Clinical intraoral image. The lesion was pedunculated involving the lingual mucogingival line and inserted on the keratinized mucosa.


Human wound myiasis caused by Chrysomya bezziana in a girl with pharyngostomy after removing the larvae (Original photo).


Prenatal ultrasound showing the neck mass.


Endotracheal tube displaced to the right position.


A. Sagittal MRI (T2) of the neck showing the teratoma.


B. Axial MRI (T2) of the neck showing the teratoma and the tracheal displacement.


The resected benign teratoma.


Fingerlike projection emerging from center of proximal nail fold.


Nonadherence to nail.


Excised tissue.


Postoperative wound healing.


MRI of the lumbar spine. (a) Sagittal postcontrast scan showing an enhancing mass at the L2-3 level.


MRI of the lumbar spine. (b) Axial postcontrast scan showing a right-sided mass extending into the right neural foramen causing foraminal expansion and canal stenosis.


MRI of the lumbar spine. (c) Axial T2 showing severe central stenosis.


Response to treatment. Primary tumor in the left lower lobe. Complete metabolic response to crizotinib as indicated by 18F-FDG-PET/CT scans before.


Response to treatment. Primary tumor in the left lower lobe. And after 4.5 months of treatment.


Response to treatment. Primary tumor in the left lower lobe. Partial response according to RECIST 1.1 criteria: tumor shrinkage from 33 to 13 mm before.


Response to treatment. Primary tumor in the left lower lobe. And after 4.5 months of crizotinib.


Patient having swelling in the cervical region, which was present since birth, and sinus in the thoracic region in midline.


Hyperpigmentation of face with hypertrichosis on the forehead and temples.


Erythrodontia.


Blisters on the dorsum of the hands.


Blisters on the feet.


Clinical photograph showing two extraoral deep necrotic ulcers on the right side.


Orthopantomograph showing irregular bone destruction from 44 to 48 with floating tooth appearance with 44, 45.


Removed maggots (Case 1).


Well-differentiated squamous cell carcinoma (x10). Section showing connective tissue infiltration by tumor cells and keratin pearls (Case 1).


Extensive necrotic wound with maggots.


Removed maggots (Case 2).


Poorly differentiated squamous cell carcinoma (x10). Section showing tumor epithelial cells infiltrating the stroma (Case 2).


Endoscopic examination of the nose showed a large, left-sided nasal polypoidal mass occluding the entire left nasal cavity with smooth overlying mucosa.


CT scan of the paranasal sinuses with contrast. The coronal section showed a left anterior lobulated nasal mass of undetermined origin at the level of the cartilaginous part of the nasal septum with mild heterogeneous post IV contrast enhancement.


Gross image of the mass revealed multiple fragments of soft to firm tan-gray tissue.


(a and b) Intraoral appearance of the wound showing pus discharge at the perforated mucosa in the anterior maxilla.


(c) The extracted maggot from the wound.


(d) Microscopic examination revealing five fingers like process in the anterior spiracle, incomplete peritreme in the posterior spiracle, and straight spiracular slits.


Erythematous feet.


Hands. At baseline with firm, nodular lesions in the beginning stages of development.


An example of extremities (C and D) during a symptom flare with progression of lesions to blisters and ulceration.


Demonstration of feet.


Hands. After successful treatment with clonidine and ketamine, and lesions in the process of healing.


Disease course before and after TSEB. . Notes: (A, D) Initial presentation of patient revealed only eczematous changes. (A-C) Progression of disease course in the face.


Disease course before and after TSEB. (B, E) Rapid disease progression within 3 months demonstrating multiple tumorous nodules throughout the body. (A-C) Progression of disease course in the face.


Disease course before and after TSEB. (C, F) Complete disease response after 3 months following TSEB. (A-C) Progression of disease course in the face.


Disease course before and after TSEB. . Notes: (A, D) Initial presentation of patient revealed only eczematous changes. (D-F) Progression of disease course in upper extremities. . Abbreviation: TSEB, total skin electron beam.


Disease course before and after TSEB. (B, E) Rapid disease progression within 3 months demonstrating multiple tumorous nodules throughout the body. (D-F) Progression of disease course in upper extremities. . Abbreviation: TSEB, total skin electron beam.


Disease course before and after TSEB. (C, F) Complete disease response after 3 months following TSEB. (D-F) Progression of disease course in upper extremities. . Abbreviation: TSEB, total skin electron beam.


Chest HRCT, transverse plane, initial examination. At the aortic arch level, a subpleural nodule in the apical S1+2 segments of the left upper lobe with pleural thickening in the adjacent area. Subpleural lesions are quite typical for necrotizing sarcoid granulomatosis (NSG) without predilection for upper or lower lobe involvement. In the right lung dorsally, a slight thickening of the pleura and of the major interlobar fissure.


Chest HRCT, initial examination, transversal plane at the level of lower lobes shows spherical nodules with smooth edges, with no apparent spiculations extending into the surrounding pulmonary parenchyma. A larger, 18 mm nodule in the S10 segment of the right lower lobe; a smaller one, 11 mm, in the S9 segment of the left lower lobe. Among frequent findings in NSG are nodular lesions with smooth or slightly irregular borders that may exhibit cavitations.


Chest HRCT, transverse plane, two-month follow-up. A tiny 'consolidation' of the pulmonary parenchyma with isolated calcifications and fibrous streaks extending towards the thickened pleura is present at the upper left lobe level in S1+2. The original S1+2 nodule adjacent to the pleura has partially regressed - a sign of a certain development of the disease over time.


Histopathological findings. Microscopically, confluent non-caseating granulomas with extensive necrosis are seen in the lung parenchyma. The granulomas are of the sarcoid type, palisaded by Langerhans-type giant cells and mononuclear lymphohistiocytes with central necrosis. Another typical finding is the presence of vasculitis, usually granulomatous, and a large zone of necrosis. Large zone of necroris (x50).


Histopathological findings. Microscopically, confluent non-caseating granulomas with extensive necrosis are seen in the lung parenchyma. The granulomas are of the sarcoid type, palisaded by Langerhans-type giant cells and mononuclear lymphohistiocytes with central necrosis. Another typical finding is the presence of vasculitis, usually granulomatous, and a large zone of necrosis. Granulomatous vasculitis (x100).


Histopathological findings. Microscopically, confluent non-caseating granulomas with extensive necrosis are seen in the lung parenchyma. The granulomas are of the sarcoid type, palisaded by Langerhans-type giant cells and mononuclear lymphohistiocytes with central necrosis. Another typical finding is the presence of vasculitis, usually granulomatous, and a large zone of necrosis. Confluent granulomas and vasculitis (x 100).


Chest HRCT, transverse plane, two-month follow-up. Compared with the initial examination, multiple nodules in the pulmonary parenchyma, predominantly in subpleural localization, have partially or completely disappeared. An 8 mm nodule (previously 18 mm) is present in S10 of the left lower lobe (indicated by the arrow).


Erythematous maculopapular eruption affecting the torso.


Patient at presentation following recurrence of epiphora 1 year after right external dacryocystorhinostomy.


MRI with T1.


T2. Weighting showing the presence of lacrimal sac mass at the time of presentation. The cavernous sinus is disease free.


T2-weighted MRI (a, b) showing the presence of a mass surrounding the internal carotid artery in the cavernous sinus 6 months following extensive cancer-clearing surgery.


The lesion is marked with arrow heads and enhanced with contrast and T1 imaging (c).


MRI of the left parotid mass.


MRI of the right parotid mass.


Histopathologic slide of intermediate-grade mucoepidermoid carcinoma of the left parotid gland (magnification, x200; hematoxylin-eosin stain).


Histopathologic slide of low-grade mucoepidermoid carcinoma of the right parotid gland (magnification, x200; hematoxylin-eosin stain).


After admission, the blood calcium level was 3.6 mmol/L. After 2000-4000 ml of NS for 5 days and salmon calcitonin (300 IU ivgtt), the blood calcium level gradually decreased and remained within the normal range. After surgery, the blood calcium level decreased, reaching the lowest level (1.65 mmol/L). After that, the calcium level was gradually restored to normal. There was a progressive decrease in the PTH level; however, the PTH level was stabilized at 50-60 pmol/L at 12 days post-admission, and this situation persisted for 1 week. One day post-operatively the PTH level rapidly decreased to 1.95 pmol/L, followed by a slow, gradual increase.


Case 1. Abundant thin colloid and follicular cells arranged in honeycombed and syncytial pattern (Diff-Quik, x200).


Case 1. Follicular cells with enlarged round to ovoid nuclei, focally overlapping nuclei, and nuclear grooves (Diff-Quik, x600).


Case 1. Follicular cells with occasional intranuclear inclusions (Diff-Quik, x600).


Case 1. Follicular cells with fine nuclear chromatin pattern and small eccentrically located nucleoli (Papanicolaou, x600).


Case 2. Follicular cells with enlarged round to ovoid overlapping nuclei and occasional nuclear grooves (Diff-Quik, x400).


Case 2. Follicular cells with focally enlarged round to ovoid nuclei and small nucleoli (Papanicolaou, x400).


Multiple papulonodular lesions of varying size over hands in a human immunodeficiency virus infected patient suffering from diffuse cutaneous leishmaniasis (case 1).


Multiple papulonodular lesions of varying size over elbow in an human immunodeficiency virus infected patient suffering from diffuse cutaneous leishmaniasis (case 2).


Color fundus photograph showing optic disc pallor and foveal atrophic changes in a bull's eye configuration in both eyes.


MRI scan of the orbit showing no evidence of active neuritis or infiltration of the optic nerves.


Fundus fluorescein angiography showing window defects with mottled hyperfluorescence in the parafoveal region in both eyes.


Lung cysts in a patient with Birt-Hogg-Dube syndrome.


Family tree of the index patient with Birt-Hogg-Dube syndrome.


Pleomorphic Xanthoastrocytoma. (A,B) Hematoxylin&Eosin staining shows a marked cellular pleomorphism, with the coexistence of several cell types.


Pleomorphic Xanthoastrocytoma. (C) Strong positivity for GFAP in immunohistochemistry.


Pleomorphic Xanthoastrocytoma. (D) Positivity for BRAF V600E in immunohistochemistry.


Sonogram of the left kidney of an emphysematous pyelonephritis patient at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, November 2019. Figure shows renomegaly, reduced renal parenchyma echogenicity and multiple irregular mixed echoes with dirty shadowing (blue arrow).


Contrast enhanced computed tomogram of an emphysematous pyelonephritis patient at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, November 2019. Figure shows left renomegaly, contrast enhancement and multiple air densities within the calyceal system (orange arrow).


Non-contrast-enhanced computed tomogram of an emphysematous pyelonephritis patient at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, November 2019. Figure shows left renomegaly with multiple air density area within the parenchyma and subcapsular region (orange arrows).


Painless bony hard swelling on the right maxilla, resulting in upward pushing of the right eyeball and eyelid.


