The same 52-year-old gentleman at the time of second presentation. Coronal.


The same 52-year-old gentleman at the time of second presentation. Sagittal T1-weighted images confirm near-complete uniform enhancement of the lesion (white arrow).


Our 52-year-old male patient underwent pre-surgical perineal ultrasound guided biopsy: (a) High-frequency B mode ultrasound image using a linear 6-15 Hz transducer showing the lesion on MRI to correspond to a well-circumscribed heterogeneously hypoechoic lesion with echogenic foci within (white arrow).


(b) Color Doppler image of the same lesion demonstrating mild surrounding vascularity with no internal vascularity(white arrow).


(c) B mode ultrasound confirming the 16 G biopsy needle (white arrow) within the lesion during ultrasound-guided tissue sampling for pre-operative tissue diagnosis.


Clinical examination showing his black teeth with enhancing accumulations of plaque calculus. No abnormal protuberance in gingival cheek groove.


The panoramic radiography of the jaw was normal.


The mandibular computerized tomography scan showing destruction in the body of mandibular bone and a mass in the surrounding soft tissue.


Positron emission tomography combined with computed tomography from the cerebellum to the upper thighs showing increased uptake in the mandibular bone body especially in the left mandible. No abnormal uptake in distant sites.


Histopathological examination of the biopsy specimen showing infiltration of carcinoma cells with nest-like distribution. The carcinoma cells, round and oval in shape and most in mitosis, were abundant of cytoplasm [H&E. 40x.


Histopathological examination of the biopsy specimen showing infiltration of carcinoma cells with nest-like distribution. 100x.


Imaging appearances in case 1. (A) Enhanced chest computed tomography (CT) showing the pulmonary thromboembolism (arrow) in right inferior pulmonary artery and bilateral pleural effusion.


Imaging appearances in case 1. (B) Iodine contrast esophagogram confirmed the bronchoesophageal fistula.


Imaging appearances in case 1. (C) Coronal magnetic resonance imaging (MRI) showed the mediastinal soft tissue shadows (arrow) surrounded the left main bronchus.


CT images of case 1 in September.


November The enlarged mediastinal lymph node (arrow) decreased after antituberculosis therapy.


Imaging appearances in case 2. (A) The neck abscess (arrow) on axial MRI.


Imaging appearances in case 2. (B) The right psoas abscess (arrow) on axial CT.


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


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


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


Postoperative follow-up after two months.


Extraoral. Intraoral.


Radiological findings. A : T1-weighted axial MRI reveals a hypointense regular-shaped cystic lesion at the ventricular border.


Radiological findings. B : Contrast-enhanced T1-weighted coronal MRI reveals that the lesion compresses the optic chiasma and elevates the third ventricle and identifies the contrast-enhanced solid hyperintense nodule at the right floor of the lesion, just above the suprasellar internal carotid artery.


Radiological findings. C : Hyperintense cystic lesion on T2-weighted axial MRI.


Radiological findings. D : Tumoral invasion of the planum sphenoidale, whole sellar area, and suprasellar cistern.


Histology reveals the tumor's papillary structure with one or more layers of columnar epithelial cells around a fibrovascular core (H&E, x40).


Micrograph of immunostained section shows positive expression of pancytokeratin (x10).


T1-weighted contrast enhanced axial.


T2-weighted sagittal. Postoperative MRI show total excision of the tumor.


Intraoperative image. A : The cystic component of the tumor (white arrow).


Intraoperative image. B : Yellowish tumoral nodule (white arrow) after opening the cystic component.


Verification of variants in the HI baby. (A) Sanger sequencing verification of the HI compound heterozygous variants identified by WES in the family.


Verification of variants in the HI baby. (B) Summarization of published HI variants. The variants identified in this study have been highlighted in red.


Multiple images from EGD procedures. (A) EGD image from September 2008 showing a normal gastric antrum.


Multiple images from EGD procedures. (B) EGD image from September 2008 showing mucosal swelling near the gastric antrum.


Multiple images from EGD procedures. (C) EGD image showing three discrete patches of inflammation in the duodenum.


Multiple images from EGD procedures. (D) EGD image from September 2008 showing inflammation and ulceration in the jejunum.


Multiple images from EGD procedures. (E) EGD image from November 2008 showing inflammation, hyperpigmented mucosa, and erythematous mucosa in the duodenum.


Multiple images from EGD procedures. (F) EGD image from November 2008 again showing duodenitis. . Abbreviation: EGD, esophagogastroduodenoscopy.


Tagged red blood cell scan showing tracer activity in the left upper quadrant raising suspicion for a proximal jejunal bleeding site.


The gross cross-sectional image of the resected jejunal lesion showing a dilated segment of artery filled with blood.


The histopathological slide of small bowel mucosal erosion with underlying dilated tortuous segments of artery filled with blood consistent with a Dieulafoy lesion.


Histopathological examination showing a single layer of columnar non-ciliated epithelial cells, with basal nuclei and abundant intracellular pale mucinous fluid.


Pelvic CT scan reveals a large tumor mass (black arrowheads) with erosion and destruction of the right sacrum. Retroperitoneal extension of tumor has infiltrated into the right iliacus (IL) and psoas (P) muscles.


CT showed a lesion of bone destruction in the right distal fibula. Sagittal.


CT showed a lesion of bone destruction in the right distal fibula. Axial. CT of bony window showed a centrally osteolytic lesion with an expansive growth pattern, scattered punctate bony sclerosis inside and a local, slight periosteal reaction.


CT showed a lesion of bone destruction in the right distal fibula. Axial CT of soft tissue window images demonstrate a well-demarcated soft tissue mass displayed uneven density in unenhanced phase. CT value = 93 HU).


CT showed a lesion of bone destruction in the right distal fibula. Mild enhancement in the arterial phase. CT value = 113 HU).


CT showed a lesion of bone destruction in the right distal fibula. Moderate heterogeneous enhancement in the portal phase. CT value = 123 HU).


Axial T1-weighted image without contrast enhancement. MRI revealed a focal, hypo- and isointense mixed mass on T1-weighted image.


Axial T1-weighted image without contrast enhancement. , T2-weighted image hypo- and hyperintense mixed mass on T2-weighted image There were no signs of necrosis, hemorrhage, or cyst formation within the mass. However, adjacent soft tissue edema and swelling was seen.


Axial T1-weighted image without contrast enhancement. And the arterial phase of T1-weighted image Gadolinium-enhanced T1-weighted images revealed obvious perilesional enhancement, particularly in the region adjacent to the normal tissue (C-E).


Axial T1-weighted image without contrast enhancement. The arterial . Gadolinium-enhanced T1-weighted images revealed obvious perilesional enhancement, particularly in the region adjacent to the normal tissue (C-E).


Axial T1-weighted image without contrast enhancement. The venous. Phase of coronal T1-weighted images. Gadolinium-enhanced T1-weighted images revealed obvious perilesional enhancement, particularly in the region adjacent to the normal tissue (C-E).


Histological images. (A) The tumor consisted of extensive areas of a densely sclerotic hyaline matrix with fibroblastic epithelioid cells arranged in cords, nests, or sheets inside accompanied by partial calcification (hematoxylin and eosin staining; original magnification: x 4).


Histological images. (B) Cells were arranged in nests or clusters (hematoxylin and eosin staining; original magnification: x 10).


The timeline of diagnosis and treatment.


Left eye showing an inferonasal opalescent limbal lesion extending into cornea with fimbriated edges.


Fundus image of the left eye showing healing necrotising retinitis after initiation of treatment.


Right eye showing an inferonasal gelatinous mass at the limbus extending into cornea with feeder vessels.


Fundus image of the left eye showing retinitis and retinal vasculitis with multiple yellowish granular lesions and perivascular sheathing.


Histopathology image showing multilayered conjunctival epithelium with dyskeratotic cells and stromal fibrosis, suggestive of conjunctival epithelial dysplasia.


A 19-year-old individual with ovotesticular disorder of sex development who presented with progressive bilateral breast enlargement. (a) Midsagittal T2-weighted MRI section shows a small male phallus (blue arrow).


A 19-year-old individual with ovotesticular disorder of sex development who presented with progressive bilateral breast enlargement. (b) Parasagittal T2-weighted MRI section through the prostatic urethra demonstrates a hypoplastic prostate (green arrow), a normal-looking vagina (yellow arrow), and a hypoplastic uterus (red arrow).


A 19-year-old individual with ovotesticular disorder of sex development who presented with progressive bilateral breast enlargement. (c) Parasagittal T2-weighted MRI section depicts a hypoplastic prostate (green arrow), a normal- looking vagina (yellow arrow), and a hypoplastic uterus (red arrow).


A 19-year-old individual with ovotesticular disorder of sex development who presented with progressive bilateral breast enlargement. (d) Parasagittal T2-weighted MRI section through the left inguinal region shows the undescended left gonad (purple arrow).


A 19-year-old individual with ovotesticular disorder of sex development who presented with progressive bilateral breast enlargement. (a) Parasagittal T2-weighted MRI section through the left inguinal region shows the left gonad containing a large number of high signal foci, consistent with cystic areas (arrow).


A 19-year-old individual with ovotesticular disorder of sex development who presented with progressive bilateral breast enlargement. (b) Parasagittal T2-weighted MRI section through the left inguinal region demonstrates the vas deferens adjacent to the left gonad (arrow).


A 19-year-old individual with ovotesticular disorder of sex development who presented with progressive bilateral breast enlargement. (c) Coronal short tau inversion recovery MR image shows the left gonad located in the left inguinal region (arrow).


A 19-year-old individual with ovotesticular disorder of sex development who presented with progressive bilateral breast enlargement. (d) Axial fat-suppressed T2-weighted MR image depicts the undescended left gonad (arrow).


A 19-year-old individual with ovotesticular disorder of sex development who presented with progressive bilateral breast enlargement. (a) Coronal short tau inversion recovery MR image shows the hypoplastic prostate (green arrow) and the hypoplastic uterus (red arrow).


A 19-year-old individual with ovotesticular disorder of sex development who presented with progressive bilateral breast enlargement. (b) Coronal short tau inversion recovery MR image demonstrates multiple disorganized tubular structures at both seminal vesicle locations (blue arrows). Note the hypoplastic uterus adjacent to the bladder (red arrow).


A 19-year-old individual with ovotesticular disorder of sex development who presented with progressive bilateral breast enlargement. (c) Axial fat-suppressed T2-weighted MR image depicts the hypoplastic prostate (green arrow).


A 19-year-old individual with ovotesticular disorder of sex development who presented with progressive bilateral breast enlargement. (d) Axial fat-suppressed T2-weighted MR image shows multiple disorganized tubular structures at both seminal vesicle locations (blue arrows).


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


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


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


Gross view of the swelling in the right lower eyelid (arrow) along with a fleshy growth in the conjunctiva (arrowhead) of the same eye encroaching upon the cornea.


Key imaging and pathology results from the Rhabdomyosarcoma and Diffuse large B-cell lymphoma. A; Axial view of the left thigh rhabdomyosarcoma demonstrating the lesion was FDG-avid on PET scan.


