluorescent areas corresponding to FA and ICGA lesions can be seen at presentation (5a) which, on the middle picture, slightly progressed after one month (5b) with return to normal at 4 months (5c).


Second episode of choriocapillaritis consistent with multifocal choroiditis. Fundus images (7a) show chorioretinal scars nasal to the optic disc. Both fundus autofluorescence (7b) and fluorescein angiography (7c) show only faint lesions, while on indocyanine green angiography, hypofluorescence is substantial (7d), but resolves one month after periocular triamcinolone injection (7e) in parallel with recovery of the visual field (see figure 1).


Lateral condylar hypoplasia with lateralisation of patellae (with a predominance on the left side) - flexion.


Lateral condylar hypoplasia with lateralisation of patellae - AP/Long Leg Views.


Pathology of the masses of the transplanted kidney, and gross photograph of the allograft nephrectomy specimen. Periodic acid-Schiff staining and Grocott methenamine silver staining of renal mass at 100 x ,at 1.


Pathology of the masses of the transplanted kidney, and gross photograph of the allograft nephrectomy specimen. 000 x. Show granuloma caused by Cryptococcus (arrows).


Pathology of the masses of the transplanted kidney, and gross photograph of the allograft nephrectomy specimen. Electron microscopy of renal mass (E) shows the Cryptococcus (arrow).


Pathology of the masses of the transplanted kidney, and gross photograph of the allograft nephrectomy specimen. (F) Renal cryptococcoma (black arrow) and enlarged renal crptococcoma (white arrow).


Coronal preoperative MRCP/MRI in patient 1 revealing pancreas divisum with a lobulated cyst lesion in the uncinate process as well as a notable dilation of the uncinate duct. Scattered benign hepatic cysts are noted, with a normal sized bile duct. MRCP, magnetic resonance cholangiopancreatoscopy.