Follow-up radiologic findings. E: Two months later, there are newly developed lesions; 2.3 cm sized hemorrhagic mass lesion with heterogeneous enhancement in right cerebellar hemisphere.


Follow-up radiologic findings. F: Six weeks later, MRI shows that the new multiple lesions are detected. CT: computed tomography, MRI: magnetic resonance imaging, WBRT: whole brain radiotherapy.


Magnetic resonance imaging of thoracic spines. (a) Sagittal plane T1-weighted section.


Magnetic resonance imaging of thoracic spines. (b) T2-weighted section.


Magnetic resonance imaging of thoracic spines. (c) Contrast-enhanced T1-weighted section.


Magnetic resonance imaging of thoracic spines. (d) Axial plane T1-weighted section.


Magnetic resonance imaging of thoracic spines. (e) T2-weighted section.


Magnetic resonance imaging of thoracic spines. (f) Contrast-enhanced T1-weighted section. The images show an oval extramedullary intradural mass lesion (3.0 x 1.6 cm in size) at T10-11 lying to the right posterolateral aspect of the spinal cord. The lesion shows heterogeneous low signal intensity on T2W images and iso- to low signal intensity on T1W images with moderate heterogeneous enhancement.


Intraoperative photographs. Intraspinal lesion.


Intraoperative photographs. Chalky white material firmly adherent to the dura mater. (see arrows).


Intraoperative photographs. The dural sac after complete excision of the gout tophus (c).


Microphotograph of histopathology showing acellular eosinophilia gouty tophi (G) surrounded by an inflammatory reaction and multinucleated giant cells (arrow) (H&E x 40).


A 66-year-old female with external ultrasound showing well-circumscribed hyperechoic mass in the left breast.


A 66-year-old female with breast magnetic resonance imaging shows heterogeneous mass with areas of T1 hyperintensity.


Suppressing on short-tau inversion recovery. In the left breast.


Postcontrast maximum intensity projection image shows irregularly enhancing mass (c).


A 66-year-old female with malignant phyllodes tumor on biopsy of the left breast mass with positron emission tomography-computed tomography scan showing area of mild uptake in left breast (arrow) with no lymphadenopathy or metastasis.


Imaging exams highlighting the injury of the patient. (A): Axial contrast-enhanced CT scan showing neoplastic lesion with an epicentre on the skullcap of the right temporo-occipital transition with intracranial and extracranial expansion.


Imaging exams highlighting the injury of the patient. (B): Sagittal contrast-enhanced CT scan showing the same lesion.


Imaging exams highlighting the injury of the patient. (C): Magnetic resonance imaging shows a highly enhancing tumour with epicentre in the right side of the posterior cranial fossa.


Imaging exams highlighting the injury of the patient. (D): Computerizsd tomography 3 years after the last surgery, the patient accompanied only with chemotherapy and radiotherapy.


Emphysematous pyelonephritis (EPN) of the right kidney. Computed tomography scan demonstrates right-sided EPN with enlarged right kidney and normal left kidney. Gas is present in the renal pelvis, in the proximal ureter (red arrows), and in a posterior cyst of the right kidney (white arrows). There is also significant perirenal infiltration (blue arrows).


The 2-month follow-up computed tomography scan. The follow-up computed tomography scan shows the normalizing size and complete absence of gas in the right kidney. A small posterior cyst of the right kidney is still present (red arrow). Perirenal infiltration has almost disappeared (blue arrows).


Slit-lamp images of the left eye of the CIN patient before the 2nd operation.


14 months after the 2nd operation.


Histological examination of the CIN tissue (c). Arrow heads indicate that nuclei of the superficial cells of the CIN epithelium remained as a shrunken pyknotic structure. H&E staining; bar = 100 mum.


Orthopantogram showing Unilocular radiolucent lesion in left body of mandible.


Computed tomography scan showed thinning and perforation of cortical plate.


Three-dimensional computed tomography scan showed perforation of buccal cortical plate.


Preoperative photograph of the patient.


Surgical removal of lesion.


After surgical removal of lesion impacted teeth visible.


Histopathologic features showing orthokeratinized stratified squamous epithelium of varying thickness lining a thin fibrous wall.


Platelet Trend in relation to Rituximab treatment.


Pre-operative photograph showing swelling on the right upper eyelid.


Photograph showing the size and the extent of the nevus.


Complete surgical excision of the lesion.


Photograph showing completely excised surgical specimen.