Key imaging and pathology results from the Rhabdomyosarcoma and Diffuse large B-cell lymphoma. B; Morphology of rhabdomyosarcoma showing spindle cells in intersecting fascicles. (H&E, 200x) c Immunohistochemical stain for Desmin showing diffuse positivity supporting the diagnosis of rhabdomyosarcoma.


Key imaging and pathology results from the Rhabdomyosarcoma and Diffuse large B-cell lymphoma. D; Axial view of the mediastinal diffuse large B-cell lymphoma demonstrating FDG-avidity on PET scan.


Key imaging and pathology results from the Rhabdomyosarcoma and Diffuse large B-cell lymphoma. E; Morphology of lymph node showing involvement by diffuse large B-cell lymphoma. (H&E, 200x) f Higher power image of the lymphoma showing large lymphoid cells in sheets. (H&E, 400x).


Pustular palmar lesions, associated with erythema and desquamation.


Pustules in the center of erythematous-desquamative lesions of the lower limbs.


Epidermis with acanthosis and exuberant exocytosis of neutrophils, which in segment configure Kogoj's spongiform pustule; note also dilation of the capillaries of the papillary dermis. HE. x10.


A cystic, nonlobulated swelling predominantly involving the left upper neck and crossing midline.


X-ray neck lateral view showed a soft-tissue swelling in the upper neck.


(a and b) Sistrunk's procedure (intermediate pictures).


Gross specimen received was a paramedian neck swelling measuring 11.3 cm x 6 cm x 4.9 cm. External surface is multinodular and well capsulated. Cut section is multilocular, cystic and filled with yellow-brown fluid. The solid areas are gray yellow with areas of calcification and focal papillary excrescence measuring 2.2 cm x 1.6 cm x 1cm.


Postoperative follow-up.


Demonstrating the four generations of affected members of the family pedigree (y: Years).


Left eye corneal photograph of Case 1. Opacities of granular corneal dystrophy were seen in the corneal stroma.


(A) Subclinical keratoconus findings in the right eye topograph of Case 1 (mother of the proband).


(B) Subclinical keratoconus findings in the left eye topograph of Case 1 (mother of the proband).


Right eye photograph of the proband (Case 4). Sharply demarcated, grayish-white, non-coalescent, star-shaped opacities localized only to the stroma.


(A) Keratoconus findings in the right eye topograph of the proband (Case 4).


(B) Keratoconus findings in the left eye topograph of the proband (Case 4).


Left eye corneal photograph of Case 7. Opacities of granular corneal dystrophy were seen in the corneal stroma.


(A) Subclinical keratoconus findings in the right eye topograph of Case 7 (daughter of the proband).


(B) Subclinical keratoconus findings in the left eye of Case 7 (daughter of the proband).


Blood pressure and diuresis during the first three days of life. This figure displays changes in blood pressure (systolic, diastolic and mean arterial pressure) as well as rate of diuresis in relation to the medication applied. See the immediate onset of diuresis after the initiation of vasopressin therapy.


Chest X-ray depicting free abdominal air due to gastric perforation.


(A) Pre-treatment granulomatous interstitial nephritis (H & E, low power), arrow demonstrating granuloma.


(B) Pre-treatment granulomatous interstitial nephritis granuloma (H & E, high power).


(C and D) Post-treatment with adalimumab showing an intact glomerulus with diabetic changes, marked tubular atrophy, minimal interstitial inflammation and complete disappearance of granulomas (H & E, low power).


Serum creatinine and daily protein excretion in a female with granulomatous interstitial nephritis who was treated with adalimumab weekly for 6 months.


Magnetic resonance imaging showed peripherally enhancing lesions in right fronto-parietal and left fronto-temporo-parieto-occipital region involving grey and white matter, subcortical region and corpus callosum; acute disseminated encephalomyelitis.


(a and b) Visual evoked potential suggestive of bilateral optic neuritis.


(A, B) Magnetic resonance imaging scan of abdomen revealed a large well-defined suprarenal mass that measured 12x10x8.3 cm displacing the right kidney inferiorly and inferior the right lobe of liver and close to the porta hepatis, with evidence of cystic changes, fatty component, and calcification.


Histopathology of the recurrent tumor revealed heterogeneous mature elements including. Epidermal cyst lined by mature keratinized squamous epithelium, and ,filled with keratinous debris (H&E, 4x).


Dermoid cyst lined by benign squamous epithelium surrounded by mature fibroadipose tissue with embedded adnexal glands (H&E, 4x).


Clinical photographs.


Intraoral Photograph. Of patient.


OPG showing multiple cystic lesions, three in maxilla and four in mandible.


Chest X-ray showing fusion of 3rd and 4th ribs on left side.


Ki 67 immunopositive.


The right eye showed severe diffuse redness with dilation of deep episcleral vesselsepiscleral vessels.


Photograph of the patient's foot on initial presentation.


Photograph of the patient's foot after surgical repair using IntegraTM and then a split thickness skin graft.


A; Muddy dark blue to black pigmentation on the dorsal hands.


B; Black to blue patches on the anterior shins, ankles, and dorsal feet.


A; Fontana-Masson stain highlighting dermal melanophages engulfing melanin. Original magnification x400 (a and b).


B; Prussian Blue stain showing iron deposition. The combination of dermal pigmentation staining positive for both melanin and iron deposition is consistent with minocycline deposition. Original magnification x400 (a and b).


Contrast-enhanced axial computed tomogram (CT) image obtained during portal venous phase shows a large mass (arrows) in the spleen, the mass is showing diffuse homogeneous enhancement on the lateral aspect and the medial aspect is hypoenhanced. A cyst in the liver is also demonstrated (arrowhead).


Changes in scalp hair on admission.


8 weeks.


8 months after tofacitinib therapy.


Topological representations of the posterior pole. Vertical and horizontal raster spectral domain optical coherence tomography line scans show that the long axis of the elliptical dome lies in the horizontal meridian, as demonstrated also by a quad-mesh projection onto an elevation-mapped near-infrared image plane. The region of atrophy lies at the inferior border of the crest of the elliptical dome, where the choroid is thinnest.


Multimodal imaging findings of choroidal neovascularization. Early and transit phase indocyanine green angiographic frames demonstrate perfusion of a choroidal vascular loop at the fovea (green arrowhead) followed by hyperfluorescence of at least three polypoidal lesions (red arrowheads) and their feeding network (yellow arrowhead). Magnified horizontal and vertical raster enhanced depth spectral domain optical coherence tomographic (OCT) line scans through these areas show the polypoidal lesions as peaked pigment epithelial detachments (PEDs) and the feeding network as an adjacent shallow irregular PED. The presence of pathologically dilated choroidal vessels is noted with overlying loss of choriocapillaris tissue, especially at the crest of the dome. En face OCT (3 x 3 mm) through the shallow PED reveals the spherical morphology of at least three polypoidal lesions. En face OCT angiography (3 x 3 mm) through the PED isolates the type 1 neovascular tissue from the rest of the choroid and shows significant flow through the feeder vessels and within the polypoidal lesions.


Bilateral lower lobe consolidation.


Left sided occipital cerebral infarction.


Preoperative angiogram.


Pathology slides,. From the scalp lesion.


From the cerebellopontine angle lesion.


Preoperative photograph showing diffuse swelling of the lower one third of the Face.


Orthopantomograph (OPG). Of lesion 7 years ago showing unilocular radiolucency with well-defined sclerotic border.


(b) The radiograph of the lesion at the present time shows extensive involvement with the lesion having crossed the midline and involved the ramus right up to the sub-condylar region. Note the multilocularity.


(c) Postoperative OPG showing stabilization of mandible with reconstruction plate and intermaxillary fixation.


Resected specimen showing the expansion of the buccal cortical plate.


Front view showing classical features of child with ectodermal dysplasia.


Side view showing classical features of child with ectodermal dysplasia.


Intraoral view showing partial anodontia of maxillary jaw with complete anodontia of mandibular jaw. Aplasia of alveolar bone in the edentulous areas is clearly seen.


Orthopantogram (OPG) showing developing permanent canines, right permanent first molar in the upper arch and permanent right first molar in the lower arch.


Lateral cephalogram showing aplastic lower jaw.


Child patient with trial denture.


Partial denture for maxillary jaw and complete denture for mandibular jaw.


Clinical images of the patient. A; Alopecia and generalized erythematosquamous patches on the trunk.


Clinical images of the patient. B; Tumorous lesions on the neck and face.


Clinical images. A; Before therapy with IFNa.


Clinical images. B; During therapy.


Clinical images. C; After 2 months of therapy.


Preoperative slit-lamp photograph of the right eye showing advanced keratoconus with a full-thickness central corneal scar from previous hydrops.


(A) One-year postoperative slit-lamp photograph of the right eye showing a clear graft. Some residual stromal scarring can be seen.


(B) One-year postoperative optical coherence tomographic image of the right eye showing good graft-host apposition. Note the graft with tapered ends to match the recipient residual stromal bed.


Clinical photograph of the patient's skin over the upper thoracic region showing a midline dimple (black circle).


Photomicrograph of the excised mass revealing a typical dermoid cyst lined by well-differentiated keratinizing squamous epithelium (original magnification, x50).


Slit-lamp examination of the left eye at initial visit shows white, branching, needle-like, crystalline corneal stromal infiltrate.


Magnified view of the corneal crystalline infiltrates.


Slit-lamp examination of the left eye at 3 months showing resolved lesion with decreased infiltration.


Clinical findings at 1 month after presentation (2 months after the head injury). . Notes: Fluorescein angiography of the left eye shows a mild leak from the peripheral vessels and from the nonperfusion areas in the peripheral retina; however, there is no retinal neovascularization. A delay in choroidal filling and arm-to-retina time was found.


Chest CT before treatment, showing a thick-walled cavity in the left upper lung, with smooth inner and irregular outer margins. The adjacent pleural and the left lower pleural were thickened.


Chest CT after 6 weeks of treatment, showing the cavity disappeared, leaving only a little patchy infiltration. The pleural thickening was improved.


Skin defect after the excision is covered with split skin graft.


FHI shows an organoid pattern and is composed predominantly of mature adipose tissue, fibrous trabaculae and spindle-shaped cells (H & E, x10).


Preoperative anterior segment optical coherence tomography (AS-OCT) of left eye. It demonstrates explicitly the Descemet membrane detachment, the overlying corneal graft oedema and graft thickness measurement (1165 mum). White arrow points towards the area of corneal thinning.


Three-month postoperative appearance of left eye. a Slit-lamp photograph and b anterior segment optical coherence tomography (AS-OCT) showing resolution of the corneal graft oedema (graft thickness is measured to be 640 and 653 mum) and restoration of the graft-host junction structural anatomy.


Second patient. Immunohistochemistry. (A) Hematoxylin and eosin (H&E) stain, 200x magnification. The tumor comprises two main elements: sheets of large cells, many with a rhabdoid appearance (top) and small, more primitive-appearing cells (bottom).


