Preoperative imaging of the glomangiopericytoma. Coronal. Computed tomography angiography demonstrating low vascular flow to the tumor in the left cavernous sinus.


Immediate postoperative imaging after endoscopic tumor debulking. Axial.


Immediate postoperative imaging after endoscopic tumor debulking. Sagittal.


Immediate postoperative imaging after endoscopic tumor debulking. Coronal. T1 magnetic resonance imaging with gadolinium depicting residual tumor in the left cavernous sinus with expected postoperative changes.


Postoperative imaging 5 months after tumor debulking. Axial.


Postoperative imaging 5 months after tumor debulking. Sagittal. T1 magnetic resonance imaging with gadolinium.


Postoperative imaging 5 months after tumor debulking. Coronal T2. Showing stable tumor with no interval growth/progression.


Multiple skin-colored papular and nodulocystic lesions varying in size (from 4 to 6 cm) over the forehead.


Lateral cervical region.


Nodulocystic lesions, scarring, and sinuses in the right axilla.


Excisional biopsy reveals cysts lined by squamous epithelium with sebaceous glands (original magnification x100, hematoxylin and eosin stain).


(A) Brain magnetic resonance imaging (MRI) revealed an irregular enhancing mass with central necrosis on the left parietal lobe.


(B) Brain MRI image after surgery at the follow-up 3-mouth.


(a) Swelling in left frontal region in a 26-year-old male patient.


(b) Contrast head CT scan.


(c) Intraoperative finding showing soft tissue mass lesion in left frontal region.


(d) Mass size 7 x 6 x 5 cm.


(a) Section showing spindle cells arranged in short fascicles and storiform pattern (Hematoxylin and eosin, x10).


(b) Tumor cells with oval nuclei, vesicular chromatin, inconspicuous nucleoli, and scanty to moderate cytoplasm (Hematoxylin and eosin, x40).


(c) Section showing tumor cells focally positive staining for Vimentin (x200).


(d) Section showing tumor cells focally positive staining for CD34 (x200).


Pelvic CT result.


Macroscopic appearance of tumor.


The histopathology results.


The tumor cells are arranged in broad.


Clinical picture of solitary nodule with central ulceration on nasal area.


Dermoscopic picture which show multiple dotted vessels on the central ulcer, with white keratin mass on the adjacent area.


Histopathological examination (H&E stain 40x to 100x) showing dermal mass which consist of enlarged endothelial cells with infiltrate of eosinophils, consistent with diagnosis of Angiolymphoid Hyperplasia with Eosinophilia.


A 56-year-old woman presents to the emergency department for a left painless dorsolumbar fluctuating mass which was progressively growing over 3 months. Ultrasonography was the first imaging study obtained. A long-axis view of the left kidney shows subcutaneous and parietal multiloculated heterogeneous hypoechoic collections, compatible with abscess adjacent to the left kidney (red arrow). Moderate left hydronephrosis is also present (white arrowheads).


Ultrasonography and computed tomography showed an infected urinoma with left pelvicalyceal rupture, secondary to an obstructive calculus with nephrocutaneous fistula. The calculus was endoscopically removed and a left ureteral stent was placed, with an antibiotic coverage. The clinical condition of the patient did not improve after antibiotic therapy. A planar image from 99 mTc-dimercaptosuccinic acid cortical renal scintigraphy was performed to estimate the remaining left kidney function and shows the uptake percentages of the radionuclide by the normal right kidney (Roi 1) and by the nonfunctional left kidney (Roi 2), estimated to 4%. The miniscule remaining left renal function leads to the decision to perform total left nephrectomy.


This patient undergoes a left nephrectomy for infected urinoma with nonfunctional kidney, secondary to an obstructive calculus, calyceal rupture, and nephrocutaneous fistula. A picture of the pathological specimen of the left ureter at the level of the obstruction shows a left ureteral obstruction by a conglomerate of microstones (white arrowheads). The proximal ureter (white arrow) is surrounded by an intense chronic fibroinflammatory process while the distal ureter is normal (red arrow).


Medical image.


T1 contrast showing homogenously hypointense lesion with minimal patchy enhancement in cerebellum. T2 fluid attenuated inversion recovery showing homogenously hypertintense lesion in cerebellum.


Axial sagittal computed tomography with brain.


Bone. Windows showing a small cutaneous mass over the previous craniotomy site with an underlying bony erosion and a small right frontal intracranial component (2016 study).


Front and top view of the patient's head showing the external appearance of the cutaneous meningioma with large lateral extension and disfigurement. There are multiple scalp ulcerations.


(a-c) Axial magnetic resonance imaging with contrast from the vertex till the basal ganglia showing significant intracranial component with bilateral frontal dural attachment and severe mass effect on the frontal lobes and lateral ventricles bilaterally.


The right superomedial invasion of the orbital cavity is appreciated (d).


(a-c) Sagittal magnetic resonance imaging with contrast showing the anterior and inferior extent of the cutaneous component with the involvement of the face and right orbit.


Coronal magnetic resonance imaging with contrast showing the lateral extent of the cutaneous component (a).


Magnetic resonance venography showing complete occlusion of the anterior and middle thirds of the superior sagittal sinus (b).


Axial T2 image showing the vasogenic edema surrounding the intracranial component (c).


(a) Preoperative patient's extraoral view.


(b) Intraoperative view of the lesion.


(c) Resected surgical specimen.


(d) 12th month Postoperative extraoral view.


(a) Histopathological image of the large blood vessel (H&E stain, x40).


(b) Photomicrograph showing lymphocyte and eosinophilic leukocyte infiltration along with blood capillaries (H&E stain, x200).


Endoscopic view of larynx. Solid arrow: trachea with normal mucosa. Hollow arrow: papillomatosis in the anterior commissure of the vocal cords.


Coronal.


Sagittal. High resolution computed tomography images showing conglomerates of cystic bronchiectasis in upper lobes and thick-walled and heterogeneous sized cysts in lower lobes. In Figure 2(b) the cystic conglomerates are seen in conjunction with an accompanying and bronchiole with bronchial wall thickening.


MRI-scan two days after symptom onset. Emerging white matter lesions with slight restricted diffusion but without Gadolinium (Gd) enhancement. T1 Gd-enhanced.


MRI-scan two days after symptom onset. Emerging white matter lesions with slight restricted diffusion but without Gadolinium (Gd) enhancement. T2-FLAIR (fluid attenuated inversion recovery).


MRI-scan two days after symptom onset. Emerging white matter lesions with slight restricted diffusion but without Gadolinium (Gd) enhancement. DWI (diffusion-weighted imaging).


MRI-scan 10 days after symptom onset. Progressive widespread white matter lesions with restriction in diffusion but still unaffected blood-brain-barrier. T1 Gd-enhanced.


MRI-scan 10 days after symptom onset. Progressive widespread white matter lesions with restriction in diffusion but still unaffected blood-brain-barrier. T2-FLAIR.


MRI-scan 10 days after symptom onset. Progressive widespread white matter lesions with restriction in diffusion but still unaffected blood-brain-barrier. DWI.


MRI-scan at 1-year follow-up visit. Markedly reduced white matter lesions. Right occipital hyperintensity on T2 reflects brain biopsy area. T2.


MRI-scan at 1-year follow-up visit. Markedly reduced white matter lesions. Right occipital hyperintensity on T2 reflects brain biopsy area. T2-FLAIR.


MRI-scan at 1-year follow-up visit. Markedly reduced white matter lesions. Right occipital hyperintensity on T2 reflects brain biopsy area. DWI.


Case 1. A 38-year-old woman on oral contraceptives presented with headache and difficulty speaking. She had no other significant past medical history. A left frontal subdural hematoma (white arrows,. Was demonstrated on CT.


Case 1. A 38-year-old woman on oral contraceptives presented with headache and difficulty speaking. She had no other significant past medical history. A left frontal subdural hematoma (white arrows,. And MR imaging A hypercoagulable work-up did not reveal any additional thrombophilias.


Case 1. A 38-year-old woman on oral contraceptives presented with headache and difficulty speaking. She had no other significant past medical history. Black arrow,. And left temporal venous infarct (white arrow,. And MR imaging A hypercoagulable work-up did not reveal any additional thrombophilias.


Case 1. A 38-year-old woman on oral contraceptives presented with headache and difficulty speaking. She had no other significant past medical history. With a left transverse sinus thrombosis (black arrow,. And MR imaging A hypercoagulable work-up did not reveal any additional thrombophilias.


Case 2. A 68-year-old woman with polycythemia vera experienced a severe headache and then deteriorated to coma. At the time of craniotomy, the neurosurgeon observed a thrombosed cortical vein following evacuation of the subdural hematoma. A coronal CT head (a) demonstrates a left acute subdural hematoma (dashed arrow).


Case 2. A 68-year-old woman with polycythemia vera experienced a severe headache and then deteriorated to coma. At the time of craniotomy, the neurosurgeon observed a thrombosed cortical vein following evacuation of the subdural hematoma. CT venogram (b) is notable for the empty delta sign (solid arrow) due to intraluminal thrombus preventing normal opacification of the sagittal sinus. Genetic testing demonstrated the V617F mutation within the JAK2 gene.


Case 3. A 60-year-old male presented with one month of escalating headaches and no history of trauma or use of antiplatelets or anticoagulants. CT head demonstrated a left isodense subdural hematoma (a). This was evacuated surgically with mini-craniotomy.


Case 3. A 60-year-old male presented with one month of escalating headaches and no history of trauma or use of antiplatelets or anticoagulants. The initial imaging on postoperative day one (POD#1, b) showed excellent radiographic results.


Case 3. A 60-year-old male presented with one month of escalating headaches and no history of trauma or use of antiplatelets or anticoagulants. Repeated imaging on postoperative day 27 (POD#27, c) showed recurrence of the left isodense subdural hematoma.


Chest radiograph showing a small left-sided pleural effusion.


Bone marrow aspiration smear showing amastigote forms of Leishmania donovani (thick arrows) and plasma cells (thin arrow) (Leishman, x 1000).


Chest radiograph showing resolution of pleural effusion after one month of treatment with IV sodium stibogluconate.


CT scan: coronal reconstruction of a left lung mass (arrow).


FNAC smears showing cohesive clusters of small, uniform, ovoid to round epithelial cells (MGG, x100).


Posterior-anterior (PA) chest radiograph demonstrating bilateral infiltrates consistent with eosinophilic pneumonia.


(A) Axial T2-weighted imaging showed multiple heterogeneous hypersignal nodules with central spots of hyposignal (arrows) in the right temporal lobe and significant edema around the lesion.


(B) Axial T1-weighted imaging revealed the heterogeneous hyposignal nodules.


(C) Diffusion-weighted imaging revealed slight hyperintense nodules.


Axial.


Sagittal T1-weighted images with contrast demonstrated the enhancing nodules arising from the meninges, with significant perilesional edema.


(F) Coronal T1-weighted images with contrast showed the mass effect of the nodules, which led to the compression of the right lateral ventricle and evident midline shift.


(G) Post-operative CT showed that no nodules with a certain amount of hypodense edematous zone could be found on the right temporal lobe.


(A) Positioning image of single-voxel magnetic resonance (MR) spectroscopy.


(B) MR spectroscopy [echo time (TE) 35 ms] revealed a slightly increased choline (Cho) peak and a moderate decrease in the peaks of creatine (Cre) and N-acetylaspartate (NAA). A lipid/lactate peak was observed at 0.9 and 1.3 ppm.


(C) MR perfusion reflected that the cerebral blood flow of the nodules (arrow) was lower than that of the contralateral hemisphere, and significant low perfusion was observed in the edema area.