Orthopantamograph showing a unilocular radiolucent lesion extending from 14 to 17.


Computed tomographic image showing a single large expansile radiolucent lesion with multiple radioopaque foci.


Computed tomographic image showing involvement of the maxillary sinus with the erosion of alveolar bone and medial, lateral and superior walls of the sinus.


Gross specimen showing a smooth, glistening, gelatinous, lobulated mass.


Schematic diagram describing timeline clinical, diagnostic and treatments features of suspected drug-associated (immune mediated) reaction in a 4-year-old male French bulldog. SPI, Staphylococcus pseudintermedius.


LMNA-NTRK1 fusion confirmed by RT-PCR. A; Schematic diagram showing the predicted in-frame LMNA-NTRK1 fusion protein joining the 5' LMNA filament domain to an intact 3' NTRK1 tyrosine kinase domain (KD). The red dashed lines denote the 1q chromosomal positions of LMNA and NTRK1, respectively.


LMNA-NTRK1 fusion confirmed by RT-PCR. B; RT-PCR Sanger sequencing trace confirming the fusion breakpoint at chr1:156100564 (LMNA, NM_005572.3, exon 2) and chr1:156844698 (NTRK1, NM_002529.3, exon 11). LTD, lamin tail domain; Ig, Tyrosine-protein kinase receptor C2 Ig-like domain.


Post treatment. Contrast-enhanced MR images demonstrating mass involving vertebrae. Axial.


Post treatment. Sagittal showing decrease in the size of the lesion compared to baseline (Fig.


Post treatment. 1). C; Gross specimen (sagittal) demonstrating a tan-white pink mass involving the paraspinal soft tissue and protruding into the underlying vertebrae body associated with sclerosis. Measurement bar = 1 cm.


Response to therapy as assessed by RECIST 1.1. Response plateau was achieved at week 12, with 45% decrease in size of the lesion.


(A and B) Pathological examination of the bone marrow including hematoxylin and eosin (H&E) staining revealed macrophages with intracytoplasmic microorganisms.


Axial computed tomography images showing expansion and thinning of the bony sinus wall that was absent at places.


Coronal computed tomography images: an unerupted maxillary canine was seen near the mesial wall.


Picture showing the bony window within the portion of the labial plate.


Enucleated specimen along with the embedded canine.


Gross examination revealed a cystic lesion measuring 6 cm x 5 cm x 4 cm.


Gross specimen showing tan-colored thickenings in the wall of the cystic lesion.


Chest X-ray showed an infiltrative process in the left lower lung field and a left sided pleural effusion.


Gross appearance of abdomen (Case 1).


Microscopic picture of pancreatic cancer (case 1).


Microscopic picture of pancreatic cancer (case 2).


Clinical presentation of the eyelid eruptions. Well-demarcated, dark-red, partially violet erythemas with small lamellar scales are visible on the patient's bilateral inner and upper eyelid from the frontal view. Mild eyelid edemas are also visible.


Clinical presentation. A dark-red erythematous plaque (approximately 1 cm) is accompanied by pityriatic scales, dark-red partially violet erythemas and coalesced atrophy, which form a large annular eruption on the right side of the patient's face. Pigmentation is visible at the center of the annular erythema, although the scales and erythemas have subsided.


Histopathological findings. Parakeratosis and hyperkeratosis of the horny skin layer as well as hydropic degenerations and vacuolar changes to the basal layer are visible. In the dermis, typical dense lymphoid cells are visible around the follicles or eccrine glands. Hematoxylin and eosin staining, x40.


"Peau d'orange" appearance involving both legs.


Multiple 3-12 mm, flat-topped moist papules, few verrucous nodules, some of these lesions coalesced to form plaques at the labia majora, soiling with fecal matter to be noted.


Multiple 3-12 mm, flat-topped moist papules, few verrucous nodules, some of these lesions coalesced to form plaques at the perianal area.


Doppler echogram of the left parotid gland. The mass showed a relatively regular border, enhanced back echoes, dissimilar internal echoes, and poor blood flow.


Superior view of the patient's scalp shows a dome-shaped nodule with multiple atrophic scars and comedones. Note the multiple grouped comedones (inset).


(a) Trichoscopy of the nodular lesion reveals a honeycomb pattern, few black dots, white dots, vellus hairs, broken hair shafts, and violaceous areas.


(b) Trichoscopy of the vertex and occipital areas shows multiple grouped comedones.


MRI of bilateral breast lumps- 3.8 x 3.5 x 3 cm irregular speculated mass in left breast (Suspicious of malignancy), 2.3 x 1.5 cm well defined mass lesion in right breast (less than 6% malignant probability).


Benign ductal epithelial cell cluster (Pap, x100).


Lesion with bare bipolar nuclei in the background (MGG, x400).


Medical image.


Clusters of cells with hyperchromatic nuclei and prominent nucleoli (MGG, x400).


Upper Endoscopic View of the Middle Esophagus Shows Pigmented Lesion of the Mucosa.


A. Microscopic Section From the Surface Squamous Epithelium Shows Scattered Pigmented Cells Between the Keratinocytes. (H & E X400).


B. Lamina Properia Shows Many Heavily Pigmented Cells. (H & E X250).


The Above Mentioned Cells Positive by Masson Fontana Stain. (Masson Fontana X250).


Intra-operative image showing the dilated residual proximal portion of the esophagus after complete resection of the schwannoma (arrow). Using this portion, a primary esophagoplasty closure was performed without compromising the esophageal caliber. Note the nasogastric tube within the lumen of the esophagus.


Illustrative drawing showing the longitudinal defect closure of the esophagus in two layers, using running 3-0 vicryl suture for the innermost mucosa and 3-0 Polydioxanone (PDS) for the muscular layer. The right lung, chest wall, and ligated azygous vein were shown for orientation purposes.


Gross specimen of the esophageal schwannoma after resection, measuring around 10 cm in longest dimension.


FISH analysis of the bone marrow. Yellow signal indicates negative CRLF2 rearrangement.


FISH analysis of the bone marrow. Two signals of red and green indicate CRLF2 abnormal rearrangement.


Morphological CR status and number of lymphoblasts in the bone marrow at different times. Autologous anti-CD19 CAR T cells bridging with allo-HSCT post CR3. CR4 was obtained followed by sequential of infusion donor-derived anti-CD22 and -CD19 CAR T cells.


Abdominal CT scan showing a moderate amount of ascites and diffuse peritoneal infiltration with omental cake formation (arrows).


Microscopic findings. A; H&E staining (x100) reveals multiple variable-sized cysts lined with flattened epithelial cells.


Microscopic findings. B; Calretinin immunohistochemical staining (x100) reveals a positive reaction.


Pre-treatment (A) axial computed tomography section demonstrating pleural recurrence from PMP disease in a 68-year-old male.


B; Day 3 post-BromAc. Treatment progress scan with contrast injected through self-retaining drain. The arrow indicates only regional diffusion of contrast around the drain site.


Pre-treatment (A, C) computed tomography sections of significant loculated pleural recurrence from PMP disease in a 41-year-old male.


Day 16 (B, D) post-BromAc. Treatment progress images demonstrating reduction in size of previous mucinous mass as indicated by the white arrows.


Clinical diagnostic criteria for tuberous sclerosis complex (TSC) [1], [2], [3].


Left side scrotal swelling which transilluminates brilliantly.


Gelatinous material with yellowish-white flakes on incising the testis.


Histopathological finding revealed benign mature cystic teratoma testis with component of all three germ layers. Here mature respiratory epithelium is seen.


Sagittal.


Axial. Preoperative MRI showing epidural compression and circumferential vertebral involvement.


Patient with age-related macular degeneration and widespread perimacular and peripheral abnormalities. Ultra-widefield pseudocolor images of the right eye demonstrate foveal retinal pigment epithelium (RPE) changes along with macular drusen in all quadrants. There are extensive drusenoid changes in the perimacular area in the temporal quadrants, as well as mid-peripheral and far-peripheral drusen and RPE changes (A-C). Analogous to this, ultra-widefield autofluorescence shows mixed hyper/hypoautofluorescence in the macula and hyperautofluorescence in the perimacula. Upgaze.


Patient with age-related macular degeneration and widespread perimacular and peripheral abnormalities. Ultra-widefield pseudocolor images of the right eye demonstrate foveal retinal pigment epithelium (RPE) changes along with macular drusen in all quadrants. There are extensive drusenoid changes in the perimacular area in the temporal quadrants, as well as mid-peripheral and far-peripheral drusen and RPE changes (A-C). Analogous to this, ultra-widefield autofluorescence shows mixed hyper/hypoautofluorescence in the macula and hyperautofluorescence in the perimacula. ; primary gaze.


Patient with age-related macular degeneration and widespread perimacular and peripheral abnormalities. Ultra-widefield pseudocolor images of the right eye demonstrate foveal retinal pigment epithelium (RPE) changes along with macular drusen in all quadrants. There are extensive drusenoid changes in the perimacular area in the temporal quadrants, as well as mid-peripheral and far-peripheral drusen and RPE changes (A-C). Analogous to this, ultra-widefield autofluorescence shows mixed hyper/hypoautofluorescence in the macula and hyperautofluorescence in the perimacula. , downgaze.


Patient with age-related macular degeneration and widespread perimacular and peripheral abnormalities. Ultra-widefield pseudocolor images of the right eye demonstrate foveal retinal pigment epithelium (RPE) changes along with macular drusen in all quadrants. The mid- and far periphery show partially mottled hyperautofluorescence (D-F). Upgaze.


Patient with age-related macular degeneration and widespread perimacular and peripheral abnormalities. Ultra-widefield pseudocolor images of the right eye demonstrate foveal retinal pigment epithelium (RPE) changes along with macular drusen in all quadrants. The mid- and far periphery show partially mottled hyperautofluorescence (D-F). ; primary gaze.


Patient with age-related macular degeneration and widespread perimacular and peripheral abnormalities. Ultra-widefield pseudocolor images of the right eye demonstrate foveal retinal pigment epithelium (RPE) changes along with macular drusen in all quadrants. The mid- and far periphery show partially mottled hyperautofluorescence (D-F). , downgaze.


Patient with age-related macular degeneration and peripheral abnormalities. Ultra-widefield pseudocolor images of the left eye demonstrate juxtafoveal geographic atrophy and macular drusen, partially extending into the perimacular region. There are a few drusen, mostly in the nasal far periphery, but also inferior along the border of mid- and far periphery (A-C). Corresponding autofluorescence images demonstrate brisk hypoautofluorescence juxtafoveally with adjacent hyperautofluorescence. Upgaze.


Patient with age-related macular degeneration and peripheral abnormalities. Ultra-widefield pseudocolor images of the left eye demonstrate juxtafoveal geographic atrophy and macular drusen, partially extending into the perimacular region. There are a few drusen, mostly in the nasal far periphery, but also inferior along the border of mid- and far periphery (A-C). Corresponding autofluorescence images demonstrate brisk hypoautofluorescence juxtafoveally with adjacent hyperautofluorescence. ; primary gaze.