Second patient. Immunohistochemistry. (B) (H&E) stain, 400x. This shows large cells, many with rhabdoid features and central mitoses.


Second patient. Immunohistochemistry. (C) INI1 stain, 400x. There is no nuclear staining in the tumor cells. A positive control is provided by the endothelial cells in the vessel at the center, and in other scattered glial and inflammatory cells.


Photograph of the patient taken at 1 week after the supraorbital nerve block using 4% tetracaine dissolved with 0.5% bupivacaine. Mild edema around his left eyelids was observed.


Clinical course of the patient. (A) Stage 1: from pathogeny to intubation.


Clinical course of the patient. (B) Stage 2: ECMO stage.


Clinical course of the patient. (C) Stage 3: transplant and post-transplant stages.


Microscopic examination of the explanted lung (hematoxylin-eosin stain, x50) shows extensive consolidation of lung tissue and pulmonary interstitial fibrosis (arrowheads). Ring fibrosis connecting alveolar orifice rings and inflammatory cell infiltration into the alveolar walls with pneumocyte hyperplasia and squamous metaplasia.


Curly, dark, and short hair on the temporal areas in contrast to the patient's normal, blond, straight hair on the parietal and frontal areas. Right temporal area.


Curly, dark, and short hair on the temporal areas in contrast to the patient's normal, blond, straight hair on the parietal and frontal areas. Left temporal area.


Skin lesions before rituximab treatment.


Clinical picture eight months after initial rituximab treatment.


(A) A large number of yellow-colored papules on the forehead, cheek, and chin.


(B) Hyperproliferation of the sebaceous glands (HEx4).


Almost complete regression of lesions after two months of treatment.


Biopsy of the left supraclavicular node measuring 6 cm.


FFA shows early hyperflourescence with late pooling in serous detachment.


Ultrasonography shows a mass lesion of uniform echogenecity and low internal reflectivity.


Showing granuloma with Langhan's giant cells and caseation necrosis.


Healing lesion two months after starting anti-tuberculous treatment.


Scarred granuloma seven months after starting anti-tuberculous treatment. Fovea is spared.


At one-year follow-up, fundus picture showed healed, pigmented scarred lesion at fovea. OCT showed reduced thickness, scarred lesion with partial restoration of foveal contour.


Periorbital swelling.


Coronal section of MRI scan showing air locule.


Transverse section of MRI scan showing air locule.


Infantography shows a large amount of free-air in peritoneal cavity before operation.


Grossly it shows a round mass wrapping around a sigmoid colon.


A hypercellular and poorly circumscribed tumor mass in submucosa and muscularis proper (H&E stain, x 40), atypical spindle cells forming fascicular arrangement with mitoses and small amount of interstitial collagen in inlet (H&E stain, x 400).


Mirror image showing mesiodens and a supernumerary tooth palatal to 21.


(a) Panoramic radiograph showing supernumerary teeth along with the absence of 18, 28, 35, 38, and 48.


(b) Intraoral periapical radiograph showing two conical supernumerary teeth with completely developed roots.


First Brain MRI. Axial FLAIR images demonstrating hyperintense extensive and confluent lesions in cerebellar white matter.


First Brain MRI. , affecting the corpus callosum.


First Brain MRI. And compromising the central and juxtacortical white matter.


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


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


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


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


Abdominal ultrasound showing a large splenic cyst containing homogenous internal echoes/debris.


Axial T1 post contrast MR image shows a non-enhancing cystic lesion (3a), Coronal T2 image shows a hyper-intense fluid signal intensity splenic lesion (3b).


Intraoperative picture of the transsphenoidal and tuberculum sellae endoscopic surgery. Intraoperative findings revealed a soft yellowish cystic lesion ( ) along the pituitary stalk ( ) and the optic chiasma (Delta).


Magnetic resonance imaging sequences:. T1.


T2 images sequences.


Intraoperative photography of the tumor.


Sectioning revealed a nodular mass having a tan-white fleshy cut surface with both myxoid and fibrous areas, along with scattered areas of necrosis. The area corresponding to the fungating lesion had a necrotic rim with a hemorrhagic cut surface.


Keloid scar at first presentation.


Follow-up after 1 month of wearing the pressure earing.


Keloid scar 5 months since the initial presentation with a flattened appearance.


Rapid regrowth of keloid scar.


Clinical aspects. Lip swelling and healing blister upon presentation.


Lower lip biopsy.


Source images of the computed tomography angiography of the lower extremities. Axial.


Source images of the computed tomography angiography of the lower extremities. Sagittal. Images show an iliacus hematoma compressing the left psoas muscle (white arrow heads), as compared with the right psoas muscle. EIA : external iliac artery, IIA : internal iliac artery, Il : iliacus muscle, Ps : psoas muscle.


Computed tomography one month after the surgical evacuation. The abdominal computed tomography scan shows a decreased amount of hematoma and a normal appearance of the left psoas muscle. EIA : external iliac artery, IIA : internal iliac artery, Il : iliacus muscle, Ps : psoas muscle.


Pictured are colonies (superior.


Inferior. Aspects of culture plate shown) with moderate to slow growth in potato dextrose agar at 25. C; colonies are low-lying, velvety, and white-gray to brown.


Lactophenol cotton blue stain following growth in cornmeal agar for slide culture at 1 week (C) reveals phialides bearing apical clusters of cylindrical, hyaline conidia and brown septate hyphae consistent with Phaeoacremonium species.


A; Right retroauricular zone before chemotherapy.


B; Right retroauricular zone after chemotherapy.


Photograph showing a nodular swelling over right lower eyelid.


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


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


A: Photograph of the lesion of the back prior to surgical intervention. Scar in the midline indicates possible biopsy of previous approach. The tumor is roughly marked by the extension of the circular nevus covering the entire lower back.


B: Photograph of the back following debulking procedure and completion of wound healing.


Histology of melanotic neurofibroma depicting clustered and scattered pigmented cells in H&E stain. Tumor cells react with antibodies against S100-protein and melan-A, note the typical wavy contours of the cells in the immunohistochemistry (Scale=50 microm).


Flaccid blisters, erosions, and crusted plaques were observed on the patient's trunk and inguinal areas.


Healed skin lesions with remained hyperpigmentation after 9 months of treatment.


Serum C4 and C1-INH plasma level between 2009 and 2017.


A 53-year-old male presented to the emergency room with acute abdominal pain, Hematemesis, Malena non-contrast-enhanced computed tomography (axial and coronal reformatted sections) (a and b) - Abdomen shows an exophytic ulcerative lesion seen along the greater curvature of stomach associate with perigastric and peri splenic fat stranding (white arrow).


A 53-year-old male presented to the emergency room with acute abdominal pain, Hematemesis, Malena contrast-enhanced computed tomography (axial section and coronal) (a and b) - Abdomen shows an exophytic enhancing ulcerative component seen arising from the proximal body of the stomach and extending up to the splenic hilum with loss of fat plane (white arrow) and non-enhancing wedge-shaped area with the apex toward the splenic hilum - splenic infarction (yellow arrow).


A 53-year-old male presented to the emergency room with acute abdominal pain, Hematemesis, Malena contrast enhanced computed tomography - Abdomen on follow-up imaging shows an exophytic enhancing ulcerative component from the proximal body of the stomach and extending up to the splenic hilum with fistulous communication between the spleen and the stomach (white arrow) and few air pockets noted within (yellow arrow).


A 53-year-old male presented to the emergency room with acute abdominal pain, Hematemesis, Malena on follow-up scan - USG image shows - There is the presence of few echogenic foci (air pockets) in the splenic parenchyma (white arrow).


Multiple serial images of esophagogastroduodenoscopy at different angulation show.


Exudative material (indicated by the blue arrow).


Proliferative growth in the region of the gastric fundus (indicated by white arrows).


Fresh or altered blood (indicated by black arrows).


(a) Split spinal cord is dissected from the bony spur.


(b) Fibrous band is cut from the attachment site in the upper lamina.


(a) Bony spur is resected from its base to expose the opening of the anterior dura.


(b) Anterior dura is sutured.


(c) Right spinal roots are exposed.


The patient was 5 year-old with obvious cone-shape teeth and scanty eyebrows.


Frontal bossing, prominent supraorbital ridge, sunken cheeks, thick lips, low-set ears, scanty eyebrows and hypotrichosis with fine, sparse and brittle scalp hair but normal sexual hair (beard).


Fragile-appearing dry skin with reduced hair follicles.


Clinical presentation upon day of surgery.


CT head showing subcutaneous extra cranial cystic lesion with no intracranial connections.


A. H&E section H&E section (2x) : Low power of the cyst lined by malignant squamous epithelium.


B. H&E section H&E section (10x) High power of cyst lining with foci of stromal invasion. (highlighted by red arrow) by islands of malignant squamous epithelium.


Patient's presentation on follow up after 2nd surgery.


MLH1 protein expression in squamous cell carcinoma by IHC.


Partial loss of MSH2 protein expression in squamous cell carcinoma by IHC.


Partial loss of MSH6 protein expression in squamous cell carcinoma by IHC.


PMS2 protein expression in squamous cell carcinoma by IHC.


(a) Frontal chest radiograph demonstrates normal sized main, right and left pulmonary arteries with a small left basal pleural effusion (arrow).


(b) Axial computed tomography pulmonary angiography demonstrated a filling defect extending from a dilated main pulmonary artery into the left pulmonary artery (arrows).


(a) Follow-up frontal chest radiograph revealed an enlarged main pulmonary artery and a left hilar mass (arrows).


(b) Axial computed tomography pulmonary angiography demonstrated a large lobulated rim enhancing exophytic mediastinal mass extending from the dilated main pulmonary artery and the left pulmonary artery (arrows).


Microscopic examination demonstrated high-grade malignant cells (small arrows) with massive haemorrhage (large arrows) and necrosis (asterisks).


Magnetic resonance imaging of left knee: T1-weighted images sagittal image, shows that the mass iso intense located in contact with the medial femoral condyle with bony scalloping.


T2-weighted images (T2 WI) coronal image.


T2 WI sagittal image, the mass appears heterogeneously hyperintense causing cortical scalloping of the medial femoral condyle.


Magnetic resonance imaging (MRI) T2-weighted fat-saturated sagittal image.


MRI T2-weighted fat-saturated coronal image.


MRI T2-weighted fat-saturated axial image shows high-intensity lesion attached to the medial femoral condyle of left knee, no signs of bone marrow edema.


Magnetic resonance (MR) post-contrast, T1-weighted images (T1WI) Sagittal image.


MR post-contrast, T1WI fat-saturated axial image, shows the mass deep to the medial retinaculum with heterogeneous intense post-contrast enhancement.


MRI of postoperative right renal percutaneous nephrostomy. (A) The axial T2-weighted MR images showing right renal atrophy, empyema in the right upper ureter with increased thickness and signal intensity in the perinephric fat and Gerota's fascia; there is a water balloon of nephrostomy tube (red head of arrow).