Histopathology showed granulation tissue with ischemic necrosis surrounded by multinucleated giant cells, plasmacytes, and lymphocytes (HE staining, original magnification x100).


A 36-year-old HIV positive male presented with a painless hard palpable "pea-size" lump in the left breast, upper outer quadrant, present for many years, increased in size over the most recent 6 months. (a) Spot compression-magnification craniocaudal view of the left breast demonstrates a small circumscribed oval mass in the upper outer quadrant of the left breast. The mass contains multiple small l dystrophic calcifications.


A 36-year-old HIV positive male presented with a painless hard palpable "pea-size" lump in the left breast, upper outer quadrant, present for many years, increased in size over the most recent 6 months. (b) Spot compression-magnification mediolateral oblique view of the left breast demonstrates a small circumscribed oval mass in the upper outer quadrant of the left breast. The mass contains multiple small dystrophic calcifications.


A 36-year-old HIV positive male presented with a painless hard palpable "pea-size" lump in the left breast, upper outer quadrant, present for many years, increased in size over the most recent 6 months. (c) Digitally magnified mediolateral oblique view of the left breast focusing on the lesion, better demonstrating the oval shape, circumscribed margins and multiple small dystrophic calcifications (white arrow).


A 36-year-old HIV positive male presented with a painless hard palpable "pea-size" lump in the left breast, upper outer quadrant, present for many years, increased in size over the most recent 6 months. (a) A color doppler ultrasound image of the lesion shows internal vascularity.


A 36-year-old HIV positive male presented with a painless hard palpable "pea-size" lump in the left breast, upper outer quadrant, present for many years, increased in size over the most recent 6 months. (b) A grayscale ultrasound image pre-biopsy better demonstrating the small hyperechoic foci of calcifications (white arrow) observed on the mammogram.


Preoperative findings. . Notes: (A) Preoperative images of the nine diagnostic gaze positions in a female patient with filamentary keratitis. Prior to surgery, hypertropia was detected in the primary gaze position of her left eye. The patient's right eye was found to have upper rotation imperfection at the inside and outside transposition.


Preoperative findings. (B) Preoperative slit-lamp examination image of the patient's left eye. The upper-third or more area of the cornea was covered to the upper eyelid due to an upper squint.


Preoperative findings. (C) A thread-like inflammation of the cornea in the upper-third area of the patient's left eye.


Preoperative findings. (D) Fluorescein staining of the left eye cornea.


Preoperative findings. (E) Hess chart shows an upward restriction on the right eye.


Postoperative findings. . Notes: (A) Images of the patient's nine diagnostic gaze positions at 3 weeks post operation. Her ocular muscles became orthophoria in the primary gaze position, and strabismus significantly decreased in all gaze directions. Her right eye performed upper rotation improved at the inside transposition.


Postoperative findings. (B) Anterior ocular segment findings in the patient's left eye at 3 weeks post operation revealed no filamentary keratitis.


Postoperative findings. (C) Fluorescein staining of the left eye cornea.


Postoperative findings. (D) Hess chart shows improvement of uplift limit of right eye.


Preoperative Xray.


CT scan.


CT scan done during CT guided biopsy.


MRI showing the tumor compressing the cord.


MRI showing the tumor arising from the D7, D8, D9 vertebral levels.


Intraoperative image showing a friable tumor mass compressing the cord.


Excised tumor mass.


Histopathological slide showing polygonal stromal cells, osteoclastic giant cells and many hemosiderin laden macrophages on high power view.


Ultrasonography showing a well-defined lobulated anechoic lesion with central echogenic nodule.


(a and b) FDG PET images showing focal increased FDG uptake in the pituitary fossa.


(a and b) CT images demonstrating mildly enhancing rounded lesion in the sella.


Fat-suppressed sagittal NMR image. Showing pituitary lesion with expanded sella pushing the optic chiasma superiorly, and ,high-resolution, T1-weighted, contrast-enhanced.


Fat-suppressed axial image. Showing enhancing sellar lesion.


Choledochal cyst imaging. Cholangiography showing the choledochal fusiform dilatation.


Choledochal cyst imaging. Magnetic resonance imaging aspect with evidence of dilatation of biliary ducts.


Histopathologic specimen. (A) H&E staining, 100x.


Histopathologic specimen. (B) Ki67 staining, 100x.


Histopathologic specimen. (C) p16 staining, 100x.


Histopathologic specimen. (D) p63 staining, 100x.


Mass of 37x35 mm detected in the left inguinal region on pelvic MRI. (A) Low signal intensity of approximately 37x35 mm detected in the left inguinal region on T1-weighted imaging (arrow).


Mass of 37x35 mm detected in the left inguinal region on pelvic MRI. (B) High signal intensity of approximately 37x35 mm detected in the left inguinal region on T2-weighted imaging (arrow).


Mass of 33x33 mm detected in the left inguinal region on pelvic MRI. (A) Low signal intensity of approximately 33x33 mm detected in the left inguinal region on T1-weighted imaging (arrow).


Mass of 33x33 mm detected in the left inguinal region on pelvic MRI. (B) High signal intensity of approximately 33x33 mm detected in the left inguinal region on T2-weighted imaging (arrow).


Clinical appearance of a solid rubbery nodular tumor on the right foot arch, before the initial surgical excision.


Histologic features: elongated neoplastic cells arranged in interconnected fascicles with a plexiform pattern (A). Hematoxylin-eosin, x100.


Ovoid and round neoplastic cells intermixed with osteoclast-like giant cells and hemosiderin deposition (B). . Hematoxylin-eosin, x200).


Preoperative view and design of the excision with 2 cm margins (A).


Early postoperative result after skin graft coverage of the defect (B).


Long-term postoperative view of the operated area 52 months after the wide excision and skin grafting.


A; The left shin showing ulcerated lesions prior to initiation of triple combination therapy with rifaximin, gentamicin and metronidazole.


B; The left shin showing completely healed lesions after 4 weeks of triple combination therapy with rifaximin, gentamicin and metronidazole.


Intraoral view showing the tumor in the left lower lip.


Ligation of the peduncle.


Excised tumor.


Surgical site postexcision showing the defect.


Grossing.


Spindle cells dispersed in connective stroma (H&E, x4).


Streaming fascicles of spindle-shaped Schwann cells having wavy nuclei (H&E, x20).


Antoni A: Cellular region - Nuclei palisaded arrangement around central acellular eosinophilic areas - Verocay bodies (H&E, x40).


Face lesions before treatment (at admission).


Thorax lesions before treatment (at admission).


Torso lesions before treatment (at admission).


Face lesions at discharge (23rd day of burn unit).


Thorax lesions at discharge (23rd day of burn unit).


Torso lesions at discharge (23rd day of burn unit).


(a) A non-contrast axial CT scan shows a large left-sided retroperitoneal hematoma (arrows) extending from T12 to L4 levels, and measuring 9.2 x 6.8 cm.


(b) A sagittal T2-weighted MR image shows the paraspinal vascular lesion (arrowhead), and a hematoma in and around the left psoas muscle (black arrows) resulting from rupture of the left L1 feeding-artery aneurysm (thin arrow).


(a) A 3D CT angiography reveals large aneurysms originating from the left T11, T12, and L1 segmental arteries (arrows).


(b) Sagittal T2-weighted MR showing a paraspinal vascular malformation with multiple flow-voids, and a direct communication (arrow) between the malformation and a T12 high-flow artery aneurysm.


Post-embolization angiogram (unsubtracted view) showing the mass of coils in the L1 segmental artery (arrow), and Onyx-34 in the aneurysms originated from T11, T12, and L1 segmental arteries.


MR images obtained at 6 months after embolization. Axial T2-weighted MR image showing increased signal on T2 in the left paraspinal region from numerous flow-voids largely resolved secondary to embolization.


Digital subtraction angiogram 6 months following embolization, showing a residual vascular malformation in the paraspinal muscles with a feeding artery coming off the left T11 segmental artery.


Numerous polyps in the colon of case 2.


Dome-shaped tumor mass of the connective tissue separated from the surface epithelium by a band of collagen. The pigmented tumor is poorly circumscribed. H&E stain, 40x magnification.


A) Coarse melanin granules obscure the epithelioid cell membranes. Intermingling of dense collagen bundles produces a checker board appearance.


B) Epithelioid cells shown little pigmentation around the periphery of the cytoplasm. They also show a prominent nucleus and occasional dot-like nucleoli. The cell membranes are indistinct. H&E stain, 200x magnification.


Duodenal mucosa with moderately villous atrophy.


Coronal fused single photon emission computed tomography-computed tomography.


Axial computed tomography.


Single photon emission computed tomography.


Fused single photon emission computed tomography-computed tomography. Images showing mild tracer uptake in the upper abdomen within a rounded, smoothly marginated mass arising from the greater curve of the gastric body (arrow).


Axial.


Coronal. 18F- FDG PET/CT scan showing significant 18-FDG uptake within the gastric mass.


Abdominal computerized tomography (CT) scan with intravenous contrast. Results A and B showed extensive colonic intramural air (pneumatosis intestinalis) prominently involving the ascending colon with significant and potentially life-threatening severe dilation of the entire colon, maximally measuring 6.78 cm in diameter without evidence of free air.


Gross examination of the resected colon. Segment of rectum measuring 15 cm in length and approximately 4.5 cm in average diameter with mucosa demonstrating diffuse necrosis.


Gross examination of the resected colon. Area of dilatation identified at the distal end of the resected rectum measuring up to 7 cm in average diameter (arrowhead).


Microscopic examination showing areas of intestinal endometriosis (H&E stain). Histopathologic examination demonstrating colonic mucosa with endometrial glandular epithelium (black arrow) and endometrial stroma (red arrow) within the submucosa and muscularis propria. Microscopic images were examined at A - 25x; and B - 100x, respectively.


Mobile larvae completely obstructing left external ear canal.


Appearance of live larvae.


Right.


Left eye visual field before LP shunt insertion. Right and left eye Visual field after LP shunt insertion. Visual field testing results obtained showed dramatic improvement of the preprocedural visual field defects.


(a and b) T1 and T2 weight MR images from the sellar region following Lumbar-Peritoneal shunt procedure shows a reversal of chiasmatic herniation and reduction in the degree of empty sella turcica.


A 9-year-old boy presenting with papillary growths on the forehead, inner canthus of eye, left angle of mouth and on vermilion border of lip.


Coalesced linear occurring lesions showing bleeding.


Intraorally small flat lesion on right buccal mucosa.


A 65-year-old man immediately after a corneal trauma caused by an olive leaf (: Large inferior trauma between 2, and ,6 o'clock.


After 2 days.


After 3 days of treatment).


Cardiac magnetic resonance imaging (MRI) with gadolinium contrast: evidence of delayed hyper enhancement (arrow) in both the basal and inferolateral left ventricular regions.


Decreased uptake in the inferolateral and apical ventricular myocardium, which was reversible during stress (reverse distribution) shown on Technetium99m sestamibiscintigraphy myocardial perfusion study.


Clinical photograph showing the melanotic gingival enlargement in the maxillary left quadrant.


The lesion covering the entire buccal surfaces of the teeth and also partially covering the occlusal surface of the first molar.


Photomicrograph showing acanthosis and parakeratosis of the surface epithelium as well as linear melanocytic hyperplasia in the basal layer. Benign melanocytes are seen in parabasal layers, and there is evidence of melanophagic activity.


Photomicrograph highlighting the dendritic morphology of the melanocytes, which are seen extending above the basal layers (Masson-Fontana, 400x).


Postoperative clinical appearance of the site after 4 weeks.