Photograph showing full-thickness graft harvested from the right post-auricular region.


One year postoperative axial.


Sagittal.


A coronal. T1-weighted MR images showing no evidence of recurrence or abnormal findings in the supratentorial region.


Two years postoperative axial.


A coronal. T1-weighted MR images with gadolinium detecting a solid mass with strong enhancement in the right cerebellar hemisphere (yellow arrow) and an hyperintense extra-axial solid mass located at posterior part of the falx (green arrow).


Histological images of meningothelial meningioma showing syncytial clusters of meningothelial cells.


Initial radiography of Lesions. A; Plain film radiography showing the lytic lesions present in the right distal clavicle and humeral head (arrows).


Initial radiography of Lesions. B; T1 MRI of the chest showing the T9 pathologic fracture (arrow).


Staining of Specimens. Histopathologic features of the T9 biopsy and intraoperative femur stabilization specimens, indicated in lower right corners. A; Nests of osteoid producing cells can be seen surrounded by swirls of pleomorphic spindle cells and reticular substance. HE x40.


Staining of Specimens. Histopathologic features of the T9 biopsy and intraoperative femur stabilization specimens, indicated in lower right corners. B; The tumor is predominantly made up of irregular spindle cells. HE x40.


Staining of Specimens. Histopathologic features of the T9 biopsy and intraoperative femur stabilization specimens, indicated in lower right corners. C; The tumor can be seen infiltrating normal bone architecture, HE x40.


Staining of Specimens. Histopathologic features of the T9 biopsy and intraoperative femur stabilization specimens, indicated in lower right corners. D; Pleomorphic spindle cells with intervening stroma. HE x200.


Staining of Specimens. Histopathologic features of the T9 biopsy and intraoperative femur stabilization specimens, indicated in lower right corners. E; Poorly defended clusters of cells can be seen surrounded by neoplastic stroma, HE x200.


Staining of Specimens. Histopathologic features of the T9 biopsy and intraoperative femur stabilization specimens, indicated in lower right corners. F; Spindle cells showing a high degree of pleomorphism, hyperchromatic nuclei, and irregular nuclear contours. HE x200.


Staining of Specimens. Histopathologic features of the T9 biopsy and intraoperative femur stabilization specimens, indicated in lower right corners. G; Positive immunohistochemical staining for OSCAR cytokeratin in scattered spindle cells, x200.


Staining of Specimens. Histopathologic features of the T9 biopsy and intraoperative femur stabilization specimens, indicated in lower right corners. H; Scattered positive immunohistochemical staining for OSCAR cytokeratin, x200.


Staining of Specimens. Histopathologic features of the T9 biopsy and intraoperative femur stabilization specimens, indicated in lower right corners. I; The same scattered positive immunohistochemical staining for OSCAR cytokeratin is seen in the femur biopsy, x200.


A 6 years old with Pol III-related leukodystrophy who presented with ataxic gait, delayed speech, difficulty with vertical gaze eye movements, and multiple unerupted primary incisor teeth. Magnetic resonance imaging of the brain with axial T2-weighted image at the level of the third ventricle and internal capsule demonstrates abnormal hyperintense T2 signal involving bilateral internal capsules and the white matter of all lobes of both cerebral hemispheres without cerebral parenchymal atrophy. Also noted is mild relative T2 hypointense signal within the anterolateral portions of both thalami.


A 6 years old with Pol III-related leukodystrophy who presented with ataxic gait, delayed speech, difficulty with vertical gaze eye movements, and multiple unerupted primary incisor teeth. Magnetic resonance imaging of the brain with axial fluid-attenuated inversion recovery (FLAIR) image at the level of the third ventricle and internal capsule demonstrates abnormal hyperintense FLAIR signal involving bilateral internal capsules and the white matter of all lobes of both cerebral hemispheres without cerebral parenchymal atrophy.


A 6 years old with Pol III-related leukodystrophy who presented with ataxic gait, delayed speech, difficulty with vertical gaze eye movements, and multiple unerupted primary incisor teeth. Magnetic resonance imaging of the brain with axial non-contrast T1 image at the level of the third ventricle and internal capsule demonstrates abnormal hypointense T1 signal involving bilateral internal capsules and the white matter of all lobes of both cerebral hemispheres without cerebral parenchymal atrophy.


A 6 years old with Pol III-related leukodystrophy who presented with ataxic gait, delayed speech, difficulty with vertical gaze eye movements, and multiple unerupted primary incisor teeth. Magnetic resonance imaging of the brain with axial diffusion tensor image at the level of the third ventricle and internal capsule demonstrates no evidence of abnormal restricted diffusion.