MRI of postoperative right renal percutaneous nephrostomy. (B and C) MRI showed no abnormal diffusion restriction in the right kidney.


Grossly, the tumor appeared as exophytic, cauliflower-shaped like mass in the right renal pelvis (3.5x2.5x2.0 cm3) (red arrow); at the ureteropelvic junction, there was another tumor with invasive growth that caused an obstruction of ureter (black arrow).


Pathological features of the carcinoma of upper ureter:. H&E showing urothelial squamous metaplasia.


Positive immunostaining in tumor cells with CK5/6.


Intense positive immunostaining for CK-HMW (+) in tumor cells.


Positive immunostaining in tumor cells with CK8/18.


Positive immunostaining in tumor cells with CK7.


Positive immunostaining in tumor cells with Vim (focal.


Tumor cell proliferation rate as determined by Ki-67 immunostaining showed 60% of positive cells.


Postcontrast MRI post-contrast with AP.


Sagittal. Images showing enhancing lesion extending from nasal sinus to anterior cranial fossa with frontal lobe invasion.


Post-operative postcontrast MRI post-contrast shows Axial axial.


AP. Views with near total resection of mass.


Intra-operative images delineating our designated craniotomy (a).


The dysplastic appearing dura visualized once craniotomy performed (b).


Preoperative nonenhanced computed tomography (CT) scan demonstrating a paramedian right occipital well-circumscribed, inhomogeneously hyperdense, lesion with sharply demarcated erosion of both tables of the skull in axial.


Sagittal view.


Preoperative 3D CT scan showing the bone defect.


Preoperative contrast-enhanced T1-weighted magnetic resonance imaging in sagittal.


Coronal.


View demonstrating the hypointense lesion obstructing the confluence of the superior longitudinal and transverse sinuses, confirmed by MRV.


Intraoperative images: the lesion, exposed through a longitudinal median parieto-occipital incision and skeletonization, bulged from the eroded outer bone table, harvested by a fibrous capsule.


Under microscopic magnification, the capsule was incised evidentiating the cyst content, which had a variegated appearance with some dark areas suggestive for previous subacute intralesional hemorrhage and other areas with the classical pearly aspect of epidermoid cysts.


The lesion was removed piecemeal.


After evacuation of the cystic contents, the fibrous capsule was separated from the borders of the bone and dissected from the intact dura mater.


The sclerotic and thickened bony borders were drilled away, highlighting blood flow restoration in the confluence of sinuses.


The bony defect was reconstructed by acrylic resin cranioplasty.


Postoperative CT scan showing complete removal of the lesion and reconstruction of the bone defect by acrylic resin material cranioplasty in axial.


In 3D CT scan.


Postoperative contrast-enhanced T1-weighted MRI in sagittal.


View, demonstrating the complete exeresis of the lesion with resolution of venous sinuses obstruction, as confirmed by MRV.


Photomicrograph of the specimen shows a cystic formation with a fibrous wall, outlined by squamous epithelium and containing keratinic material arranged in lamellae. HE, x100), foreign body granulations with moderate vascularity.


Intralesional hemorrhage can be observed at higher magnification. HE, x200; foreign body granulation in the circle).


Sagittal Section. Thick enhancing walled cystic lesion within the right retroocular space. Some calcification in the wall.


Coronal sect. Large right-sided paraspinal mass lesion extending above the right kidney and displacing it. Entirely in the paraspinal tissues. It shows prominent peripheral enhancement no real central enhancement compared to surrounding muscle tissues. The adrenal is seen separate to this lesion. Scalloping of the lateral margin of T12. There is no widening of the neural exit foramen of the adjacent vertebrae. The remainder of the spine appears unremarkable.


Axial section. Lesion lies above and displaced the right kidney extending into the intervertebral foramen in the lower thoracic spine. There is no widening of the neural exit foramen of the adjacent vertebrae.


Coronal section. Stable appearances. No evidence of recurrent disease.


Sagittal section. No axillary or mediastinal lymphadenopathy is seen. No evidence of lung nodules.


A; Multiple firm, flesh-colored and red-brown papules and nodules in a cluster present on the extensor surface of the patient's right arm.


B; Lesions after 2 weeks of liquid nitrogen cryotherapy.


C; Lesions after 4 weeks of liquid nitrogen cryotherapy.


D; Lesions after 1 year of liquid nitrogen cryotherapy. . There is a relatively well-circumscribed and well-defined dermal proliferation of intersecting fascicles of spindle cells.


Initial pathology.


NGS 400 genes.


Violaceous papules on the neck.


Violaceous pigmentation of lower lip and angles of the mouth.


Whole-body bone scan with increased uptake in two foci.


Topography, MRI, and gross pathological appearance of canine snake eye myelopathy (SEM)-like phenotype. (A) Schematic and normal T2W transverse MR image (lower inset) of canine C5 spinal cord segment illustrating putative arterial supply and Rexed laminar structure of the gray matter (upper inset). SEM-like lesions appear as bilaterally symmetric lesions (white dashed ovals) distributed in laminae VI-IX of the gray matter.


Topography, MRI, and gross pathological appearance of canine snake eye myelopathy (SEM)-like phenotype. (B) Transverse T2W MRI through the cranial aspect of C5 from Case 1 with the SEM-like phenotype demonstrating bilaterally symmetric intramedullary hyperintensities in the ventral horn gray matter and dorsoventral flattening of the spinal cord.


Topography, MRI, and gross pathological appearance of canine snake eye myelopathy (SEM)-like phenotype. (C) The SEM-like phenotype is pathologically characterized by bilateral cavitations in the C5 ventral horns and poliomalacia; Case 1.


Serial MRI and neuropathology of Case 2. (A) Transverse T2W image with hypointense extradural lesion at C5-C6 disc space, lateralized to the right aspect of the vertebral canal, and causing marked compression and displacement of the spinal cord.


Serial MRI and neuropathology of Case 2. The lesion is of mixed signal intensity on transverse TIW post-contrast images (B) suggesting the presence of extradural hemorrhage admixed with hypointense extruded disc (white arrow).


Serial MRI and neuropathology of Case 2. (C) Sagittal T2W image obtained 7 days after surgery demonstrating the C5-C6 ventral slot defect and a tubular hyperintense intramedullary lesion extending from the cranial aspect of C5 to the cranial aspect of C7.


Serial MRI and neuropathology of Case 2. On transverse images, the SEM-like phenotype appears as bilaterally symmetric T2W hyperintense.


Serial MRI and neuropathology of Case 2. Gray matter lesions that are mildly T1W hyperintense.


Serial MRI and neuropathology of Case 2. And contrast-enhancing Despite resolution of the previous extradural compression, the spinal cord throughout the lesion region is swollen with attenuation of the subarachnoid space.


Serial MRI and neuropathology of Case 2. (G) Histology of the C6 spinal cord demonstrating various stages of cavitations (black arrow) and gray matter necrosis, with neurons in the lateral portions of laminae VII and IX displaying acidophilic necrosis characterized by angular and hypereosinophilic cytoplasm and nuclear pyknosis. At the junction of the intermediate and ventral gray horns (dashed line) with spinal cord white matter, there is also white matter vacuolization. H&E stain.


MRI features of the SEM-like phenotype, Case 4. (A) Sagittal T2W image with linear hyperintense intramedullary lesion extending from the cranial aspect of C6 to the cranial aspect of C7.


MRI features of the SEM-like phenotype, Case 4. On transverse images, SEM appears as bilaterally symmetric T2W and T2*GRE There is heterogeneously increased T2W signal [, arrow.


MRI features of the SEM-like phenotype, Case 4. Hyperintense lesions in the ventral gray matter that are T1W isointense.


MRI features of the SEM-like phenotype, Case 4. And non-enhancing following intravenous gadolinium administration contrast enhancement. Of the left serratus ventralis muscle.


Autopsy on this 68 year-old patient showing hemorrhagic ulceration in the stomach.


Angioinvasive fungal organisms in the vascular channel and the vessel walls of the postmortem stomach, 400 x H&E.


Time course of serum levels of hCG ( ), TSH ( ), fT4 ( ) and fT3 ( ). FLC performed in the setting of TTTS led to resolution of hyperthyroidism within 1 week along with a rapid decrease in hCG levels. Hormones were measured by ECLIA (electrochemiluminescence immunoassay) on cobas e602 (Roche Diagnostics, Rotkreuz, Switzerland). Reference ranges (not trimester-specific): TSH, 0.270-4.20 mUI/. FT4, 12-22 pmol/. FT3, 3.1-6.8 pmol.


Contrast-enhanced computed tomography (axial section) at the level of nasal cavity showing a heterogeneously enhancing soft-tissue mass lesion (*) distending the right nasal cavity, displacing the nasal septum to the left side.


Clinical photograph showing nodular lesion on the tongue.


Contrast-enhanced computed tomography (axial section) of the neck showing a heterogeneously enhancing soft-tissue mass lesion (*) at the tip of the tongue. The enhancement of the lesion is more than the tongue muscles.


(A): Cerebellar vermis with 4th ventricle and brainstem. FCE in arteriole (arrow) (20X magnification with H&E stain).


(B): FCE in cerebellar arteriole (200X magnification with H&E stain).


Evidence of FCE in cerebellar arteriole. Alcian blue stains mucopolysaccharides/hyaline cartilage blue (400X magnification with Alcian blue stain).


CT Chest shows multifocal patchy airspace opacities and small pleural effusions.


Chest radiograph done on day 6 shows improvement in bilateral infiltrates.


Chest radiograph done after discharge showed resolution of pulmonary infiltrates.


Clinical appearance of the tumor of the lacrimal caruncle at the first visit. . Notes: (A) Outside of the tumor. It appeared smooth surface and was whitish with dilated capillaries. In addition, the apical portion of the tumor had a papilloma-like appearance with mild hyperemia.


Clinical appearance of the tumor of the lacrimal caruncle at the first visit. (B) Backside of the tumor. The "navel-like structure" was observed near the center of the lesion in the backside (arrow).


Result of the in situ hybridization for HPV positivity. . Notes: HPV-51 was detected in the apical portion (triangle). IS: Aminolevulinate deltasynthase 1 was amplified for the multiplex PCR. ES for multiplex PCR: DNA fragments derived from Brevundimonas diminuta cloned to plasmid pCRII-TOPO (Invitrogen Corporation, Carlsbad, CA, USA) were added to the PCR mixtures along with external plasmid-specific primers. HPV-35 was negligible (*). . Abbreviations: ES, external positive standard; HPV, human papillomavirus; IS, internal positive standard. .


Clinical appearance after resection of the tumor. . Notes: There has been no recurrence of the tumor up to 3 years postoperatively.


Big papillary clusters having fibrovascular core (Giemsa, x100).


Follicular epithelial cells showing intranuclear cytoplasmic inclusions (Pap, x1000).


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


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


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


CT scan showed a 50 x 42-mm rounded, solid, homogeneous expansive lesion of distinct borders in the left adrenal gland.