Yellow, greasy, coarse, clinging crusts at the apex of the scalp on physical examination.


A new lesion arised near the first one.


The crust was removed with mineral oil, exposing a clean erythematous ulcer with bloody discharge.


Photomicrograph (hematoxylin and eosin stain; original magnification x100) showing cells with elongated spindle-shaped nuclei (Antoni A type) and also homogenous acellular areas (Verocay bodies).


Abdominal CT scan: A large, low-attenuation gastric mass.


Macroscopic features: a well-circumscribed nodular lesion with a yellow, greasy, and cut-surface.


The tumor is made of an adipocytic proliferation showing a significant variation in cell size, with many branched capillaries in a fibromyxoid background (HEx100).


Lipoblasts are present within the adipocytic proliferation (HEx400).


Histological features of angiosarcoma of the bladder. A, B. Low-power view of an invasive, high-grade spindle-cell neoplasm infiltrating through the bladder wall (HE, 50X).


Histological features of angiosarcoma of the bladder: A, B. Morphological features including spindle and epithelioid pleomorphic cells (HE, 200X).


C, D. High-power view of anastomosing blood-filled channels lined by atypical, hyperchromatic, endothelial cells (HE, 100X and 400X).


Prostatic acinar adenocarcinoma (HE, 50X).


Immunohistochemical stains: Diffuse expression of CD31.


CD34. In tumor cells (IHC, anti-CD31 and anti-CD34 Abs, 200X).


Weak expression of CK AE1/AE3.


Negative p63. In neoplastic cells (IHC, anti-cytokeratin AE1/AE3 and anti-p63 Abs, 100x and 200X, respectively).


Preoperative intraoral picture.


Preoperative orthopantomograph.


Preoperative computed tomography scans (axial view).


Intra-operative picture.


Enucleated mass.


Follow-up orthopantomography showing corrected eruption axis of canine.


(A) ANA aspect of Case #1. IIF on Hep-2 (1/80) revealed presence of rare isolated cytoplasmic islets (1), homogenous staining (2), multiple nuclear dots pattern (3) and anti-Golgi apparatus pattern (4).


(B) Radiographic imaging of Case #2. Thoracic computed tomography scan revealed bilateral interstitial lung disease with lower lung predominance, thickened alveolar septa, condensations, and traction bronchiectasis.


Biological follow-up and treatment of Case #2. The full curve represents the regression of anti-MDA5 antibodies titers (expressed as relative intensity) and the dotted curve the evolution of serum ferritin level. Five plasma exchanges were performed (arrows), preceded and followed by cyclophosphamide infusions (depicted with stars). MDA5, melanoma differentiation-associated gene 5.


Clinical picture of corneal endothelial graft rejection at baseline. . Note: Slit lamp biomicroscopy with anterior segment photography at a magnification of x16 shows intense conjunctival hyperemia and severe corneal edema with diffuse Descemet's folds.


Confocal microscopy image at baseline. . Note: Confocal microscopy image shows increased number of dendritic cells.


Clinical picture of corneal endothelial graft rejection 1 month after the injection. . Note: Slit lamp biomicroscopy with anterior segment photography at a magnification of x16 shows conjunctival hyperemia recovery and improvement in corneal transparency.


Clinical picture of corneal endothelial graft rejection 3 months after the injection. . Note: Slit lamp biomicroscopy with anterior segment photography at a magnification of x16 shows full recovery of corneal transparency with few residual Descemet's folds not involving visual axis.


Confocal microscopy image 3 months after the injection. . Note: Confocal microscopy image shows dendritic cell number within the physiological range.


CT showing a soft tissue mass from the right nasal cavity extending to the posterior ethmoid air cells. Inflammatory changes are present to the right sphenoid sinus.


Intraoperative photograph showing the lesion arising from the middle turbinate.


Bilateral optic disc swelling with retinal hyperemia (optic disc hyperemia and vascular tortuosity) and diffuse intraretinal hemorrhage.


Slit lamp examination photographs of the right eye preoperatively.


Postoperatively.


Those of the left eye preoperatively.


Changes in the AS-OCT images before and after the cataract surgery, and after Descemet stripping endothelial keratoplasty. All images of each eye [right eye: preoperative.


Changes in the AS-OCT images before and after the cataract surgery, and after Descemet stripping endothelial keratoplasty. Postoperative.


Changes in the AS-OCT images before and after the cataract surgery, and after Descemet stripping endothelial keratoplasty. After DSAEK.


Changes in the AS-OCT images before and after the cataract surgery, and after Descemet stripping endothelial keratoplasty. Left eye: preoperative.


Changes in the AS-OCT images before and after the cataract surgery, and after Descemet stripping endothelial keratoplasty. After DSAEK ] are acquired for the same slice thickness at which the iridocorneal contact is most severe. AS-OCT, anterior segment optical coherence tomography; DSAEK, Descemet stripping automated endothelial keratoplasty.


Preoperative computed-tomography images. Computed tomography of a horizontal dislocation and b coronal dislocation showing a large mass in the pericardium anterolateral to the main pulmonary artery (A).


Preoperative computed-tomography images. Horizontal dislocation also showed a mass in the posterior mediastinum posterior to the bronchi (B). PA pulmonary artery.


Intraoperative picture. A large tumor can be seen anterolateral to the main pulmonary artery (T). Ao ascending aorta, RV right ventricle.


Picture of the en bloc resected tumors. Two large masses were anterolateral to the main pulmonary artery, and one small mass was adjacent to the right ventricle. All of them were soft and mucinous.


Postoperative computed-tomography images. Computed tomography showed that the pericardial tumor was almost totally resected and there was no evidence of recurrence.


Results of immunohistochemical analysis for immunocompetent cells. Paraffin-embedded tissue samples from the patient were stained with CD4.


Results of immunohistochemical analysis for immunocompetent cells. , CD8.


Results of immunohistochemical analysis for immunocompetent cells. , CD1a.


Results of immunohistochemical analysis for immunocompetent cells. , HLA-DR.


Results of immunohistochemical analysis for immunocompetent cells. , CD68.


Results of immunohistochemical analysis for immunocompetent cells. , CD163.


Results of immunohistochemical analysis for immunocompetent cells. , IL-17A.


Results of immunohistochemical analysis for immunocompetent cells. And Foxp3 CD8+ cells, instead of CD4+ cells, and HLA-DR+-activated T cells densely infiltrated into the epidermis of the erythematous lesion. CD1a+ Langerhans cells were decreased in number. While CD68+ macrophages densely infiltrated into the upper dermis, there was only slight infiltration of IL-17A+ cells and Foxp3+ cells. Bar = 250 mum.


Cervical CT with contrast. Sagittal.


Axial).


MRI. Sagittal, and . MRI. Sagittal.


Axial) shows a longitudinally oriented epidural enhancing soft-tissue mass lesion occupying the left side of the spinal canal opposite C2 down to the C7 vertebra. . Axial) shows intraspinal epidural and paraspinal avidly enhancing cervical lesions with multiple neural foraminal extensions and cord compression, which was most severe at C5.


Contrasted cervical CT. Sagittal.


Axial) during the CT-guided biopsy, preprocedure scan demonstrated improvement of the prevertebral tissue, likely related to steroids treatment. Due to the lack of enough safety margin to perform biopsy, the procedure was cancelled.


Repeated cervical MRI. Sagittal.


Axial), showed the lesion response to the steroids more profoundly.


The cervical spine MRI. Sagittal.


Axial) was repeated after 2 weeks from the previous MRI [Figure 2] while stopping the steroids and showed a significant recurrence.


(1) Low magnification - H&E stain (a) shows a well- demarcated granuloma.


(2) High magnification - H&E stain (b) the granuloma consists of epithelioid histiocytes and mature lymphocytes.


On mammograms the lesion was dense with radiolucent areas inside which were thought to be compatible with fat.


On sonographic imaging the lesion had smooth contours and was hypoechogenic with large hyperechoic components in between.


Cut surface of the material revealed, a yellow colored, elastic, firm mass with relatively well-defined lobulated contours.


(a) The lesion is composed of two to three cell layers thick, benign mammary duct epithelium lining the slit-like spaces, and a cellular spindle cell stroma.


(b) The cellular mesenchymal stromal elements protrude into cyst-like spaces in a leaf-like configuration.


(a) Adipose tissue contained a significant number of bizarre cells; with a large cytoplasm and a lobulated nucleus.


(b): These cells were evaluated as "pleomorphic lipoblasts (arrow).


Clinical presentation of Case #1: Preoperative CT-scan (A) of the tumour in the lower left abdominal wall.


Macroscopic presentation of the surgical specimen (B); central parts of the tumour are well delimited ('core'); the path of the primary laparoscopy is visible. The tumour infiltrated the abdominal skeletal muscles but did not extra into the abdominal cavity.


Histopathology of Case #1: The tumour shows patches of higher differentiated atypical lipomatous tissue.


But mostly displays only poorly differentiated spindle-shaped cells.


Prominent areas with myofibroblastic morphology were noticed.


Immunohistochemistry was positive for Desmin. And Actin.


Higher differentiated areas. HE-staining of corresponding region).


Molecular hallmarks of Case #1: Immunohistochemistry demonstrates co-overexpression of CDK4.


MDM2. In both the poorly.


Fluorescence in situ hybridisation shows strong amplification of the MDM2 locus as underlying genetic alteration (D; Green: MDM2 probe, Red: Chromosome 12 reference probe). The features are characteristic of dedifferentiated liposarcoma.


Corneal graft melting. . Note: Corneal graft melting observed when patient came to the emergency ward.


Corneal graft perforation with iris prolapse. . Note: Corneal graft melting rapidly progressed to corneal perforation with iris prolapse although given the systemic and topic broad-spectrum antibiotic therapy.


Corneal ulcer before study treatment. . Note: Corneal ulcer affected epithelium, Bowman membrane, and anterior stroma with a longest linear diameter equal to 7 mm and a greatest perpendicular width equal to 5 mm.


Confocal microscopy analysis of corneal ulcer before study treatment. . Note: Confocal microscopy analysis showed no nerve regeneration and stromal inflammation in corneal graft.


Corneal ulcer after 2 weeks of study treatment (V2). . Note: Corneal ulcer improved after therapy with a partial healing >50% already in V2.


Corneal ulcer healing after 4 weeks of study treatment (V4). . Note: Corneal ulcer completely healed in V4.


Confocal microscopy analysis of the cornea after 4 weeks of study treatment (V4). . Note: Confocal miscroscopy showed complete resolution of stromal inflammation in V4.


A periodontal pocket of 7 mm on distal aspect.


A periodontal pocket of 8 mm on distal aspect.


Radiograph showing infrabony defects distal to 46 and 47.


A flap extended to one tooth on either side for adequate reflection.


A defect of 7 mm distal to 46 seen on surgical exposure.


A defect of 8 mm distal to 47.


A; Hematoxylin and eosin. X100. The neoplasm infiltrates through the dermis and is associated with hemorrhage.


B; Hematoxylin and eosin. X400. Irregular vascular spaces are lined by layers of cytologically malignant epithelioid endothelial cells that have amphophilic cytoplasm, large vesicular nuclei with prominent nucleoli.


C; CD31. X400. Immunohistochemical stain for CD31 stains neoplastic endothelial cells in a membranous pattern.


A 43-year-old male with 12 years history of scalp folliculitis that progressed into AKN. BMI 35 kg/m2. Fitzpatrick skin type 5. (A) Initial dermatology assessment. Dissecting scalp folliculitis; recommended rifampin (300 mg oral BID), clindamycin (300 mg oral BID), clindamycin lotion daily and triamcinolone cream.