A 6 years old with Pol III-related leukodystrophy who presented with ataxic gait, delayed speech, difficulty with vertical gaze eye movements, and multiple unerupted primary incisor teeth. Magnetic resonance imaging of the brain with post-contrast axial T1 image at the level of the third ventricle and internal capsule demonstrates no evidence of abnormal enhancement.


A 6 years old with Pol III-related leukodystrophy who presented with ataxic gait, delayed speech, difficulty with vertical gaze eye movements, and multiple unerupted primary incisor teeth. Sagittal magnetic resonance imaging image through the midline of the brain using non-contrast T1 imaging demonstrates moderate atrophy of the cerebellar vermis.


Preoperative Lancaster red-green test, attaching the diplopia to bilateral sixth cranial nerve palsy.


Postoperative Lancaster red-green test, showing disappearance of the diplopia.


Medium power: Spindle cells with classic myofibroblastic cells within collagenous to myxoid stroma and associated inflammatory cells. No atypical mitosis or anaplastic elements are seen. (Note: Proliferation of spindle cells with blend nuclei and fascicular arrangement seen).


Axial cut of MRI scan showing large mass in the right submandibular region, indenting and pushing the tongue off midline.


Panorex view of the mandible.


Intraoperative photograph showing tumor attachment to the mandible. Segmental mandibulectomy was carried out sparing the inferior alveolar nerve.


(A) The 2014 pathological examination indicated a pleomorphic liposarcoma (hematoxylin and eosin staining, 400 x magnification) and MDM2 amplification in tumor tissues as revealed by fluorescence in situ hybridization (red fluorescence: MDM2, green fluorescence: CEP12; mean MDM2 signal: 35.1, mean CEP12 signal: 1.7, MDM2/CEP12 ratio = 20.65).


(B) The 2017 pathological examination indicated a de-differentiated liposarcoma (hematoxylin and eosin staining, 400 x magnification) and MDM2 amplification in tumor tissues as revealed by fluorescence in situ hybridization (red fluorescence: MDM2, green fluorescence: CEP12; mean MDM2 signal: 27.4, mean CEP12 signal: 1.8, MDM2/CEP12 ratio = 15.22).


(A) During the first apitherapy session, the patient was stung by only one bee and observed in a ward for 2 h (black arrow).


(B) After 9 weeks, the dose had gradually increased to 50 bee stings each time (black arrow).


A finger ulcer (white arrow).


A heel ulcer were side effects of apatinib (white arrow).


A flowchart/timeline of the therapy.


CT of the brain and orbits (coronal.


Axial. Sections) showing signs of orbital cellulitis (significant left-sided proptosis, inflammation and fat stranding of the periorbita and within the left orbit) and a filling defect within the left cavernous venous sinus, suggestive of a cavernous sinus thrombosis.


Examination under anesthetic demonstrating marked chemosis, dense corneal infiltrate with a large hypopyon and periorbital erythema. Note the purulent fluid aspirated from vitreous tap.


Representative histologic images of rhabdomyosarcoma. (A) Malignant mesenchymal tumor, mainly spindle cells, clear cytoplasm or acidophilic tumor cells, severe atypia, large and hyperchromatic nuclei, irregular karyotype, and visible mitotic image.


Representative histologic images of rhabdomyosarcoma. (B) MyoD1 (+) by immunohistochemistry.


Representative histologic images of rhabdomyosarcoma. (C) Myogenin (focal +) by immunohistochemistry.


Timeline of historical and current treatments.


Treatment plan for a cerebellopontine angle epidermoid tumor, the tumor was covered by 15 Gy at a 55% isodose line. One percent of the brainstem received 8 Gy, the pineal gland received 9 Gy.


Treatment plan for a patient with an epidermoid tumor and associated trigeminal neuralgia. 80 Gy hotspot was placed on the nerve while modeling 12 Gy isodose around the tumor. The optic pathway received 1.5 Gy on 1% of its volume; brainstem received 9 Gy on 1% of its total volume, and the pineal gland received a total of 1.7 Gy.


Treatment plan for a cerebellopontine angle epidermoid tumor causing trigeminal neuralgia. An 80 Gy hotspot was placed on the trigeminal nerve, and a 12 Gy isodose curve was modeled around the tumor. At risk structures including the brainstem received only 8 Gy at 7% of its total volume.