Patient with age-related macular degeneration and peripheral abnormalities. Ultra-widefield pseudocolor images of the left eye demonstrate juxtafoveal geographic atrophy and macular drusen, partially extending into the perimacular region. There are a few drusen, mostly in the nasal far periphery, but also inferior along the border of mid- and far periphery (A-C). Corresponding autofluorescence images demonstrate brisk hypoautofluorescence juxtafoveally with adjacent hyperautofluorescence. , downgaze.


Patient with age-related macular degeneration and peripheral abnormalities. Ultra-widefield pseudocolor images of the left eye demonstrate juxtafoveal geographic atrophy and macular drusen, partially extending into the perimacular region. There is hyperautofluorescence, which extends into the temporal perimacular as well as speckled hyperautofluorescence, mostly nasally and inferiorly (D-F). Upgaze.


Patient with age-related macular degeneration and peripheral abnormalities. Ultra-widefield pseudocolor images of the left eye demonstrate juxtafoveal geographic atrophy and macular drusen, partially extending into the perimacular region. There is hyperautofluorescence, which extends into the temporal perimacular as well as speckled hyperautofluorescence, mostly nasally and inferiorly (D-F). ; primary gaze.


Patient with age-related macular degeneration and peripheral abnormalities. Ultra-widefield pseudocolor images of the left eye demonstrate juxtafoveal geographic atrophy and macular drusen, partially extending into the perimacular region. There is hyperautofluorescence, which extends into the temporal perimacular as well as speckled hyperautofluorescence, mostly nasally and inferiorly (D-F). , downgaze.


Patient without age-related macular degeneration and nonspecific peripheral retinal changes. Ultra-widefield pseudocolor images of the right eye demonstrate normal macula and a few nonspecific changes in the peripheral retina (A-C). Upgaze.


Patient without age-related macular degeneration and nonspecific peripheral retinal changes. Ultra-widefield pseudocolor images of the right eye demonstrate normal macula and a few nonspecific changes in the peripheral retina (A-C). ; primary gaze.


Patient without age-related macular degeneration and nonspecific peripheral retinal changes. Ultra-widefield pseudocolor images of the right eye demonstrate normal macula and a few nonspecific changes in the peripheral retina (A-C). , downgaze.


Patient without age-related macular degeneration and nonspecific peripheral retinal changes. Autofluorescence imaging demonstrates focal retinal pigment epithelium atrophy in the superonasal mid periphery as well as patchy hyperautofluorescence inferotemporally along the border of mid- and far periphery (D-F). Upgaze.


Patient without age-related macular degeneration and nonspecific peripheral retinal changes. Autofluorescence imaging demonstrates focal retinal pigment epithelium atrophy in the superonasal mid periphery as well as patchy hyperautofluorescence inferotemporally along the border of mid- and far periphery (D-F). ; primary gaze.


Patient without age-related macular degeneration and nonspecific peripheral retinal changes. Autofluorescence imaging demonstrates focal retinal pigment epithelium atrophy in the superonasal mid periphery as well as patchy hyperautofluorescence inferotemporally along the border of mid- and far periphery (D-F). , downgaze.


Pre and Post assessment using 5D-IS and VAS.


The melanoma of the glans and meatus.


A. The 6 months outcome of first-stage surgery.


B. The neo-urethra tubularized using the preputial plate.


C. End of the second-stage surgery.


The reconstructed glans and urethra at 24 months.


Slit-lamp image of the cornea after surgery. The optical zone was clear and transparent after 1 week.


Slit-lamp image of the cornea after surgery. And 3 months.


The control CT images after the first tumourectomy. A) After two weeks. An oedema with haematoma along with air bubbles can be seen.


The control CT images after the first tumourectomy. B) After two months. The residuals of the tumour can be seen.


Images of primary . A) Angiocentric pattern in H&E.


Images of primary . B) Ki-67 index below 5.


Images of primary . C) Small areas with Ki67 index of 5-10.


Images of primary . D) Dot-like epithelial membrane antigen (EMA).


Images of primary . E) Diffuse EMA staining.


Recurrent. Tumours. F) Reaming angiocentric pattern.


Recurrent. Tumours. G) Microvascular proliferations and cellular atypia.


Recurrent. Tumours. H) Focal necrosis and residual angiocentric pattern.


Erythematous annular lesions on the back of the neonate.


Histopathological section of the skin showing fungal hyphae (Periodic Acid Schiff stain, x100).


(A) Clinical picture 4 months after surgery, local recurrences were detected (arrow).


(B) Cervical radiograph 4 months after surgery, there was local recurrence of bony bridge from occiput, cervical, and upper thoracic spine (arrow).


(C) Thoracic radiograph 4 months after surgery, there was recurrence of bony bridge from bilateral humerus to the tip of scapula (arrow head).


A 37-year-old male with the right lower quadrant pain. Axial and coronal computed tomography scan showing dilated appendix measuring about 17 mm with near water density fluid in lumen and no periapendiceal inflammatory changes suggesting mucocele.


A 35-year-old female, axial and coronal computed tomography scan in a different patient showing fluid filled dilated appendix measuring up to 15 mm without periappendiceal inflammatory changes. Sagittal computed tomography image showing the calcium in appendix and partially visualized cyst. Note the fluid density structure near the tip of appendix which represented mesenteric cyst on histopathology.


A 69-year-old female, axial and coronal computed tomography scan showing thickened heterogeneously enhancing mass at the tip of appendix measuring up to 18 mm, proximal appendix measured up to 8 mm in diameter without evidence of periappendiceal inflammatory changes concerning for the appendiceal tumor.


Post contrast sagittal image of lumbo sacral spine showing a cystic lesion at D12-L1 level with enhancement of cyst wall.


T2W sagittal image of spine showing a hyperintense cystic lesion at D12 - L1 level with hypointense cyst wall.


Intra-operative image after performing laminectomy at D12- L1 level. The lesion appears predominantly cystic but the walls are densely adherent to the surrounding nerve rootlets.


Histopathology image of cyst wall showing pseudostratified lining with goblet cells.


Cilia.


Patient presenting with breast and bilateral axillary enlargement.


Enlarged right axilla at 26 gestational weeks.


Breast and bilateral axillary involvement at 31 gestational weeks.


Breast enlargement subsided, axillary lymph nodes decreased in size.


Plain axial CT of the abdomen and pelvis. . Plain axial CT of the abdomen and pelvis demonstrated (A) inflammatory changes around the pancreatic head and large periampullary diverticulum (arrowhead).


Plain axial CT of the abdomen and pelvis. (B) A coronal slice showing no inflammatory changes around the pancreatic body and tail.


Contrast-enhanced axial CT of the abdomen and pelvis. . Contrast-enhanced CT demonstrated a significant improvement of the inflammation in the pancreatic head.


Contrast-enhanced axial CT of the abdomen and pelvis. And body and tail of the pancreas.


Computed tomography of the head revealing a hyperdense focus measuring up to 6.5 mm in the right temporal lobe.


Magnetic resonance imaging of the head with and without contrast revealing a right lateral ventricular 8mm lesion likely associated with the choroid plexus.


Tumor forceps removing the choroid plexus papilloma from the right lateral ventricle.


Gross image of the excised lesion.


Photomicrograph of tissue taken from the lesion excised from the patient showing cells within Antoni A and Antoni B regions that are characteristic of schwannoma.


A: CT axial image illustrating a right inguinal canal soft tissue density measuring 4.87 x 4.03 cm.


B: CT coronal image with right inguinal soft tissue density measuring 5.14 cm in length.


C: CT axial image 22 months prior illustrating prominent fat in the right inguinal canal region surrounding the cord structures with no suspicious lesions.


A: Right inguinal surgical approach with the spermatic cord lesion and right testicle in vivo.


B: Gross image of the right inguinal mass excision with radical orchiectomy. The testicle is on the left and liposarcoma is on the right.


C: Intraoperative image of the right inguinal mass excision with radical orchiectomy with the liposarcoma bisected illustrating the bulky heterogeneous solid lesion and typical yellow-tan appearance measuring 9 x 6 x 5 cm.


A: Hematoxylin and Eosin stained sections of the mass (200X) illustrating the well-differentiated component at the bottom, consisting of mature variably sized adipocytes with bands of fibrous stroma which contain occasional enlarged hyperchromatic nuclei. The dedifferentiated component is seen above, consisting of a cellular spindle cell proliferation.


B: Hematoxylin and Eosin stained sections of the mass (400X) demonstrating the the nonlipogenic sarcoma aspect of the specimen, which is composed of closely packed high-grade plump fibroblast-like cells arranged in a fascicular pattern. Mitoses are easily identified.


Preoperative radiological images. CT-scan of the brain without contrast showed a sharply delineated cystic lesion located in the left dorsolateral pons (a). There appear some calcifications located in the anterolateral solid mass of the lesions.


Preoperative radiological images. Contrast-enhanced T2-weighed MRI images again showing the hyperintense aspect of the cystic fluid (b). Limited edema can be noted at the dorsal side of the tumor.


Preoperative radiological images. On the contrast-enhanced T1-weighted images, the tumor mass and part of the cyst wall enhanced homogenously (c).


Solar elastosis. Three papules over the nose and right philtrum.


Solar elastosis (arrows) and mild periadnexal and perivascular infiltrate of lymphocytes. HE. original magnification x 40.


Solar elastosis. Papule over the left philtrum.


Fundus photographs of the right eye.


The left eye. Of a patient complaining of blurred vision but with 20/20 vision in both eyes. Cuticular drusen can be seen as many small yellowish sub-RPE deposits.


OCT of the right eye. Cuticular drusen (arrowhead) are seen as small nodular elevations of the RPE with a 'saw-tooth pattern'.


Chest CT in axial views of the heterogeneous right side anterior lateral mass.


Chest PET of the mass.


Intra-operative images (A, B).


Wound before.


After suture Picture B shows the placement of a transthoracic drainage.


Surgical specimen of the lesion (A, B, C).


Fluid removed from the mass before the extraction.


Microphotograph of ectopic thyroid fixed with Hematoxylin and eosin (A, B).


Clinical course of the patient with GAVE experiencing oozing and treated by APC and blood transfusion. Arrows indicate hospitalizations.


A; Endoscopic appearance of red patches or spots in a diffuse or linear array in the antrum of the stomach and oozing of blood.


B; Endoscopic appearance of gastric erosion emerged in the antrum after APC.


C; Endoscopic appearance of multiple columns of tortuous ectatic vessels with oozing in the antrum of the stomach.


A; Endoscopic appearance showed that red patches or spots had improved in the antrum of the stomach.


B; Endoscopic appearance showed gastric ulcer emergence on the gastric angle of the greater curvature.


C; Endoscopic appearance revealed small and flat red spots in the antrum, and again diffuse oozing of blood.


D; Endoscopic appearance showed the classic "watermelon stomach" with columns of tortuous ectatic vessels attenuated in the antrum of the stomach.