CT scan showed a slightly enhanced tumor in the left adrenal gland.


Gross specimen showing large lobulated phyllodes tumor (gray arrow) and a spiculated tumor at its proximity (black arrow).


Clinical photographs showing swelling in the right submandibular region in a 16 year-old male patient (fornt).


Clinical photographs showing swelling in the right submandibular region in a 16 year-old male patient (side view).


Section of lymph node shows scattered reactive lymphoid follicles with prominent germinal centers (H&E, x10).


Focal areas of interfollicular expansion by epithelioid cell granulomas and large mononuclear cells (x40).


Predominantly mononuclear cells showing prominent nucleoli (x40).


Immunohistochemical staining shows CD30 positive for the large cells.


Immunohistochemistry positive for Pax 5.


Clinical presentation.


Growth coming out from the clitoreal region.


After the repair.


Specimen cut open.


HPE shows thin epidermis and underlying hypo cellular myxoid tissue containing blood vessels of various calibers.


High power view showing hyaline thickening of blood vessels.


Normal findings of brain/spinal MRI. And T2.


Normal findings of brain/spinal MRI. MRI brain scan T1.


Normal findings of brain/spinal MRI. , MRI spine sagittal.


Ocular edema with flamed shaped hemorrhages OD.


Medical image.


Gradual improvement after treatment OD.


Normal findings of brain CT scan: CT brain scan without/with intravenous contrast dye administration (A,B).


Contact lens culture. Lactophenol cotton blue slide preparation, x1,000. Rhizopus spp. demonstrating rhizoids (arrow head) emerging characteristically at the base of a sporangiophore.


Slit-lamp photograph of resolving corneal infiltrate and satellite lesions after 1 month of treatment, using the Apple iPhone 4.


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


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


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


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


An abdominal CT scan performed on admission showed that the irregular marginal tumor that was approximately 4 cm wide contained necrosis in the central space (black arrows).


An abdominal CT scan showed hemoperitoneum from a metastatic extragonadal germ cell tumor immediately before the emergency operation (black arrows).


The operative scheme showed that venous bleeding from the surface of a metastatic extragonadal germ cell tumor ( ) was found between the ligament of Treitz and the inferior mesenteric vein in a horizontal position. Hemostatic treatment was performed with 4-0 proline thread attached to a medicated cotton sponge ).


Left eye 3 weeks post-op.


(A and B) Left eye 4 months post-op showing central corneal opacity with dense central vertical striae.


Right eye 6 months post-op showing diffuse anterior stromal haze without the central dense opacity.


Clinical photographs of the right cornea. . Notes:. Subepithelial deposits extending toward the corneal center by fingerlike projections.


Clinical photographs of the right cornea. At higher magnification, depicting the spiral-like pattern known as corneal verticillata.


Electron microscopy of the corneal biopsy specimen. . Notes: (A) Numerous epithelial rod-shaped bodies (original magnification, x7,200).


Electron microscopy of the corneal biopsy specimen. (B) Epithelial rod-shaped body at higher magnification (original magnification, x19,000).


Electron microscopy of the corneal biopsy specimen. (C) Numerous intracellular hexagonal-shaped bodies (original magnification, x19,000).


Electron microscopy of the corneal biopsy specimen. (D) Intracellular hexagonal-shaped bodies at higher magnification (original magnification, x29,000).


Before and after photographs of right cornea. . Notes: (A) Before: cloudy cornea at baseline.


Before and after photographs of right cornea. (B) After: after receiving treatment for myeloma the corneal cloudiness started improving.


Split cord radiographic and operative images. (a) Preoperative photograph of an area of hypertrichosis over the lower lumbar spine.


Split cord radiographic and operative images. (b) Sagittal T2-weighted magnetic resonance imaging (MRI) showing the division of the spinal cord above the dural division and bony septum.


Split cord radiographic and operative images. (c) T2-weighted axial MRI showed the split cord within a single dural sac.


Split cord radiographic and operative images. (d) Split cord within divided thecal sac.


Split cord radiographic and operative images. (e) Intraoperative imaging showing the split cord with associated fat and ectopic ganglion cells from the intradural lesion.


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


Coronal preoperative MRI in patient 2 revealing pancreas divisum with a cyst lesion measuring 7.3 cm involving the uncinate process and duct of Wirsung. Of note, mural nodularity is appreciated.


A large number of hemosiderin-laden macrophages and foci of fresh hemorrhage were determined. H and E, x100 and Prussian blue, x100.


Surgical shaving of the left nipple and areola.


The patient 2 years after the surgery.


Clinical manifestation and histopathological findings of herpetiformis-type drug-induced pemphigus caused by tislelizumab before and after glucocorticoid therapy. Clinical manifestation before glucocorticoid therapy.


Clinical manifestation and histopathological findings of herpetiformis-type drug-induced pemphigus caused by tislelizumab before and after glucocorticoid therapy. Clinical manifestation after glucocorticoid therapy.


Clinical manifestation and histopathological findings of herpetiformis-type drug-induced pemphigus caused by tislelizumab before and after glucocorticoid therapy. Histopathological findings: epidermal spongiosis, intraepidermal cleft, acantholytic cells in the bulla, edema, and ,mixed type inflammatory infiltration containing eosinophils in the papillary dermis (H&E staining,. . X100.


Clinical manifestation and histopathological findings of herpetiformis-type drug-induced pemphigus caused by tislelizumab before and after glucocorticoid therapy. Histopathological findings: epidermal spongiosis, intraepidermal cleft, acantholytic cells in the bulla, edema, and ,mixed type inflammatory infiltration containing eosinophils in the papillary dermis (H&E staining,. . X200).


Clinical manifestation and histopathological findings of herpetiformis-type drug-induced pemphigus caused by tislelizumab before and after glucocorticoid therapy. Direct immunofluorescence (DIF) findings: intercellular intraepidermal C3 deposition.


Clinical manifestation and histopathological findings of herpetiformis-type drug-induced pemphigus caused by tislelizumab before and after glucocorticoid therapy. IgG deposition. Within the lower part of epidermis.


A tumor measuring 30 x 40 mm in diameter was identified in the anterior wall of the gastric corpus.


Thickening of the gastric wall (arrowhead), high density of fat around the gastric wall, and the "station 3" enlarged lymph node.


Positron emission tomography/computed tomography revealed uptake by the gastric wall and perigastric lymphadenopathy.


Remarkable shrinkage in tumor size was observed, improvement of gastric wall thickness after chemotherapy and shrinkage of lymphadenopathy after chemotherapy (arrowhead).


After three cycles of chemotherapy, remarkable shrinkage in tumor size was observed.


The resected gastric tissue specimen of the angiosarcoma regressed.


Multiple metastases of liver and retroperitoneal region after the surgery.


A; Biopsy of the left abdominal lesion showing both superficial and deep dense lymphohistiocytic and plasma cell infiltrate. Hematoxylin-eosin stain.


B; Immunohistochemistry for T. Pallidum demonstrates spirochetes amidst the infiltrate confirming the diagnosis of syphilis. The PASD preparation and Fite stain did not reveal the presence of microbial pathogens.


C; Biopsy of the lesion on the right lower leg shows psoriasiform epidermal hyperplasia with interface dermatitis. The epidermis is surmounted by a parakeratotic scale. There is perivesicular plasma cell and granulomatous infiltrate. Hematoxylin-eosin stain. Immunohistochemistry for T. Pallidum showed the presence of spirochetes within the dermal-epidermal junction.


Right necrotic vulva hematoma.


After resolution of Hematoma.


Right vulvar haematoma.


After resolution of hematoma.


Histological examination showed a T1 cancer with a positive vertical and horizontal margin.


Follow-up after cold snare polypectomy. A; White light observation showed no recurrent findings.


Follow-up after cold snare polypectomy. B; Blue laser imaging showed no recurrent findings.


Follow-up after cold snare polypectomy. C; Endoscopic submucosal dissection was performed on the scar area, and the histological examination showed no remaining tumors.


Contrast enhanced computed tomography image of tumor compressing and displacing internal jugular vein.


Schwannoma on vagus nerve.


Vagal nerve after resection of tumor.


Cutaneous nodules cafe-au-lait spots.


(a) Cervical magnetic resonance imaging - T2 with solid nodular expansive lesion originating from the level of C2-C3 (5 cm x 4 cm x 5.1 cm) with extension toward the foramen magnum, causing medullary and bulbar compression and another lesion from the level of C4-C5.


(b) Dumbell type formation intradural and extramedullary.


(c) Represents an extradural component of C2C3 lesion.


(d) Anterolateral lesion of smaller size located anterolateral right.


A; The patient in April 2013 with a prolapsed, bleeding tumor mass.


B; Details of the tumor mass with temporal skin socket.


C; Details of the temporal part of the mass.


D; The patient in July 2013 with an enlarged tumor mass and bleeding.


E; The patient in September 2013 before external Co60 radiotherapy.


F; The patient in October 2013 after external Co60 radiotherapy.


A; Microscopic picture of the tumor composed of epithelioid melanocytes (star), with large areas of necrosis (arrow). X200 (a).


B; Immunohistochemical detection of some prognostic factors expressed in the tumor (high proliferation index Ki67 [positive nuclei, arrows]). Immunoperoxidase, diaminobenzidine, x200/400 (b-e).


C; Diffuse strong cytoplasmic positivity of apoptosis-inducing factor. Immunoperoxidase, diaminobenzidine, x200/400 (b-e).


D; Few cyclin D1-positive nuclei (arrows). Immunoperoxidase, diaminobenzidine, x200/400 (b-e).


E; Odd p53-positive nucleus (arrow). Hematoxylin and eosin. Immunoperoxidase, diaminobenzidine, x200/400 (b-e).


Physical examination revealed the skin had turned shiny and tight. Severe sclerosis was detected on both pretibial regions (A).


Physical examination revealed the skin had turned shiny and tight. When touched, the skin felt rather sclerotic and lost the ability to fold compared to normal skin (B,C).


Physical examination revealed the skin had turned shiny and tight. Changes in the arm and lower abdomen in favor of morphea were also observed (D,E).


Thickening and hyalinization of connective tissue of deep dermis, subcutaneous fat and muscular fascia, and mucin deposition (A).


Atrophy of adnexal structures, increased fibroblastsand dense collagens through the deep dermis (B).


Infiltrative changes in the eccrine glands (C). No obvious eosinophilic infiltration was detected.


Renal biopsy with Congo-Red stain revealing orange-red deposits in all 34 glomeruli and vascular walls.


Thoracic x-ray showing hyperostosis at the proximal extremities of the clavicles and in some sterno-costal joints.


External photos of the patient. (a) Ptosis of the left upper eyelid.


External photos of the patient. (b) Elevation of the ptotic eyelid with mouth opening, esotropia and hypotropia in the left eye.


Fundus photos of both eyes. (a) Healthy retina and optic disc in the right eye.


Fundus photos of both eyes. (b) Morning glory disc anomaly in the left eye.


(a) An echogenic mass was found in the right mid-abdomen (white arrow).