Contrast-enhanced MRI of the pituitary region showing a subtle area of flow void (arrow) in the right anterior aspect of pituitary adenoma.


CTA of the circle of Willis demonstrating a 4.5 mm x 4 mm aneurysm of the right cavernous ICA (arrow).


One-year follow-up diagnostic angiography demonstrating complete occlusion of the aneurysm with digital subtraction.


Without digital subtraction.


Clinical image showing a reticulated white plaque on the lower lip.


Photomicrograph of the lip biopsy showing a lichenoid lymphocytic infiltrate with interface vacuolar change and focal subepithelial blistering. HE. Original magnification x100.


Initial magnetic resonance imaging of brain. Axial fluid-attenuated inversion recovery image (a) through the basal ganglia shows symmetric hyperintensity in the thalamus and basal ganglia (arrows).


Initial magnetic resonance imaging of brain. Axial fluid-attenuated inversion recovery image (b) through the posterior fossa shows symmetric hyperintensity in the dorsal pons (arrowhead) and in the cerebellar peduncles (arrows).


Initial magnetic resonance imaging of brain. The axial diffusion-weighted image.


Initial magnetic resonance imaging of brain. The apparent diffusion coefficient map. Show areas of diffusion restriction in the cerebellar peduncles and pons. The diffusion-weighted images also showed restriction in bilateral basal ganglia (Images not provided).


A 2-month follow-up computed tomography and magnetic resonance imaging studies. Axial noncontrast computed tomography image (a) shows diffuse cerebral parenchymal volume loss and areas of calcification in the posterior aspects of the putamen (arrows).


A 2-month follow-up computed tomography and magnetic resonance imaging studies. (b) Diffusion-weighted sequence shows normalization of the signal abnormalities in the basal ganglia.


A 2-month follow-up computed tomography and magnetic resonance imaging studies. Axial fluid-attenuated inversion recovery images (c and d) show residual hyperintensity in the basal ganglia and the middle cerebelar peduncles (arrows).


Repeat magnetic resonance imaging. Axial fluid-attenuated inversion recovery image (a) through the basal ganglia shows extensive hyperintensity in the thalamus, basal ganglia, central and deep white matter, and the corpus callosum.


Repeat magnetic resonance imaging. The axial diffusion-weighted images (b) show corresponding areas of diffusion restriction (arrows).


Repeat magnetic resonance imaging. (c) The magnetic resonance spectroscopy shows elevated lactate doublet (arrow) and dampening of the NAA (curved arrow) metabolite peaks.


Repeat magnetic resonance imaging. (d) Axial postcontrast T1-weighted image shows areas of amorphous enhancement corresponding areas of fluid-attenuated inversion recovery signal abnormality. Notice the posterior putaminal T1 hyperintensity corresponding to the areas of calcification seen on the prior computed tomography scan (image a, Figure 2).


Sag T2-weighted through the cervical spine.


Axial T2-weighted through the conus medullaris. Show spinal cord swelling and hyperintensity of the central cord matter.


Postcontrast T1-weighted of the cervical spine.


Lumbar spine. Show focal areas of intramedullary enhancement.


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


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


(C) CECT shows large abdominopelvic mass.


(D) CECT shows presacral deposit.


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


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


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


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


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


Preoperative view of the limited mouth opening.


Preoperative panoramic view which shows the heterotopic bone mass on right temporomandibular joint and previous surgery area at the left temporomandibular joint.


Blue arrow shows the ankylotic mass at the axial view of the cone beam computerized tomography.


Preoperative model which shows the borders of the ankylosis at the right side of the temporomandibular joint.


The view of the dermis fat graft.


(a) Intraoperative view of the ankylotic mass.


(b) The view of the sutured fat graft.


Postoperative mouth opening 1 year after surgery.


MRI brain coronal T1 weighted postcontrast images reveal heterogeneously contrast enhancing hyperintense sellar and suprasellar mass lesion extending laterally into cavernous sinuses and encasing both internal carotid arteries. Diffuse calvarial thickening and expansion in right high parietal region is also present.


MRI brain sagittal T1 weighted post contrast images reveal heterogeneously contrast enhancing hyperintense sellar and suprasellar mass lesion extending superiorly up to the floor of the third ventricle and pushing the optic chiasma superiorly and anteriorly.