Red free fundus photos (a, b) of Case 2 (mother of Case 1) demonstrating bilateral angioid streaks (thick green arrows) and fibrotic disciform scars (purple triangles).


Indocyanine green angiography (c, d) demonstrates polyp lesions at the edge of the disciform scars in the right eye (yellow arrow) and late geographic hypercyanescence in the left eye (red triangle) demonstrating the appearance of a branching vascular network, consistent with a diagnosis of advanced polypoidal choroidal vasculopathy.


Zosteriform metastatic skin-colored solid papules, nodules, and papulovesicles scattered and confluent with few crusted plaques seen on the left side of the neck in a typical zosteriform distribution involving the left C3 dermatome.


A superficial ulcer of 2 x 2 cm over the hard palate in the oral cavity with an eroded surface with irregular margins and pseudomembrane formation.


Response after external cobalt therapy, showing complete clearance of oral ulcer.


Response to cobalt therapy; healing of zosteriform lesions over neck with scarring.


Pre-operative MRI (a, b) T1-weighted post gadolinium images show an avidly enhancing mass with well-defined, lobulated borders in the left frontoparietal region.


Preoperative transcranial magnetic stimulation ,intraoperative motor mapping.


Monitoring. Demonstrate that the primary motor cortex was located in front of the tumor, confirming the location of the tumor within the central sulcus.


Post-operative MRI axial T1-weighted pre gadolinium.


Post gadolinium. Show a small volume of hemorrhage in the surgical bed but no residual tumor.


Toluidine blue stained smear preparation (a) shows spindle shaped, monomorphic neoplastic cells with prominent nucleoli in a loose matrix and mast cells.


Epithelioid and spindle-shaped cells arranged in mucoid/myxoid background with hyalinised elements (b, c).


Epithelioid and spindle-shaped cells arranged in mucoid/myxoid background with hyalinised elements (b, c). The cytoplasm is frequently vacuolated and a mitotic figure is noted (c).


Eosinophilic cytoplasmic inclusions in keeping with rhabdoid cells (d).


Strong, diffuse immunoreactivity with CD34 (e).


Loss of expression in the tumor cells by INI1, while the nuclear staining is preserved in the endothelial cells (f).


Axial section of MRI images - Case 1.


Tumor cells showing strong positivity for synaptophysin.


Ki67 immunostaining: proliferative index of 4%.


Axial section of MRI images of - Case 2.


(a) Well-demarcated granulomas in an edematous stroma under the hyperplastic stratified squamous epithelium (hematoxylin-eosin stain, original magnification: x100).


(b) Granuloma formation consisting of epitheloid cells surrounded by lymphocytes in an edematous stroma (hematoxylin-eosin stain, original magnification: x400).


Palmar injection site locations (representation only, not a patient photo).


(A) Papillovesicular lesions on the dorsum of the hand.


(B) Erythematous macules, fluid filled vesicles and crusting lesions on the dorsum of the hand.


Antero-posterior and lateral x-ray view of the patient's left knee. Please note the cystic lesion in the proximal tibial metaphysis.


Periprosthetic pathologic fracture of the left tibia. An osteolytic pattern due to an evolved Hydatid Cyst is visible.


Lateral x-ray view of the total knee arthroplasty of the left knee. Extensive bone destruction is present in the proximal tibia. Loosening signs of the femoral component are present.


The pathological examination confirmed an epidermal nevus at the periphery of the lesion. H&E staining, x50 magnification.


Sheets of poorly differentiated, atypical, pleomorphic keratinocytes migrated from the epidermis into hair follicles.


The tumour exhibited a maximal depth of 7 mm.


Metastasis is visible in both lungs.


In the spinal cord. On a CT image and bone scan, respectively.


(a) Magnetic resonance image (MRI) T2 sagittal view showing isointense round mass from C3 to C6.


(b) MRI T1 with contrast axial view showing an enhancement cervical mass, encircling the dura.


(a) Intraoperative image of posterior resection which shows a fibrous epidural mass, without dural infiltration.


(b) Intraoperative image which shows cervical roots without tumor.


Magnetic resonance imaging T2 image sagittal view. After the first surgery showing anterior cervical tumor.


After corpectomy and removal of the anterior part of the tumor without any rest.


Microphotography showing important calcium deposits in vessels lumen with intimal fibroblastic proliferation (HE, 100X).


Microphotography at higher magnification showing the marked calcium deposits with an advanced diabetic microangiopathy (HE; 200X).


The X-ray shows bilateral and extensive interstitial infiltrates.


The violaceous rash extension with atypical targetoid elements (at day 3 from clinical onset) is depicted in a. b shows the complete resolution (after 6 weeks).


The extensive skin detachment is showed in a (at day 5) and its favorable evolution at 6 weeks in (b).


The figure shows the extensive disepithelialization with subcutaneous oozing and bleeding.


Proximal nailfold demonstrating several enlarged capillaries.


Telangiectasias along the marginal gingivae (arrow) and interdental papillae.


A glistening white spotty appearance in the temporal region of the scalp in case 1.


The distinctive comb attributed as the cause of trauma, with short and vertical bristles, arranged in linear rows and equidistant from each other. Also appreciate that the comb is made of plastic, has a round base with a slot to slip the fingers in for gripping.


The technique of combing adopted by these patients. (The comb was run over the scalp as vigorous strokes from the frontal aspect, brushed across the vertex and temporal aspects and ended at the occipital region, around 8-10 times a day).


Discrete spotty glistening white areas involving the vertex region with broken hairs in case 2.


Spotty white glistening areas localized strictly to the temporal aspect in case 3.


Alpaca (case no. 1), ear pinnae. Evolution of skin lesions from severe crusting dermatitis, hyperkeratosis, focal ulceration, alopecia, and scaling.


Alpaca (case no. 1), ear pinnae. To moderate to severe crusting, hyperkeratosis, scaling, erythema and alopecia.


Alpaca (case no. 1), ear pinnae. To mild to moderate alopecia, erythema and scaling.


Alpaca (case no. 1), ear pinnae. To mild alopecia and erythema.


Morphological features of Sarcoptes scabiei mites.


Llamas (case no. 2), skin lesions. Hind limb (after clipping): alopecia, moderate to severe erythema, severe scaling, and ,focal crusts.


Llamas (case no. 2), skin lesions. Hind limbs, perianal, peri vulvar region, and ,ventral aspect of the tail: alopecia, mild erythema, and ,scaling, and ,mild, focal lichenification.


Llamas (case no. 2), skin lesions. Ventral abdomen and axillae: extensive alopecia, moderate to severe erythema and focal hyperpigmentation.


Preoperative imaging. (a) NCCT - Non contrast CT image showing low-density mass lesion with irregular margins in the right lateral ventricle.


Preoperative imaging. (b) MRI T1W - MRI T1-weighted axial image showing heterogeneous signal intensity mass in the right lateral ventricle.


Preoperative imaging. (c) MRI T2W - MRI T2-weighted image showing well circumscribed lesion in right lateral ventricle with cystic changes and heterogeneous signal intensity.


Postoperative imaging. (a) MRIT1W at 36 months - MRI T1-weighted axial image at 36 months post therapy.


Postoperative imaging. (b) MRI T2Wat 36 months - MRI T1-weighted with contrast at 36 months post therapy.


Postoperative imaging. (c) MRI T1W with contrast - MRI T2-weighted axial image at 36 months post therapy complete remission.


Large, blackish growths with verrucous, lobulated surface over the pubis, penis, scrotum, groin, and upper thigh.


Large, warty, lobulated tumors over the perineum, groin and upper thigh. Some areas are reddish, with eroded surface.


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


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


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


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


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


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


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


Thoracoscopic view (semi-prone position): huge neoplastic mass involving the infra-carenal esophagus.


(A) Microscopic findings of the tumor at 5x magnification. Anaplastic large cells showing solid growth pattern and poorly cohesive growth.


(B) Higher magnification (20x) view of the solid growth area. White box underlines at 100x magnification tumor cells exhibiting large nuclei with conspicuous nucleoli and eosinophilic "rhabdoid" cytoplasmic inclusions, while the nucleus is displaced eccentrically by the cytoplasmic inclusion body.


Pre-operative mid-sagittal short-tau inversion recovery.


Contrast-enhanced T1-weighted lumbar spine MRI demonstrate a heterogenous enhancing intradural mass from L1 to S1 with some septated fluid/cystic elements. The cauda equina and conus medullaris cannot be identified. There is adjacent cord edema. In retrospect, a dorsal dermal sinus can be seen (arrow, b).


Pre-operative cervical T2-weighted mid-sagittal magnetic resonance imaging shows holocord edema or syrinx up to the level of the medulla.


(a) Pre-operative mid-sagittal contrast-enhanced T1-weighted lumbar spine magnetic resonance imaging demonstrates a heterogenous thick rim-enhancing intradural mass from L1 to S1 with multi-septated fluid/cystic components. The cauda equina and conus medullaris cannot be identified.


(b) A dorsal dermal sinus tract (arrow) can be seen on sagittal T2-weighted images.


Pre-operative thoracic T2-weighted mid-sagittal magnetic resonance imaging shows T2-hyperintensity extending from T4 along the remaining caudal length of the spinal cord.


Post-operative T2-weighted mid-sagittal magnetic resonance imaging of the. Thoracic.


Lumbar spine at 6 months after surgery shows partial decompression of the dermoid cyst with residual dermoid cyst centered at the L4-5 level. There is interval resolution of the syrinx and improved edema of the spinal cord.


The morphologic appearance of the tumor.


The T2-weighted, fat-saturated coronal MR image showed the solid mass with multilobulated, relatively homogenous high-signal-intensity pattern, with focal invasions in the deep muscle planes and cutaneus and subcutaneus tissues.


Tail-like projections in fibrosarcoma protuberans in fat- saturated T2-weighted axial MR image. The tumor with its high-signal-intensity pattern shows tail-like deep extensions (arrows) with some indefinite contours.


The mass lesion revealed a low-signal-intensity appearance with a tiny tail-like extension superiorly on T1-weighted images.


Per-operative tumor mass after resection.


Immunohistochemical appearance (x40 100 HE).


The clinical appearance of the shoulder of the patient 21 months after the operation.


The clinical appearance of patient 24 months after surgery. Open space shoulder activity is shown.


A, b Photomicrographs of the induration (hematoxylin and eosin stain; original magnification: a x100, b x200). Degeneration of the fascia ,muscle (arrows.


With infiltration of lymphocytes and eosinophils were observed.


D Immunohistochemical stains by antibodies to CD8. And CD4.


Showing predominant CD8+ T cell infiltration (original magnification: x400).


Ultrasound shows a 0.58 cm solid mass (red arrow).


Shows a 3.08 x 2.82 x 2.11 cm ovoid cystic mass (yellow arrow) both located at the right thyroid lobe.


Shows a 0.21 cm ovoid cyst (black arrow) at left thyroid lobe.