(b) High-resolution linear probe image, the mass appeared to be an intraluminal lesion (between white arrows).


(c) minimal internal vascularity or Doppler interrogation (blue arrow).


The right mid-abdominal mass is associated concentric layers of alternate hypoechoic (long arrow) and hyperechoic (short arrow), with a stalk (arrowhead) in keeping with a superimposed colocolic intussusception.


Images obtained during colonoscopy (a and b): an intraluminal well-defined lesion which is submucosal in location (red arrow).


Appearance of lesions on the patient's back on presentation.


Appearance of lesions on the patients axilla on day 1 after discharge.


Appearance of lesions on the patient's chest and abdomen on presentation.


Appearance of lesions on the patient's elbow on presentation.


Appearance of lesions on the patient's lateral abdomen on presentation.


Result of the patient's skin biopsy showing fixation of IgG in the basement membrane of the epidermis, on the roof the subepidermal blisters, with minor migration in the intercellular space of the epidermis and moderate in the papillary layer of the dermis.


Result of the patient's skin biopsy showing fixation in the basal membrane of the epidermis, and slightly in the dermis, with permeation of some keratinocytes of the C3 component of complement.


Appearance of lesions on the patients chest and abdomen on day 1 after discharge.


(a) The patient's left eye showed yellowish-brown deposits in the palpebral fissure area of the cornea.


(b) Dense yellowish-brown deposits in the deepest stromal layer of the cornea adjacent to the endothelium in the left eye.


(c) Right eye showed similar corneal deposits.


(a) Two weeks after Descemet's Stripping-automated Endothelial Keratoplasty, a significant anterior subcapsular cataract was evident.


(b) Phacoemulsification, intraocular lens implantation and temporal pupilloplasty was performed, and the cornea became completely clear 6 months after Descemet's Stripping-automated Endothelial Keratoplasty.


T1 sagittal postcontrast image showing the pituitary macroadenoma (marked by the arrow).


Axial fluid-attenuated inversion recovery image showing the edema of the optic tract bilaterally (marked by the arrows).


External photograph of the face showing bilateral ptosis.


Plantar keratoderma.


Genralised atrophy, dyschromia and xerosis; the hallmark features of poikiloderma.


Nodule over the palmar aspect of left hand (which later showed actinic keratosis).


Hypoplastic nails with longitudinal ridging.


Immunohistochemical analysis showed a marked reduction in the number of S100+ epidermal Langerhans cells.


Immunohistochemical analysis showing marked reduction in CD1a+ epidermal Langerhans cells.


Ulcer over the palm with granulation tissue in a woman on gefitinib.


Pink, hyperplastic plaques, with an uneven surface, basal infiltration, and ill-defined, sheet depigmentation in the center.


Spindle tumor cells of nodular hyperplasia, arranged in an interwoven pattern. HE. x100.


Actin-positive immunohistochemistry. x100.


Gross view of the specimen after formalin fixation with multiple fatty to solid gray pedunculated masses some of which appeared to arise from the coalescence of the smaller nodules (black arrowhead). Note the variable sizes of these pedunculated (exophytic masses) (white arrowheads); one mass was endophytic (black arrow) projecting within the cecal lumen. The white arrow highlights the ileocecal valve; the black star highlights the external aspect of the largest exophytic mass.


The largest of the appendices showed a sclerosing phenotype with occasional lobules of fat (H&E, 100X). The hyperchromatic atypical stromal cells are evident.


The largest mass showed extensive myxoid stroma (H&E, 200X).


Fundus photographs of the patient. . Notes: (A) Nonproliferative diabetic retinopathy and a swollen optic disc.


Fundus photographs of the patient. (B) Nonproliferative diabetic retinopathy.


The lesion over the hard palate.


Bony erosion of the hard palate in CECT.


Excised specimen, oral side.


Cut section of excised specimen.


Image of 18F-DOPA PET/computed tomography (CT) of patient. Image demonstrates an asymmetric dopaminergic deficit (worse on the right side) suggestive of Parkinson's Disease.


Swelling in the right buccal vestibule with displacement of second premolar.


Cross-sectional occlusal radiograph showing bicortical expansion caused by the tumor.


Cropped panoramic radiographic image showing the tumor extending from the right fi rst premolar up to the second molar.


Immunohistochemistry with S-100 showing diffuse positivity in the tumor cells (S-100, 10x).


Tumor exposed surgically.


Locally advanced locally cutaneous squamous cell carcinoma of the face extending to the zygomatic area close to the lower eyelid, the right cheek and the mandibular area, characterized by necrotic ulcerated areas and infiltration of subcutaneous tissue.


Leukoplakia over the ventral aspect of the tongue.


Perforation of the hard palate with induration and necrotic tissue at the margins.


(a) Epithelial dysplasia with basement membrane intact from a biopsy taken from leukoplakia on. X100),. (b) epithelial dysplasia on. X400).


Scalp showing sparse hairs and keratotic papules and sparse eyebrow hairs.


Closer view of scalp showing sparse hairs and prominent keratotic papules (revised).


Xanthelasma around both eyelids and multiple xanthomas around joints of both hands and feet.


Erythema associated with flyctena, cutaneous necrosis, pain, fever and staphylococcus aureus infection.


A gross photograph of the examined dog, Bull Terrier, prior to the treatment. The "flat feet" appearance and the loss of the digit in the right thoracic limb are clearly evident.


Histological section from the skin biopsy of the case under investigation. Various stages of the Demodex spp. of mites can be clearly visualized in the hair follicles (H&E staining, 50x magnification).


A gross photograph of the examined dog after the acaricidal treatment. Note the significant improvement in the appearance of the feet after 4 weeks of the treatment. Also, loss of the digit in the right thoracic limb is clearly evident in this photograph.


A, MRI (on Day 1 of admission) showing patchy enhancement of cerebral white matter associated with a mild right to left midline shift.


B, MRI (on Day 2 of admission) showing a marked progression of diffuse cerebral edema of bilateral white matter, right more than left, with worsening of a midline shift.


C, MRI (on Day 15 of admission) showing significant improvement in cerebral edema (less hyperintense white matter area) with a near complete resolution of a midline shift.


MCL. Affecting the nose, upper lips and face.


Disseminated CL. Affecting hands with characteristic multiple nodular lesions which crust at the center.


Amastigotes from Giemsa-stained smear prepared from skin lesion.


Asymmetrical edema of the left lower limb secondary to iliofemoral deep venous thrombosis.


Genital ulcer.


Sagittal image from angiotomography of the abdominal aorta, showing large volume posterior saccular aneurysm.


Volumetric angiotomography reconstruction, showing large volume posterior saccular aneurysm.


Sagittal angiotomography image of the abdominal aorta, showing aneurysm neck and dimensions.


Anteroposterior abdominal aortography before deployment, the large volume saccular aneurysm.


Control angiography after deployment of the endograft, with no leaks.


A pair of neoplastic cells (upper left) shows scant cytoplasm, irregular nuclear contours, visible small nucleoli, and a possible inter-cellular 'window'. The cytoplasmic eosinophilia of the neoplastic cells contrast with the cytoplasmic basophilia of the larger reactive mesothelial cell (lower right) (Wright stain, x1000).


Clinical presentation showing a nodular lesion on the palatal aspect between maxillary left permanent central and lateral incisors.


Clinical manifestation of PA. Dactylitis on all fingers of the right and left hands.


Histopathological findings (H&E staining 100x). Histopathological results revealed hyperkeratosis, parakeratosis, and Munro's microabscess.


A noncontrast.


Contrast-enhanced. Magnetic resonance imaging showing a large well-defined lobulated mass epicentered in the trigone occipital horn and body of left lateral ventricle showing intense homogeneous enhancement, suggestive of choroid plexus tumor.


Unremarkable CXR with no hilar lymphadenopathy.


MRI of the brain showing bilateral periventricular white matter lesions.


Non caseating granulomas seen in bone biopsy.


Liver biopsy.


Mainly right sided oculomotor paresis with elevation deficit and ptosis.


Responded positively to an intravenous test dose of 9 mg edrophonium chloride. Suggesting that double vision was caused by ocular manifestation of myasthenia gravis.


Hypopigmented and anaesthetic patches (yellow circles) on skin over right scapula and left deltoid region.


Sheathed Mf observed in slit-skin smear from ear lobule stained using the Ziehl-Neelsen method with 5 % sulphuric acid as a decolourizer (magnification, 10x).


Mf observed in Giemsa-stained peripheral blood smear. (Magnification, 10x). Note the absence of nuclei at the tail tip.


An inguinal ultrasound examination showed subcutaneous edema and numerous benign reactive enlarged lymph nodes.


A 12x6 mm pretibial ulcer with a fibrin bed on the linear morphoea lesion and erythema with ill-defined borders.


Erythematous lymph nodes on the medial side of the ipsilateral thigh up to the groin. . Note: Two small ulcerated lesions at malleolar level.


(a) Ashy gray-colored, confluent, symmetrical macules with polycyclic margins.


(b) Lesions getting confluent with some areas being spared.


Edema and significant erythema in the distal phalanx of the left thumb.


Radiography showing the bone alteration (osteomyelitis) in the distal phalanx.


Extraoral photograph showing diffuse swelling on left side of the mandible, with facial asymmetry.


Intraoral photograph showing obliteration of left buccal sulcus.


Panoramic radiograph showing multilocular radiolucent lesion in ascending ramus.


CT scan showing expansion and perforation of buccal and lingual cortical plates.


Odontogenic epithelium showing mural proliferation in the form of odontogenic islands. The inset shows the odontogenic islands at a higher magnification.


Photomicrograph showing positive p53 staining in the invading odontogenic islands.


(A) Axial contrast-enhanced computed tomography (CT) scan showing the right adrenal tumor.


(B) CT coronal section showing the right adrenal tumor.


Pathological examination showing pleomorphic rhabdomyosarcoma. (A) Hematoxylin and eosin staining. Spindle-shaped cells arranged in a fascicular pattern were present.


Pathological examination showing pleomorphic rhabdomyosarcoma. Immunohistochemical staining showing positivity for. MyoD1.


Pathological examination showing pleomorphic rhabdomyosarcoma. Desmin.


Pathological examination showing pleomorphic rhabdomyosarcoma. CD56.


Pathological examination showing pleomorphic rhabdomyosarcoma. Vimentin. Magnification, x200.


Dermatomyositis. Perivascular lymphocytic infiltrate (black arrows) and dermal edema with mucus (blue arrow) (HE, x100).


A histology slide of the resected tumour (schwannoma, WHO G1) showing spindle-shaped cells with band-like nuclei. The cells tend to form palisade patterns where the nuclei are seen on the same level in the palisade. This microscopic feature is significant for these tumours (haematoxylin and eosin [H & E], original magnification x40).


Hematoxylin and eosin staining of the cauda equina demonstrating:. X100) pleomorphic spindle cells with prominent nucleoli.


Mitotic figures. X1250), and melanin pigment.