A 43-year-old male with 12 years history of scalp folliculitis that progressed into AKN. BMI 35 kg/m2. Fitzpatrick skin type 5. (B) AKN with firm thickened scarring on occipital scalp, areas of crusting, no active drains. Recommended doxycycline (100 mg oral BID), rifampin (300 mg oral BID), lidex solution and clindamycin lotion BID and intralesional injections of triamcinolone.


A 43-year-old male with 12 years history of scalp folliculitis that progressed into AKN. BMI 35 kg/m2. Fitzpatrick skin type 5. (C) Progression of AKN lesion. Pink, firm thickened scarring plaques and purulent drainage. Patient continued follow-up in Dermatology clinic for 15 months and treated with Isotretinoin (40 mg oral daily) and additional intralesional injections of triamcinolone.


A 43-year-old male with 12 years history of scalp folliculitis that progressed into AKN. BMI 35 kg/m2. Fitzpatrick skin type 5. (D-F) Preoperative assessment by Plastic Surgery. A 12 x 12 cm occipital infected fibrotic mass with multiple ingrowing hairs and points of purulent drainage.


Post-excisional course. (A) Postoperative day 4; first postoperative assessment in outpatient clinic.


Post-excisional course. (B) Postoperative day 39; open wound getting significantly smaller, more superficial and well vascularized.


Post-excisional course. (C) Postoperative day 49; local condition during the second surgical procedure. Open area still reducing in size, smooth and well vascularized granulation tissue with small area of epidermal cells spreading out on surface.


Post-excisional course. (D) Six days after second surgery with the bolster dressing in place. Skin graft was harvested from upper back.


Post-excisional course. (E) Meshed split thickness skin graft after dressing removal the same day.


Post-excisional course. (F) Long term follow-up 3 months after skin graft.


A 65-year-old male with history of AKN for at least 9 years. BMI 27 kg/m2. An 18 x 8 cm fluctuant AKN lesion on the occipital area with multiple ingrowing hairs, hemorrhagic crusts, cysts and purulent drainage from several sites. Fitzpatrick skin type 5. (A) Initial assessment in outpatient clinic.


A 65-year-old male with history of AKN for at least 9 years. BMI 27 kg/m2. An 18 x 8 cm fluctuant AKN lesion on the occipital area with multiple ingrowing hairs, hemorrhagic crusts, cysts and purulent drainage from several sites. Fitzpatrick skin type 5. (B) Postoperative day 6 of 18 x 8 cm AKN excision.


A 65-year-old male with history of AKN for at least 9 years. BMI 27 kg/m2. An 18 x 8 cm fluctuant AKN lesion on the occipital area with multiple ingrowing hairs, hemorrhagic crusts, cysts and purulent drainage from several sites. Fitzpatrick skin type 5. (C) Postoperative day 22; wound getting smaller, more superficial and well vascularized. Dark spot in the middle corresponds to overlying tissue of suture ligation of large arterial perforator.


A 65-year-old male with history of AKN for at least 9 years. BMI 27 kg/m2. An 18 x 8 cm fluctuant AKN lesion on the occipital area with multiple ingrowing hairs, hemorrhagic crusts, cysts and purulent drainage from several sites. Fitzpatrick skin type 5. (D) Postoperative day 51; intraoperative view prior to skin graft procedure.


A 65-year-old male with history of AKN for at least 9 years. BMI 27 kg/m2. An 18 x 8 cm fluctuant AKN lesion on the occipital area with multiple ingrowing hairs, hemorrhagic crusts, cysts and purulent drainage from several sites. Fitzpatrick skin type 5. (E) Initial dressing on day 6 after placement of split thickness skin graft.


A 65-year-old male with history of AKN for at least 9 years. BMI 27 kg/m2. An 18 x 8 cm fluctuant AKN lesion on the occipital area with multiple ingrowing hairs, hemorrhagic crusts, cysts and purulent drainage from several sites. Fitzpatrick skin type 5. (F) Local condition one month after skin graft.


A 30-year-old male, BMI 48.5 kg/m2, Fitzpatrick skin type 5, giant AKN. (A) Intraoperative view of 25.5 x 15 cm 'keloid-type' lesion treated with wide local excision, complex partial wound closure and split thickness skin graft. Specimen weight: 815 g.


A 30-year-old male, BMI 48.5 kg/m2, Fitzpatrick skin type 5, giant AKN. (B) Initial dressing change. Donor site and STSG during first postoperative visit in outpatient clinic (postoperative day 6). Partial take of the skin graft treated with local care and systemic antibiotics. Of note, there are multiple skin openings on the area from underlying epidermal inclusion cysts; superficial biofilm also noticed.


A 30-year-old male, BMI 48.5 kg/m2, Fitzpatrick skin type 5, giant AKN. (C) Long-term follow-up (postoperative day 61). Local condition on grafted area and donor site.


Pathology assessment of case No. 1. (A) Cross section of surgical specimen. Multiple, ragged, necrotic, hair-bearing lesions ranging from 0.1 x 0.1 x 0.1 cm to 6.5 x 5.2 x 4.3 cm, spanning the skin surface.


Pathology assessment of case No. (B) Details of necrotic, hair-bearing intralesional cavities.


Pathology assessment of case No. (C) Widened hair follicle surrounded by dense inflammatory process and dermal fibrosis, and overlying scale crust; 20x magnification.


Pathology assessment of case No. (D) Scattered hair shafts within a fibrotic dermis and dense acute and chronic inflammation; 40x magnification.


Barium swallow picture in full phase.


Mucosal relief phase. Shows smooth long segment stricture involving the upper and mid-thoracic esophagus. Note the tertiary contractions in the lower half of the esophagus.


Composite photomicrographs. (a) Lesion with superficial epithelium and connective tissue stroma with numerous amelobastic follicles (x4 OM.


Composite photomicrographs. (b) Follicle showing ameloblast-like cells, stellate reticulum and dentinoid tissue (x10 OM.


Composite photomicrographs. (c) Numerous ameloblastic follicles seen with interspersed dentinoid-like material (x10 OM.


Composite photomicrographs. (d) Dentinoid secreted by odontoblast (x40 OM*). *Original magnification.


Fundus photographs at the initial visit in a 15-year-old boy with AMN. There are no specific abnormalities in the right eye (a).


Fundus photographs at the initial visit in a 15-year-old boy with AMN. There is a slightly darker area in the fovea of the left eye (b).


Axial, coronal, and sagittal images of a plain CT head show gyriform calcification in the right parietal cortex. Associated volume loss in the parietal lobe is noted.


Axial, coronal, and sagittal images of a contrast-enhanced MRI reveal focal enhancement with the right parietal sulci.


Preoperative CT investigation with. Non-enhanced.


Arterial phase.


Venous phase.


Delayed phase images.


Preoperative MR investigation with. T1 weighted.


T2 weighted.


Arterial phase images.


Diffusion-weighted imaging.


Gross examination: cut off surface of angiosarcoma lumpectomy.


Micrography showing vascular proliferation dissecting the mesenchymal breast tissue (x10).


Micrography showing a papillary pattern of the angiosarcoma with high nuclear pleomorphism.


Immunohistochemical profile of our case.


Deep ulcer on lateral border of tongue with no exophytic growth.


Excessive keratin flakes seen in superficial epithelium with keratin filled crypts (x10).


Low magnification shows networking or anastomosing cords of epithelial proliferation (x5).


Keratin pearls in the connective tissue ,keratin plugging seen in the deeper portions of crypt. (x10).


Photograph of the ulcerative mucosal lesion of the lower left lip before treatment.


Placement of metal needles according to the Paris system is assisted by clear plastic templates held in place by a metal frame.


Stabilization of BT catheters using radiolucent buttons in the LL.


Simulation of HDRIB with 192Ir for irradiation of the patient's tumour.


Two-year post-treatment result, indicating mild atrophy and hypopigmentation. The patient was pleased with the aesthetic result.


Dermolipoma on superotemporal aspect of the limbus.


Magnetic resonance imaging brain showing left hemiatrophy T2 image.


Magnetic resonance imaging brain showing left hemiatrophy coronal image.


Magnetic resonance imaging showing arachnoid cyst.


Magnetic resonance imaging of brain showing occipital polymicrogyria.


Pre-operative anterior-posterior X-ray view of the pelvis.


Proximal lateral X-ray view of the femur. Demonstrating a large, aggressive appearing lesion with mixed lytic and blastic features with a thin cortical rim over the margin medially about the proximal right femur.


Pre-operative coronal T1-weighted magnetic resonance imaging (MRI).


Coronal T2-weighted MRI. Of the pelvis demonstrating an aggressive lytic appearing lesion near the inferomedial femoral neck and lesser trochanter extending through the cortex with a softtissue mass of approximately 6cm in size. The soft tissue mass abuts the iliopsoas and vastus musculature appearing to cause an adjacent mass effect.


(a and b) High-power photomicrographs from curettage specimen stained with hematoxylin and eosin demonstrating proliferation of relatively uniform large polygonal cells (black arrow) with eccentric round nuclei and abundant eosinophilic cytoplasm. These cells were associated with the formation of new woven bone (white arrow) seen growing in large sheets.


Imaging at 1-year follow-up with anterior-posterior X-ray view of the right femur.


Proximal lateral X-ray view of the right femur. Confirmingthe placement of the short cephalomedullary intramedullary nailwith bony union. No hardware complications or lesion recurrence present.


Clinical manifestations and treatment response of the patient. A; Before treatment, multiple, variably sized, coalescent, pruritic erythematous urticarial papules and plaques on the thigh are shown.


Clinical manifestations and treatment response of the patient. B; Seven days later, both subjective and objective improvements of symptoms were noticed.


Clinical manifestations and treatment response of the patient. C; After the second session, almost total relief of subjective symptoms and moderate postinflammatory hyperpigmentation were noted on follow-up 12 days later.


Skin erythema migrans seen in the present patient (The photo was kindly provided by the patient).


Anti-Borrelia antibodies detected by recomLine Borrelia IgG and IgM strip immunoassays (Mikrogen Diagnostik, Neuried, Germany). Sera 2055 and 2056 were collected in July and August 2017, respectively. The patient's sera reacted to various recombinant antigens as follows; p100 (93 kDa antigen), VlsE, p41 (41 kDa antigen, Flagellin), p39 (BmpA), OspCs (21-24 kDa antigen), and p18 (18 kDa antigen). The test result suggested the patient was serologically IgM and IgG positive for Lyme disease (https://www. mikrogen. de/uploads/tx_oemikrogentables/dokumente/GARLBB007EN. pdf). The patient also tested IgM positive for Lyme disease by the Center for Disease Control and Prevention recommendations. . Note: Recommended reading: Test Performance and Interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease. MMWR. 1995;44(31):590-591. . Abbreviations: IgG, immunoglobulin G; IgM, immunoglobulin M.


(a and b) 2 cm sized erythematous semi-transparent bullae with a white nodule inside.


Photograph of a bouncy ball.


Gross specimen of excised material.


Family pedigree.


Large fourth ventricle mass consistent with medulloblastoma.


Surveillance colonoscopy showing multiple sessile polyps in the entire colon with histologic evidence of dysplasia.


Aggressive angiomyxoma in 37-year-old woman. . A. Unenhanced CT image shows large abdominal mass (stars) being hypo-attenuated in relation to surrounding muscular tissue.


Aggressive angiomyxoma in 37-year-old woman. B. Contrast-enhanced CT image shows large homogeneous abdominal mass (stars). It directly invades inferior vena cava (long arrow), causing obstruction of inferior vena cava and formation of periaortic venous collaterals (short arrow).