0.5 cm solid nodule seen on ultrasound. Black arrows show papillae with fibrovascular cores (H&E, 40x).


0.5 cm solid nodule seen on ultrasound. Red arrow shows cuboidal cells with overlapping nuclei (H&E, 100x).


Staining for HBME-1 which appears as a brownish tan stain (HBME-1, 40x).


On higher magnification, shows HBME-1 positive seen within the plasma membrane of the tumor cells (HBME-1, 400x).


Anteroposterior X-ray of the thorax does not show evidence of any pathology, no parahiliar consolidations, and no other variations (a).


Anteroposterior abdominal radiography where no abnormal changes are seen (b).


Electroencephalogram demonstrates the presence of cyclic and inverted waves. These waves are seen in the occipital region and where a marked, diffuse slowing occurs (a).


View of hyphae in brain biopsy, showing positivity for periodic acid Schiff (PAS), in which regular hyphae are observed at acute angles, as is a round conidiophore on completion of the hyphae; PAS x400 (a).


Stained hyphae with the Silver technique, showing reinforced walls, regular and septa that were observed with a more reinforced black color, forming acute angles characteristic of Aspergillus walls; Grocottmethenamine silver x400 (b).


Polygonal cells with abundant pale cytoplasm with anisonucleosis, increased nuclear cytoplasmic ratio, overlapping nuclei and irregular nuclear contours (Diff Quik stain, x400).


Hyaline stalks with overlying spindle cell with elongated oval nuclei and scant cytoplasm (Diff Quik stain, x200).


Metachromatic hyaline globules (Diff Quik stain, x400).


Factor VIII immunostain outlined the endothelial cells in cell block sections (IHC, x200).


Photograph of the lesion on the left nipple. Erosion and crust on the left nipple.


(A and B) Histopathology reveals ductal differentiation. (Hematoxylin-eosin stain, Original magnificationx40.


(A and B) Histopathology reveals ductal differentiation. Original magnificationx200.


The luminal epithelial cells were positive for (C) CK5/6 stain. (Immunohistochemistry, original magnificationx100).


The out-layer myoepithelial cells were positive for. SMA.


P63 stains. (Immunohistochemistry, original magnificationx100).


Clinical photograph showing swelling of the left paranasal area.


Intraoral photograph showing the swelling of the left maxillary vestibular area.


Orthopantomogram showing the well-circumscribed radiolucent lesion with distinct, radiopaque margins, and the multiple impacted supernumerary teeth.


Three-dimensional cone-beam computed tomography image showing the lesion and the associated impacted teeth.


Computed tomography scan showing circumscribed radiolucency with thin radiopaque margin encompassing a supernumerary tooth and the multiple impacted supernumerary teeth in both the jaws.


The whole of the excised lesion with the associated impacted teeth.


A connective tissue capsule lined by an odontogenic epithelial lining which is proliferating at one area.


The peripheral cells of the ductal pattern showing palisading arrangement.


Positive deck-chair-sign (arrows) skin eruption on the trunk of patient 1 , who was found to have Sezary syndrome.


On the trunks of patients 2-5 , who were diagnosed with mycosis fungoides / cutaneous T-cell lymphoma with evidence of blood involvement.


Radiologic evaluation at admission. Barium enema consistent with suspicion OF HD.


Postoperative plain X ray at the time diagnosis of eosinophilic myenteric gangliositis.


Histological feautures after dietary modification. Colonic mucosa with normal crypts, and rare eosinophils in the lamina propria H&E x40.


Ankle images of the patient. . Notes: Localized, irregular osseous mass at the level of anteromedial talus and medial malleolus on AP and lateral ankle radiographs (A and B).


Ankle images of the patient. Lobulated osteocartilaginous mass appearance in the vicinity of the medial malleolus at the medial aspect of the distal tibia, right side on the axial section of CT (C). . Abbreviations: AP, anterior-posterior; CT, computerized tomography.


Intraoperative view of patient. . Notes: Intraoperative appearance of osteocartilaginous lesion at medial malleolus and anteromedial aspect of talus in the ankle (A).


Intraoperative view of patient. View of the excised osteocartilaginous lesion (B).


Histopathological findings in Trevor disease. . Notes: Superficial hyaline cartilage layer, columnar chondrocytes (right side), and mature bone trabeculae containing osseous spicules and bone marrow (left side) (hematoxylin-eosin stain, magnification 400x).


27-year-old male presented with chronic low back pain for a year and half after he sustained minor back trauma at work. Pain was radiating to both lower extremities, but more to the right side. It was later diagnosed as a form of spinal cord malformation. Sagittal T2W.


27-year-old male presented with chronic low back pain for a year and half after he sustained minor back trauma at work. Pain was radiating to both lower extremities, but more to the right side. It was later diagnosed as a form of spinal cord malformation. Axial T2W MRI of the thoracic spine show arachnoid cyst posterior to T5 and T6 segments of the spinal cord causing anterior displacement of the cord and posterior cord flattening (arrowhead). Epidural arachnoid cyst herniation through the posterior dura is a possible differential diagnosis.


27-year-old male presented with chronic low back pain for a year and half after he sustained minor back trauma at work. Pain was radiating to both lower extremities, but more to the right side. It was later diagnosed as a form of spinal cord malformation. Axial T2W MRI of the thoracic spine show split cord (arrowhead) starting at the level of T7-T8 spine segment and continuing down to the level of T12 where the two hemicords then fused back into normal conus medullaris.


27-year-old male presented with chronic low back pain for a year and half after he sustained minor back trauma at work. Pain was radiating to both lower extremities, but more to the right side. It was later diagnosed as a form of spinal cord malformation. Axial T2W MRI of the lumbar spine show a low-lying conus medullaris that once again split into two hemicords (arrowhead in b) at the L3-L4 level, with a low-lying tethered cord inserted posteriorly at S1. Notice in the sagittal T2W MRI the presence of intradural hyperintense circular lesion and hyperintense lesion in T1W (not shown) characteristic for lipoma (arrowhead in a).


Computed tomography (CT) scan of the chest and abdomen. Multiple metastases of the tumor were observed in the lung.


Computed tomography (CT) scan of the chest and abdomen. , liver, vertebral body.


Computed tomography (CT) scan of the chest and abdomen. , retroperitoneum.


Computed tomography (CT) scan of the chest and abdomen.caput femoris.


Treatment with cutting the abscesses and lavaging the abscess cavities with fluconazole saline solution (A).


A large amount of pus from the abscesses (B).


Inflammation within the skin lesions was obviously improved after a week of treatment (C and D).


(A, B) In thyroid echography, both lobes of the thyroid gland were swelling although increase of blood flow was not observed.


(C, D). In brain magnetic resonance imaging, there was a giant tumor (51 x 34 x 22 mm) around pituitary fossa, pressuring on optic chiasm from the middle. Bilateral internal carotid arteries were surrounded by the tumor, and infiltration into the cavernous sinus was observed.


(A) Time course of GH and IGF-1 levels for 6 years. After the diagnosis of GHoma and TSHoma, pituitary tumor resection was performed. After about 1 year later, cyber knife therapy was performed together with the treatment with somatostatin analog and GH receptor antagonist. After these therapies, GH and IGF-1 levels were suppressed for a long period of time.


(B) Time course of TSH, FT3 and FT4 levels for 6 years. After the operation, since thyroid function was not sufficiently suppressed, we started the treatment with anti-thyroid drug thiamazole. Since thyroid function was normalized after about 3 years later, we stopped the treatment with thiamazole. After then TSH, FT3 and FT4 levels were not increased for a long period of time.


Sole of the patient's affected left foot.


Sole of the patient's minimally affected right foot.


Extraorally (a), an ill-defined swelling extending from the malar region upto the inferior border of the mandible on the left side (short black arrows) was seen.


Intra-orally (b), an irregular exophytic growth (green arrows) was present in the left retromolar trigone region distal to 26, causing vestibular obliteration, and a diffuse swelling (white arrow) in the adjoining posterior buccal mucosa. The deepest part of the growth opposite 38 was laden with food deposit (yellow arrow).


OPG revealed extensive destruction of the alveolar process of maxilla distal to 26 (black arrow) and anterior border of the ramus (white arrows) of the mandible (a). PNS View showed complete opacification of the left maxillary sinus (star).


Destruction of the postero-lateral wall was seen on the left side (red arrows) as opposed to the contralateral normal side (yellow arrows) (b).


Ultrasonogram revealed a hyperechoic, thick-walled, soft tissue mass (black arrows) with a central hypoechoic paisley-shaped, fluid-filled area (yellow star) below the zygomatic arch, occupying the buccal and masseteric regions.


Coronal.


Axial. Sections of contrast-enhanced T2W MRI revealed hyperintense, soft-tissue mass with central necrosis, epicentre of the mass being left masticator space (yellow star). Left masseter and buccal spaces were involved alongwith pterygoid muscles with erosion of the ramus of the mandible (1,2, and 3 represent the normal masseteric and buccal spaces, and pterygoid muscles on the contralateral right side). Mass compressing the left maxillary antrum (4) seen with smooth scalloping of its wall.


Clinical picture showing the biopsy site and the extent of the lesion.


Dermoscopy of pigmented nail fold squamous cell carcinoma shows areas of homogeneous brown pigmentation, pigmented dots or globules, polymorphic vessels.


Sagittal view contrast enhanced CT scan of the neck with retropharyngeal, epiglottic, and vocal cord edema.


Axial contrast enhanced CT scan of neck soft tissue at the level of hyoid body shows edema of the pharyngeal mucosa and retropharyngeal space with airway narrowing.


Preoperative T1-weighted . Sagittal view.


T2-weighted. Magnetic resonance images without gadolinium enhancement demonstrating an intradural extramedullary cystic tumor at the T1-T2 level. Sagittal view.


Preoperative T1-weighted . Axial view.


T2-weighted. Magnetic resonance images without gadolinium enhancement demonstrating an intradural extramedullary cystic tumor at the T1-T2 level. Axial view.


T2-weighted magnetic resonance images at 1 day.


10 months. After the first surgery.


(c) Contents of the cyst.


(d) Intraoperative photograph of the second operation showing a cyst-subarachnoid shunt tube inserted into the cyst.


Successive gadolinium-enhanced magnetic resonance images (MRIs) showing the clinical course of the craniopharyngioma during a 6-year period. (a) Tumor regrowth in the left cavernous sinus at 31 years of age.


Successive gadolinium-enhanced magnetic resonance images (MRIs) showing the clinical course of the craniopharyngioma during a 6-year period. (b) MRI after removal of the lesion and gamma knife surgery.


Successive gadolinium-enhanced magnetic resonance images (MRIs) showing the clinical course of the craniopharyngioma during a 6-year period. (c) Tumor regrowth at 36 years and 3 months of age. The tumor grew around the left optic nerve.


Successive gadolinium-enhanced magnetic resonance images (MRIs) showing the clinical course of the craniopharyngioma during a 6-year period. (d) MRI after transsphenoidal biopsy.