Spreading of neoplastic cells along subpial and perivascular spaces (c, x100).


Immunohistochemical stains for melanoma cocktail including Melan-A demonstrate cytoplasmic reactivity (d).


Midline sagittal magnetic resonance images (MRI) of thoraco-lumbar area. (a) T1-weighted MRI shows the spinal cord tumor at the level of T12, which has high signal intensity relative to that of the cord and combined syrinx.


Midline sagittal magnetic resonance images (MRI) of thoraco-lumbar area. (b) Contrast-enhanced T1-weighted MRI image shows homogenous enhancement.


Brain MRI with and without contrast performed on arrival to our hospital. A; Axial FLAIR images show multiple, extensive and bilateral areas of abnormal signal intensity in the white matter.


Brain MRI with and without contrast performed on arrival to our hospital. B; Axial T1 post-gadolinium images show numerous large, confluent, and patchy ring-enhancing lesions.


Auricular mass (Note the absence of inflammatory sign).


Anterior view of the skin lesion diagnosed as Kaposi sarcoma and Molluscum contagiosum.


Posterior view of the skin lesion diagnosed as Kaposi sarcoma and Molluscum contagiosum.


Low power view of the coexisting Kaposi sarcoma (golden arrow) and Molluscum contagiosum (black arrow). Haematoxylin and eosin staining X 40.


(a) Section showing a lobular lesion composed of enlarged keratinocytes with central eosinophilic molluscum bodies.


(b) Section showing plump spindle cells with bland nuclei delimiting slit-like vascular spaces, consistent with Kaposi sarcoma. Haematoxylin and eosin staining X 200.


Unusual Paraclinical findings of AOSD in lung. A chest radiograph shows a patchy right lobe consolidation in the lower lung zone (a). CT image shows extensive areas of airspace consolidation due to alveolar hemorrhage in right lung.


Unusual Paraclinical findings of AOSD in lung. The bilateral pleural effusions are also notable (b).


Abdominal skin biopsy with haematoxylin-eosin-stained. Perivascular and interstitial infiltrate composed mainly of neutrophils on upper and middle dermis with original magnification x 20 (a).


Abdominal skin biopsy with haematoxylin-eosin-stained. Shows the same specimen in more detail with original magnification x 100 (b).


Areolae of a 38-year old woman with hyperkeratotic, dark brown plaques.


No pathological effloresces after treatment with 70% isopropyl alcohol.


Acrocyanosis of the feet.


Diffuse alopecia prior to treatment.


Initial regrowth of hair after 3 months.


Partial regrowth of hair after 6 months.


Total regrowth of hair after 10 months.


Anterior segment photograph of the left eye. . Note: Severe inflammation of the anterior chamber and entire anterior synechiae.


B-scan ultrasonography of the left eye. . Note: The retina was thought to be not detached, and high-intensity opacities of the vitreous body were also absent.


Fungal mass on the right retina. . Notes: A xanthochromistic fungal mass developed on the right temporal retina during systemic therapy. The photo was hazy due to OCV. . Abbreviation: OCV, opacitas corporis vitrei.


Bilobed oral component of the tumor arising from the upper alveolus eroding the hard palate and extending into the maxillary sinus.


Magnetic resonance imaging of the paranasal sinuses: Laterally, the mass was extending in to the buccal space and medially in to the oral cavity. Superiorly, the mass was eroding the floor of the maxillary sinus, completely occupying the antral cavity, occluding the osteomeatal complex. Anteriorly, the mass was eroding the maxilla up to the first molar tooth.


Da Vinci Xi surgical robot docked from the head end of the patient. The central arm with a 30. upward endoscope, monopolar spatula on the right arm and bipolar Maryland forceps mounted on the left arm.


Palatal defect which healed spontaneously.


(a) Slit lamp photograph of the right eye in diffuse illumination showing a central ring-shaped anterior to mid stromal dry infiltrate (4 mm x 5 mm) with dense focus of infiltrate within the ring.


(b) Slit lamp photograph of the right eye with sclerotic scatter highlighting the central scar.


(a) Pseudopestalotiopsis theae conidiomata sporulating on potato dextrose agar at day 20.


(b) Lactophenol cotton blue mount (1000x magnification) showing fusoid 4-septate conidia with slight constrictions at the septae and conical basal cell with truncated base. The 3 median cells are concolorous and brown with darker colored septae. The conical apical cells have filiform branched appendages.


(c) ITS sequence analysis generated a phylogram which shows that our sample GMRV-L 825/15 has 99% similarity with Pseudopestalotiopsis theae.


Figure 1 : Macula off superior retinal detachment showing areas of patch retinal necrosis (black arrow), site of globe perforation (green arrow), and free triamcinolone particles (blue arrow) in vitreous cavity.


Pre-operation image of lesion.


Macroscopic features of excised specimen.


Postsurgical defect.


Typical cartwheel appearance of DFSP.


Defect after skin grafting.


The surgical specimen with its longest axis at 4,8cm.


Borderlines form adrenal gland cortex to the tumor with Schwann cells into the fat tissue.


Schwann cells positive at S100 protein.


Preoperative adrenal CT and post-operative specimen of the patient. The right adrenal nodule with low density (arrow) was identified on CT.


Preoperative adrenal CT and post-operative specimen of the patient.surgical resection specimen revealed three nodules (red arrow).


Expression of CYP11B1/2 in three nodules of patients. Histological and immunohistochemical staining of three nodules (N1, nodule 1; N2, nodule 2; N3, nodule 3) of this patient and cortisol-producing adenoma from another patient (control, as a reference for positive CYP11B2 staining). HE, hematoxylin-eosin staining.


Expression of CYP11B1/2 in three nodules of patients. Histological and immunohistochemical staining of three nodules (N1, nodule 1; N2, nodule 2; N3, nodule 3) of this patient and cortisol-producing adenoma from another patient (control, as a reference for positive CYP11B2 staining). CYP11B1: immunohistochemical staining of 11beta-hydroxylase ; 200x magnification.


Expression of CYP11B1/2 in three nodules of patients. Histological and immunohistochemical staining of three nodules (N1, nodule 1; N2, nodule 2; N3, nodule 3) of this patient and cortisol-producing adenoma from another patient (control, as a reference for positive CYP11B2 staining). CYP11B2: immunohistochemical staining of aldosterone synthase.


Gene sequence of KCNJ5 and PRKACA in three nodules. Genomic DNA was isolated from the patient's three adrenal nodules and amplified by PCR. Sanger sequencing detected a p. Leu168Arg mutation of KCNJ5 gene (A) in two nodules (N1, N3) and no p. Leu206Arg mutation of PRKACA gene in all three nodules. Positive control: a cortisol-producing adenoma harboring a p.


Gene sequence of KCNJ5 and PRKACA in three nodules. Genomic DNA was isolated from the patient's three adrenal nodules and amplified by PCR. Sanger sequencing detected a p. Leu206Arg mutation of PRKACA gene (B); WT, wild type.


Rhizopus arrhizus associated lethal midline granuloma/rhino-orbital cerebral mycosis. " Destruction of the sinus, nose, face, palate, and orbit; defects of the left sided external nose, soft tissues, and the front wall of the maxillary sinus; and yellow pus was seen within the left maxillary sinus. (A,B) Show patient onset before and after debridement with biopsies.


Rhizopus arrhizus associated lethal midline granuloma/rhino-orbital cerebral mycosis. " Destruction of the sinus, nose, face, palate, and orbit; defects of the left sided external nose, soft tissues, and the front wall of the maxillary sinus; and yellow pus was seen within the left maxillary sinus. (C) Reveals the patches dark discoloration (short arrow), light discoloration (medium arrow), and perforation (long arrow) of the hard palate that represent inflammation, ischemia, and necrosis, respectively.


Rhizopus arrhizus associated lethal midline granuloma/rhino-orbital cerebral mycosis. " Destruction of the sinus, nose, face, palate, and orbit; defects of the left sided external nose, soft tissues, and the front wall of the maxillary sinus; and yellow pus was seen within the left maxillary sinus. (D) Shows widespread destruction in the left side of the palate (arrow).


Rhizopus arrhizus associated lethal midline granuloma/rhino-orbital cerebral mycosis. " Destruction of the sinus, nose, face, palate, and orbit; defects of the left sided external nose, soft tissues, and the front wall of the maxillary sinus; and yellow pus was seen within the left maxillary sinus. (E) Reveals pale gray wool-like mycelium grown on the necrotic nose tissue (arrow).


Rhizopus arrhizus associated lethal midline granuloma/rhino-orbital cerebral mycosis. " Destruction of the sinus, nose, face, palate, and orbit; defects of the left sided external nose, soft tissues, and the front wall of the maxillary sinus; and yellow pus was seen within the left maxillary sinus. (F) Shows complete remission with scars 4 months after antifungal therapy.


T1-weighted MRI coronal.


Sagittal. Images clearly show inhomogeneously gadolinium enhancing mass in sellar turcica extending into suprasellar lesion.


T1-weighted MR coronal.


Sagittal. Images show a partial removal of the tumor after the first operation via translabial transsphenoidal approach.


Sagittal. Images show a partial removal of the tumor after the second operation via a basal interhemispheric approach.


Sagittal. Images show an aggressive extension to the left cavernous sinus, the left orbital fossa and the left forehead with no regrowth in the sellar region.


T1-weighted MR images.


Contrast computed tomography image. Show intracranial dissemination (arrow head) and distant metastasis in the lung (arrow head).


(a) A CT scan axial cut soft tissue setting showing the non-enhancing soft-tissue density from the left posterior ethmoid sinus breached the lamina papyracea.


(b) The mass extended downward into the maxillary infundibulum.


(H&E, x400) Spindle cells ( ) are shown more clear. Slightly mitotic figures were seen (*).


Treatment course of maggot therapy. (a) Before maggot therapy. Necrotic tissue is seen on the surface of the wound.


Treatment course of maggot therapy. (b) After one session (48 h) of treatment, the reduction of necrotic tissues is seen.


Treatment course of maggot therapy. (c) Maggots growing from second to third instar larvae.


Treatment course of maggot therapy. (d) After six sessions of treatment, debridement was conducted to the deep portion from the ulcerated base, and favourable granulation can be seen on the amputated surface.


Intra-/post-operative view. (a) Intra-operative. Additional debridement is done.


Intra-/post-operative view. (b) Three post-operative weeks. Approximately 70% of the skin graft was taken. After conducting partial simple reefing, split thickness skin graft of 20/1000 inches was used.


CT scan of the last follow up show no recurrent disease.


CT scan image showing cystic lesion at tail of pancreas and mucinous ascites. Coronal section show mucinous content around pancreatic cyst.


Upper abdominal part. Axial section show scallop liver.


Intraoperative images showing epidural removal of the lesion.


Extraforaminal component.


A and B - Ultrasonography of the left scrotal sac showing a heterogeneous mass with some scattered cystic areas (notedly in B).


Abdominal CT. Coronal reformation showing a heterogeneous mass involving the aorta and left iliac artery.