Aggressive angiomyxoma in 37-year-old woman. C. Coronal reconstruction image from contrast-enhanced CT shows mass encasing colon (long arrow) and causing portion of loop of small bowel to deviate superiorly (short arrow).


Aggressive angiomyxoma in 37-year-old woman. D. Coronal reconstruction image from contrast-enhanced CT shows inferior vena cava filling defect (long black arrow) extending superiorly to level of right atrium (short black arrow). Image also shows prominent enhancing nodules within inferior vena cava (black arrowheads) and collateral vessels around aorta (white arrow).


Aggressive angiomyxoma in 37-year-old woman. E. Contrast-enhanced CT image shows heterogeneously enhancing mass in left lower lobe (long arrow) and apparent inferior vena cava filling defect (short arrow).


Aggressive angiomyxoma in 37-year-old woman. F. Low-power view shows vascular appearance of tumor, against myxoid, hypocellular background.


Aggressive angiomyxoma in 37-year-old woman. G. Medium-power view shows bland cytological appearance of spindle cells.


(a) MRI, T1W image showing hypointense lesion in the left frontal lobe.


(b and c) showing peripheral enhancement on contrast administration.


The vessels showing perivascular infiltrate of lymphocytes and neutrophils causing wall destruction. H and E, x100.


MR angiography in the postoperative period shows focal narrowing of vessels in the left frontal region, indicating vasculitis.


Clinical photo.


Adequate mouth opening post treatment.


Color fundus photograph of the right eye showing normal macula.


Color fundus photograph of the left eye showing one smooth bulging in the subretinal layer in macular region.


FFA - In AV phase, showing a small dot of dye leaking from superior parafoveal region.


FFA - Late phase showing extensive dye leakage in the same zone giving a characteristic "Smokestack" pattern.


Patient phenotype. . Notes: (A) Coarse facial features, AFA, low anterior hairline, synophrys, long eyelashes, epicanthic folds, broad lips, bulbous nose, and broad mouth. Phenotypic similarities with CS.


Patient phenotype. (B) Generalized hypertrichosis predominantly on back and extremities. . Abbreviations: AFA, acromegaloid-like appearance; CS, Cantu syndrome.


Schematic representation of TTC19 gene (GenBank accession no. NM_017775.3). The blue boxes indicate exons. Novel (shown in red) and previously reported mutations are shown.


Sequence chromatograms of. Parents.


The patient. The arrow indicates the site of the causative mutation.


18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) detected the presence of an FDG-avid tumor (arrow) in the ascending colon.


Peritoneal nodules (arrowheads).


(C) A biopsied peritoneal nodule showed epithelioid cell granuloma with partial necrosis on hematoxylin-eosin staining.


(D) Abdominal CT showed a thickened peritoneum with massive ascites at the onset of tuberculosis peritonitis.


Before treatment.


After treatment.


PET/CT image showing hyperdense lesions in the anterior and posterior right thigh. Views are anterior.


PET/CT image showing hyperdense lesions in the anterior and posterior right thigh. And right lateral.


Surgical resection of the posterior thigh mass.


Ultrasonographic view.


Computerized tomography scan.


Frozen section material.


Foci of squamous cell carcinoma. HE. x5.


Atypical mitotic figures and giant cells with storiform pattern-clustered and scattered polygonal cells to spindle cells with markedly pleomorphic characteristics (inflammatory cell infiltration).


Cells show CD68 positivity on immunohistochemistry.


Edema of the penis and scrotum.


Reduction of the edema.


Intraoperative ultrasound revealing a 2 cm heterogeneous right-sided mass consistent with an abnormal right upper parathyroid gland.


Photomicrographs of the resected parathyroid gland showing multiple endothelium-lined intercommunicating vascular channels filled with blood (capillary hemangioma-like proliferation) without evidence of endothelial atypia or mitotic activity and atrophy of the adjacent tissue (H&E, 20X).


(A) Erythema and lots of tiny pustules on the abdomen.


(B) Many pustules on the basis of erythema on the lower abdomen.


(A) Lots of tiny pustules on the trunk.


(B) Many tiny pustules and some scales on the upper limbs.


Multiple, 1-2-mm, hyperpigmented papules on the flexor aspect of forearm.


Bone marrow eosinophilia. A representative Wright-Giemsa stain, (x400) of bone marrow aspirate smears from case 1. Notice the presence of various immature eosinophils, including eosinophilic band and Polymorphonuclear eosinophils.


Bone marrow eosinophilia. A representative Wright-Giemsa stain, (x400) of bone marrow aspirate smears from case 1. , as well as eosinophilic myelocyte and eosinophilic metamyelocyte.


The clinical course of case 1. The X axis indicate the time (days). AZA, azacitidine; WBC, white blood cells; PLS, prednisolone.


The clinical course of case 2. The X axis indicate the time (days). WBC, white blood cells; PLS, prednisolone.


Representative images of periodic acid methenamine silver staining (high magnification) of renal specimen from patient 2 showing duplication of the capillary wall consistent with membranoproliferative glomerulonephritis.


Preoperative photograph (complete adhesion of tongue to floor of the mouth and 1 cm mouth opening).


Intraoperative photograph of skin graft placed at buccal mucosa after excision of fibrous bands.


Intraoperative photograph of skin graft placed at ventral surface of the tongue after releasing tongue adhesion with the floor of the mouth.


Postoperative photograph with improved mouth opening.


Preoperative photograph.


Postoperative photograph.


Intraoperative photograph.


Preoperative radiograph.


Postoperative radiograph.


Clinical photomicrograph showing a lobulated soft mass on the hard palate region.


Histological stained section reveals infiltration of macrophages with abundance of acid fast bacilli.


Histological stained section using ZN stain shows the acid fast bacilli.


Histological section showing intense infiltration of macrophages, lymphocytes and plasma cells and Grenz zone that seperates the epithelium and connective tissue.


Eosinophil and neutrophil percentages with references according to day. Day 0 indicates the day before treatment with piperacillin/tazobactam, and day 1 indicates the first day of treatment. AGEP: acute generalized exanthematous pustulosis, DRESS: drug-related rash with eosinophilia and systemic symptoms.


CT urogram showing filling defect in the left lower pole calix.


Filling defect in the left lower pole calix in retrograde pyelography.


Subepithelial corneal edema, with deep stromal infiltration.


Central leukoma of 1mm, with sectoral iris atrophy.


I; It was possible to obtain a specular microscopy reading unlike the first day.


Precontrast.


Postcontrast. Axial T1-weighted magnetic resonance images of the lower extremity demonstrate the presence of a well-circumscribed, mildly heterogeneously enhancing mass in the location of the right sciatic nerve (arrows).


Intraoperative photograph at open biopsy showing the hypertrophic, firm, and bulbous sciatic nerve.


Timeline of patient's care.


Pathological aspect of the rectal Kaposi's sarcoma. A; Microscopic aspect of the biopsy of rectal ulceration: the rectal mucosa is infiltrated by an ill-defined cellular fasciculated to diffuse proliferation (HES x10).


Pathological aspect of the rectal Kaposi's sarcoma. B; Microscopic aspect showing spindle cells with little to moderate nuclear atypia surround vascular clefts. Few mitoses are noted. Lymphocytes and plasma cells are admixed (HES x40).


Pathological aspect of the rectal Kaposi's sarcoma. C; IHC with ERG antibody: the lining cells of vascular structures and spindle cells express the ERG endothelial marker (x20).


Pathological aspect of the rectal Kaposi's sarcoma. D; IHC with HHV8 antibody: see the nuclear positive immunostaining of spindle tumor cells (x40).


(a) Axial noncontrast head computer tomography showing significant bilateral frontal horn, third and fourth ventricular hemorrhage.


(b) Sagittal noncontrast head computer tomography showing third and fourth ventricular hemorrhage. The lateral ventricles are not well visualized here, but some intraventricular hemorrhage is still seen.


Magnetic resonance imaging brain, sagittal T1-WI with contrast shows a large sellar mass with suprasellar extension. Mass measures 3.5 cm x 1.7 cm.


Magnetic resonance imaging sella, sagittal T1-WI with contrast shows a large, enhancing sellar/suprasellar mass extending into the third ventricle. Significantly enlarged compared to prior imaging, no measuring 5.7 cm x 2.9 cm.


Magnetic resonance imaging sella, coronal T1-WI with contrast shows the mass now extending into the bilateral cavernous sinuses, right greater than left, and encasing the internal carotid arteries.


Axial T2.


Coronal.


Axial fluid-attenuated inversion recovery. Magnetic resonance images showing rounded hyperintense area in the right subcortical frontal region.


Postcontrast magnetic resonance T1-weighted images (d) showing faint enhancement of the lesion.


Coronal T2.


Coronal fluid-attenuated inversion recovery.


Axial fluid-attenuated inversion recovery. Images showing T2-hyperintense area in the splenium of the corpus callosum to the left side. Arrowhead shows linear hyperintensity in the left periventricular white matter region.


Susceptibility weighted imaging - Maximum intensity projection.


Phase images. Showing linear hypo-intense sub-cortical area in the left parietal cortex which could represent micro-hemorrhage in the parasite migratory tract.


(A-C) Bright red warty papules on bilateral groins, scrotum, perineum, and crissum of the proband.


(D-F) Almost all of the warty papules subsided after 5 days of treatment.


(G-I) 4 weeks later, only a few greyish white papules remained.


(A,B) Epidermal hyperkeratosis accompanied by parakeratosis, acantholysis with the appearance of a dilapidated brick-wall, and formation of intraepidermal blisters.


(C) Some lymphocytes and a few eosinophils in the dermis.


Keratotic, micaceous scaly lesion over the glans with meatal involvement.


Post partial penectomy.


Clinical photo showing clitoromegaly.


Extent of the cyst.


Surgical excision of the cyst.


Postoperative appearance 4 months after surgery.


(a-e) The study models of the patient showing different views of the dental arches, dental occlusion, and different positions and rotations of the teeth within the dental arches.


The panoramic radiograph (a) showing radiculomegaly of 43 with root dilacerations mesially, agenesis of second mandibular premolars, increased root length of maxillary canines, and impacted 38 and 48.


The intraoral periapical radiograph 43 (b) shows the radiculomegaly of the 43, increased root curvature mesially, increased size of the root canal, and the notching of the root apex of 44 mesially.


A large thoracolumbar meningomyelocele in a newborn.


Appearance of the repair at the end of surgery.


The repair 7 days postoperatively.


Post-contrast MRI (A-C) showing a large irregular mass with heterogeneous enhancement in the left frontal lobe with mild peritumoral edema.


Plain CT demonstrating a large mass mixed hypo- and isodensity (D).


Magnetic resonance venography showing no development was seen in the superior sagittal sinus of the frontal area (E).


Diffusion tensor imaging showing compression, displacement, and partial interruption of nerve fibers in the lesion area (F).


Postoperative CT.


MRI 7-days postoperatively. Revealed that the lesion was completely removed with no signs of recurrence.


Light microscopic image showing a number of small, round, oval, undifferentiated cells, with intense staining of the nuclei and basophilic cytoplasm (A).


Immunohistochemical staining showing positivity for CD99 (B).


FISH revealing positive results for EWSR1 rearrangement as indicated by the separation of red and green signals (C,D).


The facial phenotype of Case 1 at 11 months. Note the significant short palpebral fissures, ptosis, epicanthic folds and high forehead with flat, broad nasal bridge.


The facial phenotype of Case 2 and 16 months. Not the high and broad forehead, flat nasal bridge, short palpebral fissures and ptosis, thin lips.


Skin lesion (right leg) before treatment.


Skin lesion (left leg) before treatment.