Successive gadolinium-enhanced magnetic resonance images (MRIs) showing the clinical course of the craniopharyngioma during a 6-year period. (e, f) MRIs at 31 years and 8 months of age. Tumor size increased drastically, and the tumor invaded the cavernous sinus and the internal carotid artery.


Computed tomography scans with contrast enhancement before.


After. The operation of transcranial and transsphenoidal dual surgeries with an extracranial-intracranial bypass. The tumor was totally removed.


Pathological findings of a specimen from the transcranial and transsphenoidal dual surgeries at 36 years and 9 months of age. (a) The number of squamous cells has increased.


Pathological findings of a specimen from the transcranial and transsphenoidal dual surgeries at 36 years and 9 months of age. (b) The lamina propria has collapsed, and infiltration of atypical cells is seen.


Pathological findings of a specimen from the transcranial and transsphenoidal dual surgeries at 36 years and 9 months of age. (c) Tumor cells have enlarged nuclei and clarification of the nucleolus.


Pathological findings of a specimen from the transcranial and transsphenoidal dual surgeries at 36 years and 9 months of age. (d) Parakeratosis and intercellular bridges are present in the tissue. Hematoxylin and eosin staining at the original magnification.


(A) Slit-lamp examination of the left eye demonstrates 2+ conjunctival injection with a central, feathery infiltrate and corneal edema. A 1 mm hypopyon is also present.


(B) Fluorescein staining confirmed the presence of an overlying epithelial defect.


(C) Lactophenol-cotton-blue stained microscopy reveals typical branched and densely clustered phialides.


(D) Violaceous-red-rose pigmented and velvety colonies grew on Sabouraud agar.


Clinical findings of dermatomyositis. The patient had erythematous papules over the dorsal knuckles (Gottron's papules), with peri-ungual erythema and cuticle hypertrophy (a).


Clinical findings of dermatomyositis. Violaceous erythematous plaques were noted on the volar forearms.


Clinical findings of dermatomyositis. Also noted was photo distributed violaceous erythema of the forehead and midface, involving the nasolabial folds, as well as erythema and edema of the upper eyelids (heliotrope rash) (c).


Clinical findings of dermatomyositis. And posterior arms (Shawl sign;. Poikiloderma with a mottled pattern of hyper-pigmented and hypo-pigmented macules interspersed with telangiectasia was noted on the upper back (d).


Large swelling of the penis and the scrotum with mossy papules and cobblestone-like nodules.


Delayed lymphoscintigraphy image showing no uptake in bilateral inguinal lymph nodes (arrow).


Skin biopsy showing: Hyperkeratosis, irregular epidermal hyperplasia with sparse superficial and midperivascular infiltrate.


Lesions before thalidomide.


Lesions after thalidomide.


severe swelling of the neck and the face including the eyes lids, the checks, and the lips immediately after changing the patient from prone to supine position.


Regression of angioedema after 24 h.


The patient after 72 h with complete resolution of the angioedema.


T2W MRI of the brain showing symmetrical hyperintense lesion in bilateral periventricular deep white matter.


T2W MRI of the brain showing symmetrical hyperintense lesion in bilateral periventricular deep white matter and centrum semiovale.


T1W MRI of the brain showing symmetrical hypointense lesion in the white matter of centrum semiovale.


Image of the biopsied mass on CT in axial plane.


(A) CT lumbar spine image in sagittal section showing no evidence of metastatic disease.


(B) T1, fat-saturated image in sagittal section showing extensive bony metastatic disease on MRI performed only one week after the CT of lumbar spine.


Brain MRI at 3 years, axial view: supratentorial white matter increased the T2 signal in the periventricular and frontal areas.


Familial Pedigree of case. The proband is indicated by an arrowhead. Squares represent males, circles represent females. Solid symbols represent affected individuals. Symbols with slash indicate deceased individuals. Age at cancer diagnosis is reported following the corresponding disease and the age of death is reported on the top right corner of symbol. GC, gastric cancer; CRC, colorectal cancer; OC, ovarian cancer; LC, lung cancer.


Demonstration of NGS results of APC and BRCA1 germline mutations. The heterozygous loss of exon 15 in APC gene was detected in the proband.


Demonstration of NGS results of APC and BRCA1 germline mutations. The same heterozygous loss of exon 15 in APC gene was also detected in the 20-year old male patient.


Demonstration of NGS results of APC and BRCA1 germline mutations. The heterozygous p. Lle1824AspfsX3 in BRCA1 gene was detected in the 20-year old male patient.


Irregular, circumscribed erythematous, infiltrated plaque with complete alopecia, and ,an uneven surface studded with multiple whitish globoid structures, on the left parietal scalp of a 5-year-old boy.


Same plaque showing a marginal extension of milia in a linear fashion along the posterior nuchal area following blaschkoid patten.


Diffuse KS skin lesions involving back.


Diffuse KS skin lesions involving leg.


Chest x-ray shows moderate right effusion, hazy opacities at the right lung base and vague ground glass changes in the left lung base.


CT chest with contrast shows moderate size right pleural effusion with bilateral scattered infiltrates.


Computed tomography scan showing lytic lesion in mandible.


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


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


Histopathology of parathyroid adenoma (x400).


Exophytic mass of the right forearm.


Magnetic resonance image of the right forearm showing the extent of the lesion.


A firm mass measuring 5 x 3 x 2 cm in size in the right zygomatic region.


A submentovertex view of skull showed resorption of zygomatic arch.


Isolation of tumor mass.


Erosion of zygomatic arch.


Histopathologic picture showing interlacing fascicles of compact spindle cells with twisted nuclei. The nuclear palisading formed the Verocay bodies.


Blue-gray colored eye lid with underlying tissue necrosis.


Intraoperative appearance of advancing wound.


Well-defined lesion on the right buttock.


Nests of basaloid cells with peripheral palisading and surrounding cleft were attached to seborrheic keratosis. H&E staining. x40.


Basal cell carcinoma was selectively positively stained with Ber-EP4. Immunostaining. x40.


Fixed, purple, reticulated skin lesion seen in the left upper and lower limbs.


Atrophic changes seen over the left upper and lower limbs.


Macroscopy shows whitish, oval shaped specimen measuring around 1.5x1 cm (inset: cut section showed a cystic cavity with yellow viscous fluid).


IgG immunoglobulin deposits along the dermo-epidermal junction.


C3 deposits along the dermo-epidermal junction.


Bullous pemphigoid reappearance after steroid tapering and continuous therapy for 5 months; skin of left hip joint.


Fundus photo on presentation showing bilateral tortuosity of the small venules and multiple intra- and preretinal hemorrhages.


The histopathology reveals neuroendocrine tumor cells , immunopositive for chromogranin.


Synaptophysin. Respectively).


68-Ga-DOTANOC positron emission tomography-computed tomography shows somatostatin receptor expressing tumor in both lobes of liver with extensive skeletal metastasis (a-c; transaxial computed tomography, positron emission tomography-computed tomography and maximum intensity projection images, respectively).


Hyperpigmented, indurated plaques with marked hypertrichosis arranged symmetrically over medial aspect of thighs, and ,legs.


Hyperpigmented hypertrichotic indurated plaques over lower back and sacral area.


Hallux valgus deformity of both great toes seen.


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


Timeline highlighting case patient diagnosis.


Ultrasound of renalpelvic mass (arrows). LC = Lower calices, U = Ureter.


MRI IVP coronal view mass in left renal pelvis (arrow), dilatation of lower calices (LC) without excretion.


MRI cross section view left renal pelvic mass (arrow).


Left retrograde ureteropyelography filling defect (arrow) of renal pelvis, LC = Lower calices.


Superior conjunctival hyperemia with pannus.


Cases of a recurrent RRD at 10 and 11 years after a successful initial reattachment by PPV. A; Fundus photograph of the left eye of a 42-year-old Japanese woman (Case 1). A retinal detachment that extended to the 4 quadrants including macula can be seen. Her visual acuity was 20/250.


Cases of a recurrent RRD at 10 and 11 years after a successful initial reattachment by PPV. B; Fundus drawing of the left eye showing an epiretinal membrane and reopened breaks at the superior temporal retina (arrow). There were also multiple breaks at the nasal retina (arrowhead).


Cases of a recurrent RRD at 10 and 11 years after a successful initial reattachment by PPV. C; Fundus photograph at 6 months after surgery. The retina is reattached, and the protrusion of the encircling scleral buckle is evident. Her visual acuity was 20/200.


Cases of a recurrent RRD at 10 and 11 years after a successful initial reattachment by PPV. D; OCT image showing the attached fovea with foveal depression. A dome-shaped macular can also be seen.


Cases of a recurrent RRD at 10 and 11 years after a successful initial reattachment by PPV. E; Fundus photograph of the left eye of a 70-year-old Japanese man (Case 2). A retinal detachment that extends to the inferior 2 quadrants including the macula can be seen. His visual acuity was 20/150.


Cases of a recurrent RRD at 10 and 11 years after a successful initial reattachment by PPV. F; Fundus drawing of the left eye showing an inferior retinal detachment. There is a suspicious retinal break at 6 o'clock of the retina (arrow). The scar lesions surrounding a previous break are not detached (arrowhead).


Cases of a recurrent RRD at 10 and 11 years after a successful initial reattachment by PPV. G; Fundus photograph at 4 months after surgery. The retina is successfully reattached with a mild protrusion of the encircling buckle. A newly treated retinal break and lattice degeneration by photocoagulation can be seen on the buckle (arrow). His visual acuity was 20/30.


Endoscopy showing mucosal changes in the stomach (antrum) that resembled melanosis gastri.


Endoscopy showing mucosal changes in the duodenum that resembled melanosis duodeni.


Computed tomography scan of subcutaneous mass.


Intraoperative view of lesion.


Views of cataract surgery. . Notes: Before surgery.


Views of cataract surgery. And after phacoemulsification The arrow indicates iridodialysis.


Anterior segment photograph and ultrasonographic findings. . Notes: Pigment dispersion in anterior chamber.


Anterior segment photograph and ultrasonographic findings. And ciliary body mass.


Light microscopy views. . Notes:. A pigmented mass in the ciliary body (40x).


Light microscopy views. Involvement of trabecular meshwork by the tumor cells (100x).


Light microscopy views. Round to oval bland cytologic features of tumor cells (400x). They show prominent nucleoli (arrows) and marked cytoplasmic melanin pigments.


Pre- and postoperative imaging of the child. Preoperative MRI showed hypo- and isointensity mixed signal, together with focal hyperintensity on T1WI.


Pre- and postoperative imaging of the child. And T2-weighted FlAIR.


Pre- and postoperative imaging of the child. The lesion is iso- and hyperintensity mixing signals and well-circumscribed on axial T2WI (C).


Pre- and postoperative imaging of the child. Post-contrast T1WI showed moderate heterogeneous contrast enhancement of the lesion (D-F).