Abdominal CT. Axial plane showing periaortic lymph nodes, delayed concentration/excretion of the contrast, and slight hydronephrosis.


Abdominal CT. Axial plane showing lymph nodes conglomerate with signs of central necrosis along the left iliac artery.


Abdominal CT. Axial plane - multiple bilateral enlarged inguinal lymph nodes.


Clinical appearance of OD. Note the mucous secretion, protrusion of the nictitating membrane, chemosis and congestion of conjunctival vessels.


Orbital ultrasound (10 MHz linear probe, transverse scan, temporal fossa approach) showing a large orbital fluid-filled space-occupying mass (M). The OD ocular examination (E) showed no abnormalities.


Transverse plane through the orbit showing a large mass displacing the eyeball dorso-laterally.


Crowded, multiple, abnormal, unerupted maxillary molars.


Six month follow-up CT exam: transverse plane through the orbit.


Volume rendering, ventral view (e). Note the underdeveloped molar part of the right maxillary bone (arrow) and crowded, multiple, abnormal, unerupted maxillary molar teeth.


Volume rendering, ventral view showed no recurrence of the orbital pathology.


Gross anatomy of the mass (A).


Histopathology of the mass haematoxylin and eosin x100.


X400 Note the granulation tissue embedding large, irregularly shaped lakes of clear amorphous material (mucous secretion/salivary secretion of zygomatic gland origin).


Clinical and histological findings. (a) A verrucous skin lesion on the dorsum of the left third metatarsal head.


Clinical and histological findings. (b) Close-up of the lesion.


Clinical and histological findings. (c) Skin biopsy specimen showing epidermal hyperplasia and elongation of the rete ridges.


Clinical and histological findings. (d) Individual cell keratinization and mild atypism were observed.


Radiograph and computed tomographic scan. (a) Radiograph showing the presence of skin staples (arrow) at the amputation stump.


Radiograph and computed tomographic scan. (b) Computed tomographic scan showing the lesion (arrowhead) overlaying a residual skin staple (arrow); no tumor invasion to the surrounding tissue was evident.


Preoperative and postoperative findings. (a) Resection with a 1-mm horizontal margin was performed.


Preoperative and postoperative findings. (b) Artificial dermis placed onto the skin defect.


Preoperative and postoperative findings. (c and d) Resected verrucous nodule with skin staples (arrow).


Histopathology of pseudocarcinomatous hyperplasia. (a) Epidermal hyperplasia and elongation of the rete ridges were observed.


Histopathology of pseudocarcinomatous hyperplasia. (b) No atypia was noted in the elongated rete ridges.


Histopathology of pseudocarcinomatous hyperplasia. (c) Invasion of inflammatory cells was recognized around the skin-stapled site.


Histopathology of pseudocarcinomatous hyperplasia. (d) Two years after the last operation.


Two large multilobulated masses: A. Left laterocervical mass.


B. An ulcerated subcutaneous mass in the abdomen.


High-grade liposarcoma with prominent round cell component (H&E x 400).


A. Abdominal masses resecting.


B. Cervical mass resecting.


C. Femoral mass resecting.


Gottron's papules seen on the hands.


CT chest with contrast showing the anterior mediastinal mass.


Preoperative radiographic images. (a) Axial head computed tomography scan shows a round lesion, 2.5 cm in diameter, originating primarily from the right frontal dura mater.


Preoperative radiographic images. (b) Enhanced axial head computed tomography shows strong enhancement.


Preoperative radiographic images. (c) Head computed tomography angiography shows an apparent feeding artery (red arrow).


Preoperative radiographic images. (d) Contrast-enhanced axial magnetic resonance imaging shows a homogeneously enhanced extra-axial mass lesion.


Preoperative radiographic images. (e) Contrast-enhanced coronal magnetic resonance imaging shows enhanced extensive dural thickening around the tumor.


Operative findings. (a) The tumor was soft and grayish. Dura mater adjacent to the tumor was thickened. Capillary blood vessels on the inner layer of the dura mater were dilated.


Operative findings. (b) Arachnoid around the tumor was yellowish. It was partially difficult to exfoliate the tumor from brain parenchyma.


Operative findings. (c) Successful removal of the tumor was achieved by frontal craniotomy. Most of the thickened dura mater remained.


Operative findings. (d) Contrast-enhanced coronal magnetic resonance imaging shows complete resection of the tumor. Most of the enhanced dura mater was still present.


Histopathological findings. Hematoxylin-eosin staining,. (a) In most parts of the tumor, oval-shaped arachnoid-like cells were proliferating like sheets. Numerous eosinophils were diffusely observed in the tumor. Square area demarcates eosinophils at higher magnification (x20, magnification bar: 100 mum).


Histopathological findings. Hematoxylin-eosin staining,. (b) Dura mater was strongly thickened and capillary blood vessels were dilated. Eosinophils were not observed in the dura mater. Degenerated collagenous fibers were observed (x20, magnification bar: 100 mum).


Histopathological findings. Hematoxylin-eosin staining,. (c) An inflammatory reaction was observed in the arachnoid attached to the tumor as evidenced by a small number of eosinophils and nuclear debris (x20, magnification bar: 100 mum).


Histopathological findings. Immunohistochemical analysis of IgG, CD138, and IgG4. (d) Diffuse IgG-positive cell infiltration was observed in the tumor (x20, magnification bar: 100 mum).


Histopathological findings. Immunohistochemical analysis of IgG, CD138, and IgG4. (e) CD138 (also known as syndecan-1, SDC1) is a highly specific marker for terminally differentiated normal plasma cells. Diffuse CD138-positive cells infiltration was also observed in the tumor (x20, magnification bar: 100 mum).


Histopathological findings. Immunohistochemical analysis of IgG, CD138, and IgG4. (f) Most of the CD138-positive plasma cells also expressed IgG4. Diffuse IgG4-positive plasma cell infiltration was observed in the tumor. The ratio of IgG/IgG4 was 70%. Square area demarcates IgG4-positive plasma cells at high magnification (x20, magnification bar: 100 mum).


MR scan images of low extremity. Contrast enhancement T1-weighted axial.


MR scan images of low extremity. Sagittal scans. With fat-suppression show diffuse synovial enhancement (white arrows) and tenosynovitis (black lined white arrows) around right ankle joint. Abnormal enhancement lesion is also noted in the right 2nd metatarsal shaft (black arrow).


MR scan images of low extremity. Contrast enhancement T1-weighted sagittal scans (C) with fat-suppression show joint effusion with diffuse synovial enhancement (white arrow) in the left tibia MR scans.


Histopathological findings of the biopsied tissue. Non-caseating, sarcoidal, chronic granulomatous inflammation is observed in the skin rash.


Histopathological findings of the biopsied tissue. And subcutaneous nodule, and synovium of knee joint (H&E stained, A x 200;. X 100.


Histopathological findings of the biopsied tissue. And subcutaneous nodule, and synovium of knee joint . X 200).


Histopathological findings of the biopsied tissue. However, the pathological finding of right tibia is compatible with enchondroma (D). . X 200).


Autofluorescence image of the right eye showing hypoautofluorescence at the paravenous zone.


Autofluorescence image of the left eye demostrating hypoautofluorescence at the paravenous zone.


SS-OCT image of the right eye reveals external retina altered with an increase of choroidal signal due to retinal pigment epithelium atrophy.


SS-OCT age of the left eye exhibits external retina damage with an increase in choroidal signal due to retinal pigment epithelium atrophy.


Residual erythema and skin peeling on the plantar aspect of the feet.


(A) Endoscopic image of a centrally umbilicated nodule in the gastric body.


(B) Endoscopic image of two centrally umbilicated nodules of varying diameter in the gastric body.


(C) Endoscopic image of an ulcerated, nodular lesion in the duodenum.


(A) Hematoxylin & eosin stain, showing gastric oxyntic mucosa undermined by nests and sheets of polygonal tumor cells (arrow) with enlarged hyperchromatic nuclei, coarse chromatin, and minimal cytoplasm, similar to that in the scalp lesion.


(B) Tumor cells in the gastric lesion show diffuse and strong membranous immunoreactivity for BerEp4 (arrow), while the background oxyntic mucosa is immunonegative.


Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography scan done in January 2016, showing transaxial images. Fused positron emission tomography/computed tomography, and ,computed tomography images showing fluorodeoxyglucose avid cutaneous thickening involving right vulva, and ,posteromedial aspect of right thigh (marked with red arrow).


Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography scan done in January 2016, showing transaxial images. Fused positron emission tomography/computed tomography, and ,computed tomography images showing fluorodeoxyglucose avid right inguinal lymph node.


Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography scan done in January 2016, showing transaxial images. Fused positron emission tomography/computed tomography, and computed tomography images showing fluorodeoxyglucose avid right external iliac lymph node.


The tumor is 4 cm in size with a perforation of 2 mm. The arrow indicates the perforated area (a).


The tumor is 4 cm in size with a perforation of 2 mm. H&E staining shows that the tumor is characterized by spindle-shaped cells in disarray with invasive growth (b).


The tumor is 4 cm in size with a perforation of 2 mm. Immunohistochemical findings show that tumor cells are broadly positive for cytokeratin-AE1/AE3.


The tumor is 4 cm in size with a perforation of 2 mm.that the Ki-67 labeling index is about 50% in the hot spot.


PET-CT scan at 7 months postoperatively shows lymph node metastasis with an SUVmax of 7.2 in front of the inferior vena cava. Arrow).


Recurrence with an SUVmax of 8.3 in the abdominal cavity of the right lower abdomen. Arrow).


Seven months after the recurrence had been identified, the CT scan shows that ascites appeared. Arrows), as well as rapid growth of metastatic lymph nodes, and . The recurrent tumor. Arrows).


The recurrent tumor. Arrows).


Gross specimen with whitish solid mass in renal pelvis, ureter and kidney.


Section showing sarcomatous area with abundant osteoid production (H&E stain X 200.


Enhanced magnetic resonance imaging (MRI) of the patient's head: (A) Coronal view of the gadolinium-enhanced T1-weighted image showing a spherical enhancing mass in the right frontal convexity and a dural tail sign. A round low-intensity lesion can be seen on the right side of the pituitary gland, and the pituitary stalk is displaced to the right.


(B) Sagittal T1-weighted sequence with contrast showing the degree of enhancement is lower than that of the pituitary in the sellar region.


(A) Histopathologic examination revealed a pituitary adenoma (Hematoxylin and eosin staining, 100x).


(B) Histopathologic examination revealed a meningioma (Hematoxylin and eosin staining, 100x).


Abdominal appearance with striae. Preoperation.


4 months postoperation.


Chest X-ray of case 1 showing pulmonary hemorrhage.


A; Erythemas with multiple pustules and pus lakes at the onset of GPP.


B; Histology of a lesion. Infiltrates of neutrophils into the epidermis and a spongiform pustule of Kogoj are evident. Scale bar = 50 microm.


Day 3 marked swelling, erythematous tense right eyelid presented at the first presentation.