Skin lesion (right leg) after treatment.


Skin lesion (left leg) after treatment.


Clinical image of eccrine spiradenoma presenting as erythematous nodule on the scalp.


Trichoscopy of eccrine spiradenoma showing "serpentine-like" linear reddish structure (yellow arrow) surrounded by whitish areas (black arrows).


A-c Slit-lamp photographs on POD 5 (1 day after flap lift and irrigation). A; Right eye with improving peripheral keratolysis.


B; High magnification of peripheral keratolysis in the left eye.


C; Left eye with persistent peripheral keratolysis.


E Photographs at postoperative month 6, showing resolved keratitis with mild peripheral stromal scarring in the right eye. And left eye.


Electron microscopy of the renal biopsy showing subepithelial membranous deposits (arrow) and adjacent foot process effacement (description courtesy of John Higgins, MD, and Christina Kong, MD, Department of Pathology, Stanford University School of Medicine, Stanford, Calif. , USA).


The scar from a previously excised nevus located 4 cm below the metastatic inguinal lymphadenopathy.


A; At low power, nevoid melanoma has the architecture of a banal compound nevus (HE staining, x20). Diagnostic clues included.


B; The presence of dermal mitotic figures (5 mitoses/mm2) at high power (HE staining, x80).


C; A high Ki-67 immunoreactivity (Ki-67 index 20%) in the lower parts of the lesion (x80).


Progression and examination of the clinical course. PTE, pulmonary thromboembolism; BNP, brain natriuretic peptide; CTPA, computed tomography pulmonary angiography; TTE, transthoracic echocardiogram; CMR, cardiac magnetic resonance; PET, positron emission tomography; CCTA, coronary computed tomography angiography.


CT study of right leg: A - Sagittal sections reveal multiple patchy cortical erosions/irregularities in the right tibia centered in the diaphysis and contiguously involving the adjacent upper metaphysis. Note adjoining soft tissue thickenings.


Streak artifacts are noted due to postoperative changes (Screws); B - MRI Sagittal section of right leg reveals cortical erosions/irregular outlines of the tibia with altered signals in the adjoining bone marrow and soft tissue. Susceptibility artifacts are noted due to postoperative metallic screws.


Computed tomography scan abdomen and pelvis showing recurrent benign multicystic peritoneal mesothelioma as paracolonic mass.


The specimen of benign multicystic peritoneal mesothelioma.


Microscopic view showing multicystic nature of the tumor lined by mesothelial cells (hematoxylin and eosin stain 200x).


Immunohistochemistry showing Calretinin positive (400x).


Ulcer over dorsum of right hand with pustules over index and middle fingers, showing flexion deformity.


Inadequate response after 2 weeks.


Healed ulcer with pinkish scar tissue and corrected deformity.


Photographs of. The palms of the hands showing normal skin.


The soles of the feet showing very slight hyperkeratosis.


Intraoral photographs showing. Severe gingival recession, and ,inflammation, especially in anterior region, and ,aggressive periodontitis.


Swelling related to the maxillary right missed canine region extending toward occlusal surface.


Panoramic radiograph showing severe destruction and loss of alveolar bone in both maxillary and mandibular arch, especially in the anterior region and anterior teeth appear as if floating in air without surrounding alveolar bone.


Photograph showing. Removal of the swelling.


Excisional biopsy of the swelling.


Histopathological image showing evidence of calcifications in the hypercellular fibroblastic stroma confirming the lesion as peripheral ossifying fibroma.


Follow-up photograph after 2 years showing loss of more teeth with no recurrence of the lesion.


Follow-up photographs after 2 years showing. Absence of change in the palms of the feet.


Slight increase in keratosis in the soles of the feet.


Right hydronephrosis secondary to a right ureteral mass.


Retrograde pyelography showing right ureteral mass with goblet sign (arrow).


Intraoperative picture of right ureteral mass during retrograde ureteroscopy.


Multiple erythematous, round to oval, scaly lesions with distinct borders scattered mostly over the trunk (arrows).


Skin biopsy showing focal keratosis, parakeratosis, and ,acanthosis with upper papillary dermal fibrosis with perivascular lymphocytic infiltrates (Hematoxylin, and ,Eosin stain, x10).


Spongiotic changes and neutrophilic exocytosis, consistent with parapsoriasis with focal spongiotic dermopathy (Hematoxylin and Eosin stain x40).


Pancreatic histology showing dilated main pancreatic duct with intermediate grade intraductal papillary mucinous neoplasm (IPMN) arranged in papillae, lined by pancreaticobiliary type epithelium (arrows, Hematoxylin, and ,Eosin stain x20).


Focal mucinous appearance with lining cells showing focal crowding, and ,stratification (arrows, Hematoxylin, and ,Eosin stain, x40).


Occasional foci showing areas of microinvasion (arrow, Hematoxylin, and ,Eosin stain, x40).


Surrounding stroma showing mild inflammatory infiltrates (Hematoxylin and Eosin stain, x40).


Post Whipples surgery, the skin lesions resolved completely.


A 12-year-old female presented with acute onset of urinary retention. (a) Transverse, color flow ultrasound image through the pelvis demonstrates a large, heterogeneous mass posterior to the bladder measuring 10.1 cm x 8.8 cm x 12.4 cm (anteroposterior x transverse x craniocaudal), with minimal vascularity, and large hyperechoic foci, some of which shadow, suggestive of calcifications. (b) Axial T1 fat-sat precontrast MRI with a Foley decompressing the bladder (arrowhead) better depicts the large heterogeneous pelvic mass, containing areas of high T1 signal (arrows) corresponding to calcifications present on low-dose noncontrast CT for attenuation correction performed as part of the 18F FDG-PET (not shown). (c) Axial T2 image at a similar level as b shows areas of high T2 signal representing cystic necrosis. (d and e) Axial diffusion and apparent diffusion coefficient map images show extensive restrictive diffusion. (f) Sagittal contrast-enhanced T1 MRI of the pelvis confirms that the large, heterogeneously enhancing mass with areas of necrosis arises from the posterior wall of the vagina, compresses the bladder and the rectum and displaces the uterus superiorly. (g) Sagittal three-dimensional maximum intensity projection 18F FDG-PET/CT demonstrates heterogeneous hypermetabolic uptake in the pelvic mass (arrowhead) as well as additional hypermetabolic foci in the lung bases and at the T11 vertebral body (arrow), consistent with metastatic lesions. (h) Histologic examination shows sheets of small round blue cells with inconspicuous nucleoli (H and E, x400). The cells are focally arranged in primitive rosettes (top center).


Contrast-enhanced magnetic resonance imaging, T1-weighted fat saturated coronal image shows a large isointense signal intensity mass admixed with hyperintense signal intensity.


Immunohistochemistry - CD 31 - positive staining of atypical endothelial cells.


(A) A dark-red hard nodule of 3 cm * 3 cm * 2.5 cm in size was found on the anterior chest, with an opening at the edge.


(B) Postoperative scar.


(C) The pedigree chart of the index patient (black arrow) and his family. The patient's mother had endometrial and oral mucosal cancer.


(D) Colonoscopy showed irregular neoplasms protruding into the intestinal lumen 28 cm away from the anus, with the size of 3 cm * 3 cm whose irregular protrusions in the central part were brittle, hard texture, contact bleeding and covered with soiled moss.


Pathological presentation of sebaceous carcinoma on the chest:. Tumor cells formed nests or lobules of different sizes, with clear boundary and capsule (HE x40).


(B) The tumor was composed of basal-like cells and vacuolated sebaceous cells, some of which had large, hyperchromatic nuclei (HE x200).


Immunohistochemical staining for DNA mismatch repair proteins (MMR proteins MLH1, MSH2, MSH6, and ,PMS2) of the sebaceous carcinoma. Normal nuclear expression of MLH1 protein.


Immunohistochemical staining for DNA mismatch repair proteins (MMR proteins MLH1, MSH2, MSH6, and ,PMS2) of the sebaceous carcinoma. (D) Lack of nuclear expression of MSH2 protein.


Immunohistochemical staining for DNA mismatch repair proteins (MMR proteins MLH1, MSH2, MSH6, and ,PMS2) of the sebaceous carcinoma. (E) Lack of nuclear expression of MSH6 protein.


Immunohistochemical staining for DNA mismatch repair proteins (MMR proteins MLH1, MSH2, MSH6, and ,PMS2) of the sebaceous carcinoma. (F) Normal nuclear expression of PMS2 protein.


(A, B) Histopathology showed that tumor cells were arranged in columnar and glandular tubular shape, with obvious cellular atypia as well as interstitial and muscularis mucosae infiltrate (HE x200; x400).


Immunohistochemical staining for DNA mismatch repair-related proteins (MMR proteins MLH1, MSH2, MSH6, and . PMS2) of the sigmoid adenocarcinoma:. Normal nuclear expression of MLH1 protein.


Immunohistochemical staining for DNA mismatch repair-related proteins (MMR proteins MLH1, MSH2, MSH6, and . (D) Lack of nuclear expression of MSH2 protein.


Immunohistochemical staining for DNA mismatch repair-related proteins (MMR proteins MLH1, MSH2, MSH6, and . (E) Lack of nuclear expression of MSH6 protein.


Immunohistochemical staining for DNA mismatch repair-related proteins (MMR proteins MLH1, MSH2, MSH6, and . (F) Normal nuclear expression of PMS2 protein.


T1-weighted magnetic resonance imaging with contrast enhancement before tumour removal. The images revealed a supratentorial and infratentorial mass with a cyst.


T1-weighted magnetic resonance imaging with contrast enhancement before tumour removal. The images revealed a supratentorial and infratentorial mass with a cyst. Coronal view. Axial view.


Postoperative imaging findings. (a) T1-weighted magnetic resonance imaging without enhancement 6 months postoperatively showed low signal intensity within the cavity.


Postoperative imaging findings. (b and c) Computed tomography 6 months postoperatively showed low density in the supratentorial and infratentorial cavities.


Imaging findings upon admission. (a) T1-weighted magnetic resonance imaging with contrast enhancement on admission showed a signal change from low to mildly high within the cavity.


Imaging findings upon admission. (b) Computed tomography on admission revealed low and iso-density of the infratentorial lesion with compression of the brain stem.


Imaging findings upon admission. (c) The supratentorial lesion also exhibited mixed density on computed tomography.


Intraoperative and postoperative findings. (a) Intraoperative image after dural incision shows the outer membrane of the haematoma on the cerebellar hemisphere.


Intraoperative and postoperative findings. (b and c) Computed tomography after haematoma evacuation shows removal of the haematoma and resolution of the brain stem compression.


Intraoperative and postoperative findings. (d) Postoperative MRI shows signal change in the cavity.


A, b. Slit-lamp photos of the lesion with gentle traction on lower lid. A; Left eye in primary position.


A, b. Slit-lamp photos of the lesion with gentle traction on lower lid. B; Left eye in superior gaze.


A, b Pathology revealed a proliferation of plump and spindle fibroblasts, consistent with nodular fasciitis. A; Dense fibrous tissue is observed which is representative of the samples. H&E. X20.


B; Higher magnification of the sample reveals normal fibroblasts in a field of dense irregular fibrous tissue. H&E. X40.


Showing oral candidiasis.


The finger nail changes.


Timing of major clinical features in APS type 1.


Facial profile of the patient showing hypodontia, hypotrichosis, periorbital wrinkling, and depressed nasal bridge.


Contrast-enhanced computed tomography (CECT) neck showed mildly dilated right Internal jugular vein (IJV) at rest, markedly increasing in size with valsalva maneuver. The focal fusiform swelling on valsalva measured 24 and 35 mm as max. Antero-posterior and transverse diameter respectively (a).