Pre- and postoperative imaging of the child. Follow-up MRI at 29-month after surgery revealed that the lesion was completely removed with no signs of recurrence (G-I).


Histopathology of the cerebellar liponeurocytoma. Hematoxylin and eosin-staining showing that a large number of small round tumor cells with low mitotic activity grow in sheets, and clusters of fat cells.


Histopathology of the cerebellar liponeurocytoma. That chrysanthemum clusters. Are seen among the cells.


Histopathology of the cerebellar liponeurocytoma. Immunohistochemical examination presented a Ki-67 index of 5% grossly, and 10-20% focally (C).


Cheilitis over both angles of mouth.


Radiological findings. (a and b) Initial magnetic resonance imaging study revealed leptomeningeal enhancement especially at the inferior portion of the fourth ventricle and suprasellar region (white arrows), ventricles were dilated.


Radiological findings. (c and d) In posterior fossa, bilateral mass located in the lower part of both foramina Luschka and midline mass located just superior from the foramen Magendie. Follow-up magnetic resonance imaging (1 week after steroid treatment) showed attenuation of the leptomeningeal enhanced lesions and hydrocephalus was improved.


Clinical photographs of ectopic cilia (top left) and hypochromic lesions on the right arm (top right). . Notes: Histologic analysis showing. Dermal, and ,subcutaneous pilosebaceous follicles (arrows).


Clinical photographs of ectopic cilia (top left) and hypochromic lesions on the right arm (top right). Pilosebaceous follicles (arrows) packed in a dense fibrous tissue core (*), with pores of the infundibula on the epidermal surface (arrowhead).


Clinical photographs of ectopic cilia (top left) and hypochromic lesions on the right arm (top right). Well developed sebaceous lobules (arrow).


Clinical photographs of ectopic cilia (top left) and hypochromic lesions on the right arm (top right). Bulbs of pilous follicles.


Clinical photographs of ectopic cilia (top left) and hypochromic lesions on the right arm (top right). Apocrine-lined epithelial ducts consistent with glands of Moll (arrow), and ,associated with a pilous follicle (arrowhead).


Clinical photographs of ectopic cilia (top left) and hypochromic lesions on the right arm (top right). Striated orbicularis muscle fibers present in the depths of the specimen (*), with hair bulbs (arrow) superficial to these muscle fibers.


Erythrodermia on the shoulders; confluent large salmon-colored plaques with mild induration and fine scales on the upper trunk, and discrete small circular or oval lesions along the cleavage lines on the lower trunk of the patient.


Mild hyperkeratosis and focal epidermal parakeratosis, mild spongiosis, extensive intracellular edema and focal lymphocytic exocytosis, moderate inflammatory infiltrate from the lymphocytes and histiocytes in his upper dermis and few polymorphonuclear cells perivascularly. Immunohistochemistry showed an intracellular accumulation of HHV-6 (brown stain).


Cat toy.


Granulomatous response to synthetic fibers.


Synthetic fibers with polarized light.


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


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


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


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


(a,b) Pre-operative Imaging Right Tibia. AP view (1a) of the right leg demonstrates an expansile, multilocular, lytic lesion with 'soap bubble' appearance and narrow zone of transition within the diaphysis of the tibia affecting the cortex and medullary canal. There is associated cortical remodeling and endosteal thinning. No cortical breakthrough is present and only a slight benign-appearing periosteal reaction is present (Arrow I). Lateral view (1b) of the right leg corroborates the findings on the frontal projection.


(a-c) Coronal T1 weighted image (2a) demonstrates hypodensity of a tibial lesion. Sagittal fat-saturated T2 weighted image (2b) of the left tibia demonstrates marked hyperintensity of the lesion, which extends from the anterior to posterior cortex. Axial contrast-enhanced, fat-saturated T1 image (2c) through the mid diaphysis demonstrates marked enhancement of the soft tissue mass, which completely obliterates the marrow. The cortex is thinned, but there is no extension of mass beyond the periosteum. No edema is present within the musculature.


(a) Initial gadolinium-enhanced MRI showing irregular-shaped pituitary macroadenoma with multiple cyst formations invading the cavernous sinus, completely encasing the right ICA.


(b) Preoperative MRA indicating no abnormal findings (right oblique projection).


(a) Dosimetry of the GKS procedure. The marginal dose to the tumor margin was 15 Gy at the 50% isodose curve.


(b) Isodose lines on the dosimetry planning showing the dose received by the intracavernous segment of the ICA, retrospectively (red line = 20-22 Gy isodose line, yellow line = 15 Gy isodose line).


Five years postradiosurgical MRI and MRA. (a) Nonenhanced MRI demonstrating a remarkable reduction of the tumor volume.


Five years postradiosurgical MRI and MRA. (b) MRA indicating severe stenosis and disappearance at the distal portion of the intracavernous segment of the right ICA (right oblique projection).


Angiogram of the right common carotid artery showing slight restenosis of cavernous segment of the ICA (arrowhead) one year after the treatment.


Periorbital swelling of the right eye without erythema or pain.


The magnetic resonance imaging of the orbit. (A) Axial T2-weighted post-contrast images showed a mildly enhanced mass compressing the adjacent right lateral rectus muscle and the globe.


The magnetic resonance imaging of the orbit. (B) Coronal T2-weighted post-contrast images showed an extra-conal lesion, which was well-defined and iso-intense as the lateral rectus muscle.


Marrow biopsy was done for increased blasts in peripheral blood and disclosed hypercellular marrow with around 80% cellularity. In HPF (X400) view, there was increased myeloid series and more than 20% blasts, indicating acute leukemia transformation.


Fundus photographs of a patient diagnosed with carcinoma-associated retinopathy who developed choroidal atrophy during a 2-year follow-up period. Fundus photographs of the right.


Fundus photographs of a patient diagnosed with carcinoma-associated retinopathy who developed choroidal atrophy during a 2-year follow-up period. Left. Eyes taken at the initial examination in June 2010.


Fundus photographs of a patient diagnosed with carcinoma-associated retinopathy who developed choroidal atrophy during a 2-year follow-up period. Left. Eyes taken in October 2012.


(a) Photograph of the infant showing hypotrichosis over scalp, lack of eyebrows and eyelashes, and milia over face, Eyebrows have been drawn by the mother.


(b) Milia over scalp and right ear.


Scattered milia on both thighs and legs.


Numerous pits on the palm.


Schematic description of patients included.


Post contrast CT showing retroperitoneal soft tissue mass with peripheral hypervascularity and central area of breakdown.


Coronal T1WI, post Gadolinium showing lobulated retroperitonea mass with heterogenous enhancment and renal displacement.


Glomeruli showing expansion of mesangial matrix with mild increase in mesangial cellularity. Interstitial inflammation seen [Periodic Acid Schiff stain, 40X].


Nodules over axilla.


Nodules and scarring over gluteal region and thighs.


Nodules over face.


Macroscopic appearance of the prolapsed intraductal papilloma.


Intraductal papilloma, (Hematoxylin & Eosin x200).


Subcutaneous nodule over the left knee.


Satellite nodules.


Furrowed colonies at 3 days on Sabourads Dextrose Agar.


Growth at 10 days with brown pigmentation and satellite colonies.


Lactophenol cotton blue preparation of the growth.


Healed lesion.


Oesophagogastroduodenoscopy images of the duodenum. Initially, white villi are sparsely observed in the second portion of the duodenum (A).


Oesophagogastroduodenoscopy images of the duodenum. Eight months later, the duodenal lymphangiectasia is unchanged (B).


Oesophagogastroduodenoscopy images of the duodenum. Endoscopy examinations performed six months.


Oesophagogastroduodenoscopy images of the duodenum. Twelve months. After radiotherapy show gradual progression of the lymphangiectasia.


Oesophagogastroduodenoscopy images of the gastric MALT lymphoma. A pale lesion with indistinct boundaries is noted under white light observation.


Oesophagogastroduodenoscopy images of the gastric MALT lymphoma. And magnifying observation with narrow-band imaging.


Oesophagogastroduodenoscopy images of the gastric MALT lymphoma. Endoscopic ultrasonography confirms that the lymphoma is confined to the gastric mucosal layer (C).


Oesophagogastroduodenoscopy images taken 55 months after radiotherapy show obviously worsened duodenal lymphangiectasia (A).


Magnifying observation shows dilated, whitish duodenal villi (B). The margins of the villi are distinct.


Magnifying observation with narrow-band imaging reveals elongated microvasculature within the villi (C).


Pathological images of the duodenal lymphangiectasia. Biopsy examination reveals dilated lymphatic duct in the duodenal villi.


Orthopantomogram.


Previous computed tomography.


Current computed tomography.


Paranasal sinus - skull.


Chest X-ray.


Extraoral examination.


Cone beam computed tomography.


Cone beam computed tomography-three-dimensional image.


Cone beam computed tomography-three-dimensional view.


Bony window created on posterior antral wall.


Enucleation.


Enucleation - mandibular lesion.


Enucleated lesions from maxilla and mandible.


Satellite cyst.


Histopathologic slide view.


Reticulate pigmentation on the trunk.


Diffuse nonscarring alopecia.


Onychodystrophy of finger nails.


Plantar hyperkeratosis.


Histopathology; showing melanophages and absence of skin adenexa.


A; CT scan of the abdomen and pelvis showing a left renal mass 13 cm in diameter with features suggestive of primary RCC.


MRI of the spine sagittal section showing anterior and posterior parallel thick lines of avid enhancement corresponding to the leptomeninges, which is highly abnormal and indicates leptomeningeal carcinomatosis.


A histopathological exam confirming papillary RCC.


Initial CT head demonstrating periorbital edema and inflammation in the ethmoid and maxillary sinuses. There is no evidence of acute intracranial abnormality.


(Left) Gomori methenamine silver (GMS) stain highlighting fungal wall and the pathognomonic non-septate branching hyphae. (Right) High-power H&E stain demonstrating hyphae and inflammatory cells with limited blood product. Photo Credit: Sin Nguyen, MD.


CT scan in September 2010. Intravesical mass on the bladder dome.


Breast MRI with multiple nodes in February 2015.


At the end of the treatment in May 2015.


Clinical examination of patient's penile shaft and glans: Multiple firm skin-colored papules, some with exophytic crusting and underlying edema, present on the right side of the patient's penile shaft, immediately proximal to the glans.


Histopathological image following biopsy of patient's penile lesions: Histopathological staining from biopsy by punch technique of distal dorsal penile shaft shows dilated vascular channels consistent with benign lymphangioma of the penis.


Photograph of the female patient shows male pattern of facial hair growth.


Arterial phase axial multidetector computed tomography (MDCT) scan of the abdomen shows a hypervascular heterogeneously enhancing mass with radially arranged vessels (arrows) in the right adrenal region.


Volume rendered image of the abdomen depicts the hypervascular mass, in the right adrenal area, giving a can-of-worms appearance (arrows).