The whole body 99m-Tc-MDP bone scan image reveals multiple regions of intense activity on the right side of the skull, mandible, right humerus, scapula, hemi pelvis, femur and tibia. Foci of increased uptake were also present in the lumbar spine and the left humerus.


X-ray pelvis AP view showing expensile radiolucent lesion with sclerotic foci in neck and metaphysis of B/L femur with sephered cook deformity on left side.


A plain X-ray film lateral view shows extensive involvement of skull base with thickening and sclerotic changes.


Postoperative CT scan showing gross total excision of the lesion.


Beaded lesions over both eyelid margins.


Multiple scars over elbows, upper arm and lower back.


Mucosal infiltration.


Pebbling in lower lip mucosa.


Histopathological study showing PAS-positive hyaline material around capillaries and adnexal structures.


Serial 3D angio CT scans. Arrows in the CT indicate thrombosis in.


Serial 3D angio CT scans. Left portal vein.


Serial 3D angio CT scans. Main portal vein. Splenic vein.


Serial 3D angio CT scans. Superior mesenteric vein.


Right . Color photographs of the fundus.


Right . Early.


Right . Late-phase. Fluorescein angiograms.


Left. Eye. Color photographs of the fundus.


Left. Eye. Early.


Left. Eye. Late-phase. Fluorescein angiograms.


T1 sagittal MRI. Adenohypophysis is morphologically not definable, therefore, aplasia is suspected. The neurohypophysis presents as punctuate signal enhancement midsize of the hypophysis stem.


Abdominal CT scan: umbilicus lump (arrow), which was suspected to be an umbilicus tumor.


CT scan: postoperative changes of lymph nodes in the right axillary area (arrow). The density of soft tissue around this structure was increased.


The PET-CT scan: umbilicus lump (arrow). An increased metabolic rate was revealed. Radioactive tracer: 18F-FDG.


The PET-CT scan: axillary lymph nodes (arrow). Radioactive tracer: 18F-FDG.


Indirect immunofluorescence of the frozen serum of the patient for IgG, IgA, and C3 was all negative.


The symptoms of the patient after 2 years of treatment. A small amount of hair had grown and all skin lesions had disappeared.


Imaging results in our patient. CT of the abdomen:. Arterial phase, axial projection.


Imaging results in our patient. Arterial phase, sagittal projection. Three pheochromocytomas in the body and medial pedicle of the left adrenal gland (short arrows). Uniformly thickened lateral pedicle of the left adrenal gland (long arrow). The adrenal lesions were located close to each other, 21 x 22 x 23 mm, 24 x 14 x 19 mm and 24 x 22 x 24 mm.


Imaging results in our patient. MRI of pituitary adenoma (long arrow) with cystic component (short arrow), subtotally replaces adenohypophysis:. T1 CE (contrast-enhanced) coronal projection.


Imaging results in our patient. T1 CE sagittal projection. The size of pituitary adenoma was 22 x 8 x 14.8 mm.


Erythema and edema are greatest over the lateral one-third of the upper eyelids (photo was taken after the application of flouroscein and with the patient's written permission).


Chemosis and injection of the sclera are present (photo was taken after the application of flouroscein and with the patient's written permission).


Coronal CT image showing bilateral lacrimal gland inflammation (arrows).


Axial CT image showing bilateral lacrimal gland inflammation (arrows).


MRI of esthesioneuroblastoma/inverted papilloma collision tumor. Mass can be visualized in addition to inspissated secretions in the surrounding sinuses.


Nasal endoscopy view of collision tumor.


Hematoxylin and eosin stain - high power of sinonasal inverted papilloma with infiltration of epithelium by atypical cells (esthesioneuroblastoma).


Immunohistochemistry of lesion for synaptophysin (characteristically stains positive in esthesioneuroblastoma).


Immunohistochemistry of lesion for neurofilament stain (characteristically stains positive in esthesioneuroblastoma).


Pre-operative intraoral view shows buccal and lingual expansion in the posterior mandible.


Medical image.


Computed tomography shows an expansile lesion of the right mandible. Tomographic reconstruction image shows the extent of the lesion.


The axial T1.


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


A horny growth of around 2 cm in length with a broad base over the palmar aspect of the middle phalanx of the left middle finger.


Hyperkeratosis, and ,focal parakeratosis, Hematoxylin & Eosin (H & E) stain 4x.


Loss of polarity and disordered arrangement of keratinocyte in stratum malphigian with part of normal dermis, H & E stain 10x.


A; Skin lesions in patient 1 which consisted of maculopapular rash with ulcerations and edema at lower leg and foot before treament.