Contrast-enhanced computed tomography (CECT) neck showed mildly dilated right Internal jugular vein (IJV) at rest, markedly increasing in size with valsalva maneuver. The focal fusiform swelling on valsalva measured 24 and 35 mm as max. The swelling extended from C4 vertebral body level to clavicle for cranio-caudal length of 7 cm (b).


Contrast-enhanced computed tomography (CECT) neck showed mildly dilated right Internal jugular vein (IJV) at rest, markedly increasing in size with valsalva maneuver. The focal fusiform swelling on valsalva measured 24 and 35 mm as max. However, on performing valsalva maneuver, the entire right IJV , ipsilateral sigmoid.


Contrast-enhanced computed tomography (CECT) neck showed mildly dilated right Internal jugular vein (IJV) at rest, markedly increasing in size with valsalva maneuver. The focal fusiform swelling on valsalva measured 24 and 35 mm as max. Transverse sinus. Were noted to be very prominent, compared to the normal left side. Screening CECT of brain revealed no additional abnormality.


Photo of the anterior segment showing the dislocated Ozurdex implant in the pupil at week 4.


Photo of the anterior segment showing the dissolving Ozurdex implant in the pupil at week 8.


Photo of the anterior segment showing that the Ozurdex implant was dissolved at week 12.


MR images obtained 2 weeks . Coronal T1-weighted image demonstrated intra-and suprasellar mass with a central area of high signal intensity consistent with hematoma of subacute phase. Compared with MR images obtained 2 weeks after onset.


MR images obtained 2 weeks . The hyperintense signal may correspond to hemoglobin degradation content as extracellular methhemoglobin,. Sagittal postgadolinium T1-weighted image showed rim enhancement of hematoma capsule.


3 weeks. After onset,. Coronal T1-weighted image demonstrated enlargement of pituitary hematoma resulting in compression of the chiasm (arrows). No sign of rebleeding was detected. The compression of chiasm was markedly worsened for this one week. Arrows).


Intraoperative microphotograph showing the content of hematoma. Xanthochromic fluid was spouted after dural opening (arrows).


Intraoral findings.


Orthopantomogram revealed a bilateral irregular radiolucency in the rami sparing the condyles.


Orthopantomogram after 2 years of follow-up showing bilateral osteolytic lesions in the posterior mandible.


A computerized tomographic scan showed well-defined multilocular, bilateral expansile lesion in the rami of the mandible with multiple areas of cortical thinning and discontinuity.


Photomicrograph under x4 showing peripheral bone, perivascular cuffing, fibrocellular stroma, and multinucleated giant cells.


Photomicrograph under x10 showing peripheral bone, fibrocellular stroma, and multinucleated giant cells.


Photomicrograph under x40 showing perivascular cuffing, fibrocellular stroma, and peripheral bone.


Photomicrograph under x40 showing multinucleated giant cells in a fibrocellular stroma.


Swelling of the mandible seems to be increased after 2 years of follow-up.


Slit-lamp biomicroscopy image of the right eye. Adenoviral keratoconjunctivitis-related SEIs in the central part of the cornea.


IVCM image of the right eye. Subepithelial Langerhans cells with characteristic pseudopods (depth: 41 microm).


Slit-lamp biomicroscopy image of the right eye after the use of 0.05% CsA nanoemulsion formulation for 1 month. SEIs appear less active.


IVCM image of the right eye. No visible subepithelial Langerhans cells are present after 1 month of treatment with the 0.05% nanoemulsion formulation (depth: 40 microm).


Penile keloids.


Two months post operatively.


Three years post operatively.


Worms pouting out of root of scrotum.


(A) Fundus photo on presentation: elevated left optic disc with indistinct margins.


(B) Fundus photo 1 month after posterior fossa decompression with duraplasty. Regression of papilledema.


(C) Pre-operative MRI: Etaerniation of the cerebellar tonsils below the foramen magnum.


(D) MRI after posterior fossa decompression with duraplasty and cerebellar tonsillectomy.


Typical cushingoid face of the patient.


Axial CT post contrast image.


Sagittal reconstruction. Shows an irregular extra-axial solid mass with heterogeneous enhancement and deep cystic change (arrow) adjacent to the falx extending into the right frontal lobe. There is significant peritumoral oedema and mass effect involving the right frontal lobe with displacement of the midline. These findings, together with tumour interdigitating with the brain substance, are consistent with an aggressive frontal meningioma.


Axial thorax CT post contrast image showing an ill-defined soft tissue mass (arrow) superficially located in the left trapezius muscle with peripheral enhancement and low signal in the centre.


Sagittal T2.


Axial T1.


Axial T2 fat saturated. MR images demonstrate a solid well defined soft tissue mass in the medial left trapezius muscle which returns isointense T1-W (between arrow heads) and heterogeneous predominantly high T2-W signal relative to skeletal muscle. There is mass effect on the deeper paravertebral muscles and peripheral feeding vessels along the lateral aspect of the lesion (arrow).


PET-CT confirms the presence of an FDG avid soft tissue mass in the left trapezius muscle.


Verrucous epidermal nevus in the interscapular region, showing a darkened papule with pearly shine in its central portion.


Dermoscopy showing a cerebriform pattern with follicular pseudo-openings and a large ovoid nest with arboriform vessels (x10).


Histopathology showing epidermis with hyperkeratosis, acanthosis, papillomatosis and clear basal melanic pigment: verrucous epidermal nevus (HE, x40).


Photograph of the toxic contact dermatitis due to the jellyfish sting on the hand of a 16-year-old boy.


Photograph shows the erythematous infiltrated plaques with ulceration prior to the first ESWT treatment on day 72. On the back of the hand, there is a small amount of ultrasound gel visible.


Photograph shows completely healed skin area on day 110, after 4 weeks and 8 treatment sessions (each 15 min).


Hip view shows multiple discrete myelomatous lesions in the pelvis and a lucent lesion in the left femoral neck.


FDG PET/CT scan. (A) Extensive nodular increased activity most evident in long bones such as both humeri and femurs.


FDG PET/CT scan. (B) Conspicuous foci with intense activity are seen in the medial condyle of the right femur (SUV 3.3) and left acetabular roof and femoral neck where a 3 cm lytic lesion is seen with cortical destruction (SUV 15.8).


(a) Plain computed tomography (CT) of the head revealing a 40-mm-diameter tumor with calcification and cyst formation in the right parietal lobe.


(b, c) Axial images are shown for magnetic resonance imaging (MRI). T2 and T2*-weighted imaging shows signal hyperintensity. T2 and T2*-weighted imaging reveals an area of marked hypointensity around the solid component, which may represent the calcification seen on CT or hemosiderin deposition due to an old hemorrhage.


(d-f) Coronal images are shown for MRI. T1 gadolinium enhancement shows a heterogeneous contrast effect. Note: The normal-appearing choroid plexus was placed within the lateral ventricle and continuity of the normal choroid plexus and the lesion was not confirmed.


Axial fluid attenuation inversion recovery (FLAIR).


T2-weighted images. Show a large cystic mass in the left frontoparietal region. Note incomplete suppression of fluid signal on FLAIR and mild perilesional edema and mass effect on the posterior horn of the left lateral ventricle.


On post contrast image (c) there is complete rim enhancement and irregular, peripheral nodular enhancement in the anterior portion of the lesion. There is scalloping of the overlying bone cortex (arrow).


Decompression of the cyst with biopsy of the enhancing lesion was performed. Hematoxylin and eosin stained section (x20) of left temporal lobe showing perivascular granulomatous inflammation within unremarkable background brain parenchyma.


Hematoxylin and eosin stained section (x10) of right level V cervical lymph node demonstrating non-necrotizing compact epithelioid granulomas.


Pedigree of the present family and the variant screening diagrams. The proband is indicated by an arrow. Black indicates affected. Squares indicate males. Circles indicate females.


Brain magnetic resonance imaging (MRI) findings. No signal changes are seen in the axial T2-weighed brain MRI of the proband.


Brain magnetic resonance imaging (MRI) findings. Sagittal T2-weighed brain MRI of the proband.


Brain magnetic resonance imaging (MRI) findings. Sagittal T2-weighed brain MRI of the proband . White matter hyperintensity (red arrow) is also evident in cerebellum of the proband (C).


Brain magnetic resonance imaging (MRI) findings. And his mother.


Brain magnetic resonance imaging (MRI) findings. His mother. Shows manifest cerebellar atrophy (yellow arrow).


Case of phlegmasia cerulea dolens of the lower limb.


Electrocardiogram.


Optical coherence tomography angiography (OCTA) with the right eye represented by the right column.


The left eye by the left column The structural slabs a, b of the lesions in both eyes were obtained using an RPE-RPE fit segmentation.


Optical coherence tomography angiography (OCTA) with the right eye represented by the right column En face OCTA with customized segmentation between RPE and Bruch's membrane shows a type 1 neovascular network with evident aneurysmal dilatation, as demarcated by the crossing blue and green lines (c, d). Dense B-scan with angiographic flow overlay e, f demonstrates the corresponding cross-sectional view and the customized segmentation of the respective lesions.


The left eye by the left column The structural slabs a, b of the lesions in both eyes were obtained using an RPE-RPE fit segmentation. En face OCTA with customized segmentation between RPE and Bruch's membrane shows a type 1 neovascular network with evident aneurysmal dilatation, as demarcated by the crossing blue and green lines (c, d). Dense B-scan with angiographic flow overlay e, f demonstrates the corresponding cross-sectional view and the customized segmentation of the respective lesions.


Chest radiography revealed consolidation in the right lower lung field at the initial visit.


Pulmonary findings of chest high-resolution computed tomography. (A) At the initial visit, subpleural consolidation with volume reduction in the right lower lobe and localized ground-glass opacity in the left lower lobe were present.


Pulmonary findings of chest high-resolution computed tomography. (B) Two weeks after she began receiving prednisolone (PSL), consolidation had not improved.


Pulmonary findings of chest high-resolution computed tomography. (C) Two months after discontinuation of PSL, bilateral consolidation developed. Then, a surgical lung biopsy (SLB) of the right upper lobe was performed (arrow).


(A) Mechanic's hand (arrows).


(B) Gottron's papules on the dorsum (arrowheads).


Pulmonary findings of chest high-resolution computed tomography. (A) One month after the surgical lung biopsy, bilateral subpleural consolidation and ground-glass opacity had worsened.


Pulmonary findings of chest high-resolution computed tomography. One month.


Pulmonary findings of chest high-resolution computed tomography. Six months after starting the treatment, these findings had improved.


Solitary firm nodule with central ulceration over left parietal region and bluish red indurated plaques in the retro-auricular regions.


Eyelid edema with indurated plaques over both eyes.


Dermis showed an ill-defined tumor composed of anastomosing infiltrative vascular channels lined by crowded variably plump and atypical endothelial cells. The mitotic figures are 32 per 10 hpf. The lumen showed presence of RBCs.


Magnetic resonance imaging scan showing hyperintense cystic lesion.


Cut surface of the tumor showing cystic degeneration.


Immunohistochemistry pictures showing cytoplasmic S-100 positivity (IHC, S-100, x100).


Immunohistochemistry (IHC) showing KI67 negativity (IHC, KI67, x100).


Histopathological findings. A; Immunohistochemical staining. The spindle tumor cells show a positive reaction for S100 protein.


Histopathological findings. B; A cuff-like lymphoid aggregate was recognized around the tumor.


Contrast-enhanced CT scan of the abdomen showing a huge right-sided retroperitoneal mass in front of the right kidney.