Axial multidetector computed tomography scan scan of the abdomen in the portal venous phase shows the mass in right adrenal region with early wash-out of contrast and a central nonenhancing area (arrow).


Image of the well-encapsulated mass measuring 16 x 12 cm removed by surgery.


Hematoxylin and eosin stain at 400x of the smear shows sheets of oncocytic cells with uniform round nuclei and abundant eosinophilic cytoplasm.


Clinical presentation of cutaneous horn on upper lip vermillion.


Gross specimen A. Cutaneous horn with base - cut surface B. Excised tissue from adjacent area.


Stereo microscopic view of the lesion A. horn with compaction of keratin B. verrucous carcinoma at the base.


Magnified view of horn showing compact concentric layers of cohesive keratinized material.


Axial CT scan showing a hyper-attenuating lesion centered by an hypodensity of the posterior fossa.


MRI on axial T1 weighted image revealing an hypointense and heterogeneous contrast enhancement of the solid component of the dermoid cyst.


MRI on axial T2 weighted images showing a hypointense signal of the dermoid cyst.


MRI on Sagittal T2 weighted images showing a hypointense signal of the lesion.


Histopathological examination of the surgical specimen revealing a stratified squamous epithelium with fatty cellular debris, few hair follicles and scattered sebaceous glands consistent with the diagnosis of dermoid cyst.


A spindle-shaped larvae of Oestrus ovis with a pair of sharply curved hooks.


Repeat magnetic resonance imaging brain axial images after 3 months showing partial resolution of the previous hyperintense signals in bilateral cerebellar hemispheres:. T1-weighted image.


T2-weighted image.


Fluid-attenuated inversion recovery image.


(a and b) Pre-operative sagittal and axial T1-weighted MRI with gadolinium contrast injection showing the homogenous enhancement by an olfactory groove meningioma.


(c) Immediate post-operative brain CT shows tumor removal and vasogenic brain edema.


(d) Post-operative sagittal T1-weighted MRI with gadolinium contrast reveals near total resection of the tumor.


Egyptian child with Berardinelli-Seip syndrome type 1.


Prominent orbital ridges, large ears and empty cheeks.


Large hands.


Prominent pectoral and calf muscles.


Acanthosis nigricans of the neck.


Medical image.


Placido topography imaging of the OD.


Skin lesions on the trunk.


Lesions on the upper limb.


Improvement in the lesions of skin after treatment.


(A-C) Erythema around the nail and insignificant Gottron's signs can be seen on the patient's hands.


Initial brain magnetic resonance imaging demonstrating a 3 cm, extra-axial mass along the right frontal convexity with some underlying edema and mild diffuse atrophy.


Formalin-fixed pathological specimen with brisk mitoses, small foci of necrosis rarely, and hypercellularity, all consistent with a World Health Organization Grade II or atypical meningioma.


Plain X-ray of the left clavicle demonstrating a mass lesion and adjacent pathological fracture.


Photomicrograph of the pulmonary nodule showing a vessel injury and granuloma (Weigert-Van Gieson, 100X).


Extra-oral facial profile.


Intraoral view.


Occlusal view of the maxilla.


Intra-operative - Removal 22.


Post-operative.


Intraoperative photograph of setting the Prolene sutures for the wheel spokes technique. A; Three straight needle-attached Prolene sutures were passed through the cornea in a limbus-to-limbus pattern resembling wheel spokes.


Intraoperative photograph of setting the Prolene sutures for the wheel spokes technique. B; The 3 Prolene sutures support the floating donor graft (edge indicated by the arrows). Additionally, intraocular lens haptics were fixed to the sclera in the 2 o'clock-8 o'clock direction, posterior to the limbus, which could also serve as support.


A computed tomography scan shows and abdominal wall mass (in red circle).


Microscopic findings. The transformation from neurofibroma (left area) to malignant peripheral nerve sheath tumor (right area) is present (hematoxylin and eosin stain, x100).


Immunochemical findings. The tumor cells are weakly positive for S100 protein.


Immunochemical findings. Negative for H3K27me3. (immunohistochemial stain, x200).


Intraoral swelling on the palate having intact margins.


Gross specimen measuring 1.5 cm x 1.5 cm x 1 cm.


Histopathological image showing a well-circumscribed lesion composed of multiple cystic spaces (H&E, x40).


Histopathological image showing tumor stroma showing large number of cystic spaces having keratotic lamellae and lined by squamous cells (H&E, x200).


Histopathological image showing tumor stroma having numerous gland-like tubular structures (H&E, x100).


Histopathological image showing tumor stroma showing tumor cells composed of basaloid, plasmacytoid and angular cells (H&E, x400).


Histopathological image showing presence of mucous cells containing mucin (Periodic acid-Schiff stain, x200).


A: Neck mass near the left common carotid artery.


B: Mycotic pseudoaneurysm on the left common carotid artery.


C: 3D Reconstruction of the mycotic pseudoaneurysm.


A: Aneurysmal sac during surgery.


B: Saphenous vein graft bypass after debridement.


Preoperative view showing increased intercanthal distance (68 mm), broad, and ,flat nasal bridge, deformed nasal tip.


Three-dimensional computed tomography scan revealed the absence of nasal bones with square-shaped head and temporal displacements of orbits.


Vertical osteotomy cuts placed perpendicular to the frontal bar.


Circumferential osteotomy around the orbit was carried out.


Removed median segment.


Large asymmetrical critical-sized dural matter tear was observed at the anterior cranial fossa.


Fat, and ,fascia lata were harvested from the lateral aspect of the right thigh.


Fibrin sealants were sandwiched in between the fascial graft. Surgicell. Was used to achieve haemostasis.


Fixations of the other segments were done using titanium plates, and ,screws.


Scalp were re-draped, and ,sutured with 2.0 vicryl, surgical drain was placed, and ,staples were placed.


Postoperative view reduced interocular distance.


Nuclear 99mTc-ethambutol scintigraphy shows increased pathological radioactivity imaging in the distal-third of the left lower leg at 4 hours post-radiopharmaceuticals injection.


Clinical image after 6 months of anti-tuberculosis therapy. Cutaneous nodules started to regress, ulcer and crusts healed with atrophic scar and post-inflammatory hyperpigmentation.


A; Clinical manifestation showing alopecia accompanied by thickened scalp.


B; CT scan showing thickening scalp with marked expansion of subcutaneous adipose tissue approximately 15 mm in the occipital region.


A; H&E staining revealing mild perivascular mononuclear infiltration into the superficial dermis and increased subcutaneous adipose tissue (x100 magnification).


B; H&E staining showing perifollicular fibrosis (x400 magnification).


C; H&E staining revealing disruption of adipocytes (x400 magnification).


D; Alcian blue staining showing mucin deposition in the dermis (x400 magnification).


Clinical presentation of the lesion in the anterior maxilla causing facial asymmetry.


Firm, non-ulcerated, non-pigmented, non-pedunculated swelling in the anterior maxilla with displacement of deciduous central incisors.


An IOPA Intraoral periapical radiograph showing a mixed radiolucent and radioopaque lesion with ill-defined and irregular borders.


The background of the tumor as fibrotic and containing irregular islands of tumor cells. There appears to be two populations of tumor cells, the large melanotic (pigmented) type and the small (non-pigmented) type (x10).


Frontal view of the patient showing mandibular swelling.


Intraoral view showing missing lower canines.


Orthopantomograph showing multiple cysts in maxilla and mandible.


Lower occlusal view showing radiolucency and impacted teeth.


Lateral skull view showing bridging of the sella turcica.


CT, axial view showing multiple cystic lesions in maxilla.


CT, axial view showing extensive cystic lesion in mandible.


Bifid third rib on the right side with dextrocardia.


CT, axial view showing calcification of falx cerebri.


CT, axial view showing calcification of tentorial cerebelli.


CT, axial view showing bifid spine, cervical and thoracic vertebrae.


Ultrasonographic image showing spleen in right hypochondrium.


Ultrasonographic image showing left hypochondrium.


Ultrasonographic image showing transposition of great vessels.


Multiple palmer pits.


(a-d) Preoperative magnetic resonance imaging. . Magnetic resonance imaging: Heterogeneous T2 hyperintense lobulated mass at the left cavernous sinus extending into Meckel's cave with bony remodeling, also with extension into left prepontine cistern, with avid contrast enhancement with no imaging evidence of intratumoral cystic degeneration or dural tail.


(a) Cyanosis on the left hand and skin ulcer on the fourth finger.


(b) Subtle livedo reticularis in fingers dorsum, without cuticle involvement.


(c) Intense livedo reticularis lesions in right palm, together with cyanosis in distal phalange.


(d) Erythematous-violaceous papules over left knuckles, one of them also hyperqueratotic due to a previous ulcer.


(a) Violet erythema in both eyelids, without involvement of nasal dorsum.


(b) Erythematous plaque on the right elbow with central desquamative and hyperkeratotic area from a previous ulcer.


(c) Right dorsum foot with erythematous warm and tender nodule.


(a) Superficial perivascular infiltrated of lymphocytes, with epidermal atrophy and dilated papular vessels with prominent endothelial cells (biopsy from the right-hand dorsum). Hematoxylin and eosin stain, original magnification:. X10.


(b) Dense, mostly septal, neutrophilic infiltrate with necrosis of fat lobules and calcium deposition, without dermal or epidermal involvement (biopsy from the right foot). X2.


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


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


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


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


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


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


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


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


Superior temporal artery branch occlusion with perivascular sheathing, cotton wool spots, and edema involving the macula.


Renal branch arterial sheathing and occlusion.


Esophagogastroduodenoscopy showed multifocal raised nodules in the duodenal bulb.


Dermoscopy showed central porcelain-white structureless area crowded by hairpin vessels.


Skin of the shoulder spared of erythroderma showing discrete, horny, follicular papules.


Tightening of skin of the face resulting in bilateral ectropion and furrows at the nasolabial area.


Thickened nail with subungual hyperkeratosis.


Enlarged knees with bilateral genu valgum.


Imaging data in a chronic granulomatosis disease patient with invasive aspergillosis caused by Aspergillus nidulans;. A plain X-ray revealing the laminectomy of L4-L5 with pedicular screw, along with post-operative changes, and ,exhibiting a destructive soft tissue density mass lesion centered on the body of T4-T5 vertebrae with adjacent prevertebral soft tissue formation mostly in the right side leading to central spinal column involvement, and ,right fifth rib destruction.


A computed tomography scan revealing brain abscess leading to hydrocephaly, showing extensive vasogenic edema in the right tempoparietal lobe, along with the dilations of the left ventricle and occipital horn of the right ventricle.


Baseline clinical presentation of left eye shows uniaxial proptosis with marked palpebral edema and conjunctival chemosis. Note the corneal ulcers.


Multi slice computed tomography (MSCT) scan of the orbit clearly shows right eye proptosis with lesion involving superior orbit, lateral orbit, and ,retro bulbar space.


The lesion had variegated appearances and was indenting the globe.


(A) Clinical improvement after three days.