A histopathological picture of the retroperitoneal schwannoma.


Contrast-enhanced MRI after the first operation showing a left-sided VS.


Chordoid glioma in 34-year-old man. . A. Axial unenhanced CT showing hyperattenuated mass compressing frontal horn of right lateral ventricle. Note small calcification (arrow) in periphery of mass.


Chordoid glioma in 34-year-old man. B. Sagittal T1-weighted (upper left panel) and axial T2-weighted (upper central panel) images showing isointense lobulated mass (arrows) relative to cerebral cortex in anterior third ventricle. Axial susceptibility-weighted image (upper right panel) showing no evidence of intratumoral hemorrhage. Sagittal (lower left panel), axial (lower central panel), and coronal (lower right panel) post-contrast T1-weighted images showing strong enhancing main tumor with lobulated margin (arrows) in anterior part of third ventricle and smaller enhancing masses (arrowheads) along wall of lateral ventricles and fourth ventricle.


Chordoid glioma in 34-year-old man. C. CBV map of perfusion MRI showing elevated CBV within tumor (arrows) in third ventricle.


Chordoid glioma in 34-year-old man. D. Photomicrograph of hematoxylin and eosin stained slide showing solid cellular components composed of clusters and cords of epithelioid tumor cells (arrows) within variable mucinous stroma (original magnification x 400).


Chordoid glioma in 34-year-old man. Photomicrographs of immunostained slides for GFAP.


Chordoid glioma in 34-year-old man. CBV = cerebral blood volume E, F. CD 34. Showing diffuse and strong expression in tumor cells (dark yellow and brown colors) (original magnification x 400). GFAP = glial-fibrillary acid protein.


Tufted hair folliculitis on the scalp, a patch of alopecia characterized by perifollicular erythema and follicular hyperkeratosis.


The patient showed clinodactyly of the fifth finger of both hands.


More evidently on the left side, confirmed by X-ray examination.


Direct stool wet mount showing non-bile stained egg of Hymenolepis nana.


Direct stool wet mount showing the adult worm of Hymenolepis nana. The adult worm revealing the rostellum (black arrow), scolex (red arrow), and broader than long segments (yellow arrow).


Cut section of the excised tumor reveals a fleshy mass with areas of hemorrhage and necrosis.


Immunohistochemical profile shows.


Focal positivity for pancytokeratin.


More reactivity for epithelial membrane antibody. CD34 highlights the hemangiopericytomatous pattern of the blood vessels with the negative reaction of the tumor cells.


(d) Tumor cells show diffuse nuclear positivity for transducer-like enhancer of split - 1 (DAB, x200).


Preoperative appearance of breast mass. Image of the breast lesion illustrating the superolateral fungating breast ulcer on a large, irregularly shaped, nodular breast mass.


Examination findings. 2A: an anterior image of the patient illustrating the limb deformity confined to the right side of the body with limb shortening and irregular angular deformity. 2B: a lateral image of the patient illustrating limb abnormalities. 2C: Image of the patient's right hand illustrating nodular prominences of the bones of the hand and fingers as well as finger shortening and irregular angular deformity.


Cellular smears containing pleomorphic cells having very large nuclei (monster cells) with scanty cytoplasm. Few of the nuclei revealing nucleoli (Giemsa, x400).


Lesional cells revealed positive staining for vimentin (IHC, x200).


CECT abdomen showing mass replacing the right ovary with nonvisualization of the uterus.


(a) Microphotograph showing islands of large polygonal tumor cells surrounded by lymphoid cells. The tumor cells possess clear cytoplasm and centrally placed nuclei with vesicular chromatin and prominent nucleoli.


(H&E 400x) and (b) Microphotograph showing tumor cells arranged in papillary fronds having vesicular coffee bean nuclei. (H&E 100x).


Radiological evaluation of CG postoperatively. Post-contrast MRI images of the residual tumor 1 month (a,b).


Radiological evaluation of CG postoperatively. The size of the residual tumor decreased following GKRS (c-f).


Preoperative photograph showing diffuse swelling on the right side of infraorbital region without obliteration of nasolabial fold.


Intraoral photograph showing minimal or no swelling in the intraoral region.


Intraoperative photograph showing spillage of keratin material during incision.


Intraoperative photograph showing the enucleated cystic lining mass from the right maxillary sinus.


Intraoperative photograph after enucleation/curettage showing a large bony defect.


Gross specimen of the enucleated cyst.


The subretinal larva in the inferotemporal quadrant.


The subretinal larva after application of focal photocoagulation laser on and around the larval body.


Appearance of the patient at the time of presentation.


Maggots in the maxillary anterior region.


Removal of maggots with a tweezer.


Healing of the tissues after removal of larvae.


(a) T1-weighted contrast-enhanced image showing variegated contrast uptake by the tumor.


(b) Sagittal section showing pontine tumor completely occluding the fourth ventricle.


(c) Photomicrograph showing psammoma body like micro-calcification in tumor (Hematoxylin and Eosin, x200).


(d) Photomicrograph showing nuclear Ki67 labeling in the tumor cells (Ki67 immunostain, x400).


Axial T1 contrast-enhanced MRI (44 days after headache) and DWI (30 days after headache) through the point at which the oculomotor nerve emerges from the midbrain in this patient with left oculomotor ophthalmoplegic migraine. (A-C) Acute phase. The MRI shows a nodular, enhancing lesion in the cisternal segment of the left third nerve (arrow) in (A).


Axial T1 contrast-enhanced MRI (44 days after headache) and DWI (30 days after headache) through the point at which the oculomotor nerve emerges from the midbrain in this patient with left oculomotor ophthalmoplegic migraine. (A-C) Acute phase. In (B,C), a signal was demonstrated at the midbrain of the left-sided third cranial nerve on DWI and ADC.


Axial T1 contrast-enhanced MRI (44 days after headache) and DWI (30 days after headache) through the point at which the oculomotor nerve emerges from the midbrain in this patient with left oculomotor ophthalmoplegic migraine. (D-F) Quiescent phase, taken 7 weeks after the left ptosis and diplopia had resolved. (D) Demonstrates the decreased enhancement.


Axial T1 contrast-enhanced MRI (44 days after headache) and DWI (30 days after headache) through the point at which the oculomotor nerve emerges from the midbrain in this patient with left oculomotor ophthalmoplegic migraine. (D-F) Quiescent phase, taken 7 weeks after the left ptosis and diplopia had resolved. (E,F) Demonstrate that the signal had disappeared at this point on DWI and ADC.


Clinical manifestation and histopathological findings of porokeratosis ptychotropica. (A) Clinical manifestation shows "Butterfly shaped" verrucous plaque over buttocks with multiple satellite papules.


Clinical manifestation and histopathological findings of porokeratosis ptychotropica. (B) Histopathological findings shows characteristic multiple cornoid lamellae. Dyskeratotic cells and focal hypogranulosis were present in the epidermis underlying the column of parakeratosis (H&E staining, x200).


Erythema nodosum with bilateral eruption of painful subcutaneous nodules with overlying inflammatory redness. Involvement of only the upper extremities is unusual.


Two months after the initial skin eruption. Clinical examination revealed only residual discoloration and slight induration.


Case 1 CT image.


Case 2 CT image.


Magnetic resonance imaging of the left brachial plexus demonstrating a heterogeneous T1-hyperintense.


Homogeneously enhancing. Well-circumscribed lesion located in the posterior brachial plexus (white arrows).


Magnetic resonance imaging of the brachial plexus demonstrating a T1-isointense.


Avidly enhancing. Soft tissue mass along the left C7/T1 and T1/T2 neuroforamina (white arrows).


Erythroderma and pustulosis of our patient at the first day of hospitalization.


Pre- and postoperative funduscopy images in the right eye of case 1. Bullous rhegmatogenous retinal detachment developed from the upper quadrants (a).


Pre- and postoperative funduscopy images in the right eye of case 1. Following scleral buckling surgery, the retina was well reattached and corrected visual acuity improved from 0.01 to 0.6 (b).


Pre- and postoperative funduscopy images in the right eye of case 2. Bullous rhegmatogenous retinal detachment developed from the temporal two quadrants (a).


Pre- and postoperative funduscopy images in the right eye of case 2. Following scleral buckling surgery, the retina was well reattached and corrected visual acuity improved from 0.4 to 0.9 (b).


Funduscopy images of case 3. Preoperative.


Funduscopy images of case 3. Postoperative. Funduscopy images of the patient's right eye. Retinal detachment developed from the upper temporal quadrants. Following scleral buckling surgery, the retina was reattached; however, localized downward redetachment occurred and epiretinal membrane formation in the macula also developed at a late stage. Thus, vitreous surgery was then performed. Following surgery, the retina was reattached and corrected visual acuity improved to 0.7.


Chest CT in case 1 after chemo- and radiotherapy treatment. After 1 year of treatment, the patient showed a complete remission of the disease.


A) The fundus photo shows the sharply defined small pigmented lesion.


B) The fluorescein angiogram showed. Block fluorescence at the area of pigmentation and window defect at the marginal depigmentation.


Verrucous lesion on the chest.


Multiple, brownish pigmented, scaly lesions over the right arm, elbow and proximal forearm.


Nephrectomy specimen after longitudinal incision.


Axial brain CT demonstrates left gyriform calcifications as well as bilateral cerebral atrophy and dilatation of both lateral ventricles that is more prominent on the left side.


Coronal brain MRI (T1 with contrast) demonstrates a dura-based mass in the left parasagittal posterior parietal region, with enhancement and surrounding vasogenic edema.


Coronal brain MRI (T1 with contrast) shows post-operative changes after resection of the meningioma. It also demonstrates asymmetrical dilatation of the lateral ventricles.


Left face lesions due to nevus sebaceous.


Left frontotemporal lipoma.


Fourteen-days-old neonate with congenital melanocytic nevus on face.


Three months infant following surgical curettage and dermabrasion.


Protective metallic barrier as eye shield for laser surgery on table.


Outcome at 1 year of age.


Case 1. Axial T1-weighted.


Axial T2-weighted.


Coronal fluid-attenuated inversion recovery reveal a well-demarcated lobulated mass in the right temporal region causing bone erosion. It has an intracranial component and is hypointense on T1 and heterogeneously hyperintense on T2 and fluid-attenuated inversion recovery images.


Appearance of the wounds on the 2nd post-operative day. (A) Sternal incision.


Appearance of the wounds on the 2nd post-operative day. (B) Saphenous incision.


Necrosis in the superficial layer, infiltration of the dermis with interstitial lymphocytes, plasmocytes and neutrophils, and intradermal abscess formation (20 x 10, hematoxylin and eosin staining).


Recovery of the sternal wound on the 20th day of the treatment.


Lateral post-operative view of the right temporoparietal scalp.


Close-up view of Figure 1.


Low power micrograph of the lesion shows an extensive cystic component.


High power image of a solid area shows basaloid cells typical of poroma and occasional ductal structures (top right corner). The cells are uniform and cytologically bland. No mitotic figures are seen.


Cutaneous tuberculosis: fagedenic perianal ulcer.


Lepromatous leprosy: erythematous papules and nodules on the upper limbs.


Histopathological exam of the perianal ulcer showing a dense histiocytic infiltrate and central caseous necrosis.


Skin nodule consisting of foamy macrophages with globi of bacilli. Fite-Faraco staining revealed the presence of lepromatous leprosy acid-fast bacilli.


Cutaneous tuberculosis: phagedenic perianal ulcer showing worsening of the perianal ulcer after treatment for leprosy lesion, for two months.


M. tuberculosis,
positive culture on Lowenstein-Jensen medium at 37 C.