B; After treatment with rituximab.


Photomicrograph of a section of skin in patient 1, showing dilated subepidermal small vessels with swollen endothelial cells. There is a perivascular infiltrate consisting mainly of lymphocytes, few plasma cells and extravasated erythrocytes of which some are fragmented. No vascular necrosis is seen (HE, x200).


Initial imaging - Axial and coronal contrast-enhanced computed tomography of the abdomen (portal venous phase) demonstrates a large, complex mass lesion in the right abdomen. It abuts the inferior liver border with a poor plane of separation and displaces the bowel to the left (arrowheads). There is a lack of peripheral hepatic parenchymal extension along the edges of the mass (claw sign); therefore, hepatic origin cannot confidently be suggested. Solid and cystic elements are clearly distinguishable (arrow) with the classic 'swiss cheese appearance'.


Follow-up imaging - Abdominal computed tomography scout image and coronal contrast-enhanced imaging (portal venous phase) demonstrates the mass to have shifted into the left abdomen (arrow), causing displacement of the bowel to the right (arrowheads). This reveals the mass to be mobile and separable from the right and left liver lobes.


Follow-up imaging - Axial contrast-enhanced computed tomography of the abdomen (portal venous phase) shows the mass within the left upper abdomen. A thin pedicle is seen connecting the mass to the caudate lobe of the liver (arrowheads). This confirms a pedunculated mass of hepatic origin.


Mediolateral oblique view of mammogram demonstrates a small well-circumscribed oval mass just underneath a radiopaque skin marker in the medial right breast near the nipple. The mass contains multiple small punctuate calcifications.


A gray-scale ultrasound image of the lesion shows a well-defined isoechoic oval mass, parallel with the skin measuring 7 mm x 3.5 mm, containing the small hyperechoic foci of calcification observed on the mammogram.


Typical basaloid and shadow cells of pilomatrixoma (Hemotoxylin and eosin, 10x).


Conjunctival chemosis and proptosis of the right eye.


CT scan imaging of the orbit and paranasal sinuses: A) Axial view (left) demonstrated right periorbital soft tissue swelling with right extraocular muscle bulkier compared to left side. There was enlargement of the right lacrimal gland. Soft tissue density was seen within ethmoidal air cells.


B) Coronal view (right) demonstrated soft tissue density in the frontal sinus, ethmoidal air cells and mucosal thickening in both the maxillary sinuses with obliteration of both osteomeatal complex. There was erosion of the right lamina papyracea.


Ethmoid sinus biopsy specimen A: H&E stain (100x) showed a piece of lymphoid tissue covered by respiratory epithelium (black arrow) and the stroma was densely infiltrated by neoplastic lymphoid cells (red arrows) B: H&E stain (400x) showed dense infiltration of the stroma with neoplastic lymphoid cells. There were prominent scattered areas of necrosis and apoptotic bodies seen (black arrow).


Bilateral soft tissue swelling of the hands with loss of skin crease and clubbing of the fingers.


Chest X-ray above shows central vascular prominence with abnormal alveolar opacities in the mid and lower lungs bilaterally in addition to small effusions.


High-resolution CT chest above showing diffuse ground-glass opacity in the lungs and bilateral pleural effusion.


Histopathological staining revealing a pure squamous cell carcinoma arising from the left ovary, a notable observation in the absence of any concomitant dermoid cyst or endometriosis (stain, hematoxylin and eosin; magnification, x200).


Immunophenotyping by flow cytometry of the blasts at acute B-lymphoid leukemia phase.


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


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


Hematoxylin and Eosin Staining of Pre-Tibial Soft Tissue Nodule. Microscopic hematoxylin and eosin (H&E) section showing (A) large, deep dermal collections of non-caseating granulomas (a, 2x) extending into the subcutaneous tissue (b, 2x). Higher magnification shows tightly formed granulomas containing multinucleated giant cells separated by fibrous connective tissue (c, 4x). Scattered mature appearing lymphocytes are seen surrounding the granulomatous inflammation (d, 10x).


PD-L1 Staining of Pre-Tibial Soft Tissue Nodule. PD-L1 antibody stained section of the granulomatous inflammation shows strong membranous staining of the histiocytes within the granulomas and scattered positive lymphocytes. 4x.


PD-L1 Staining of Pre-Tibial Soft Tissue Nodule. . 20x).


A late-onset corneal flap displacement with superior and inferior portion of flap being folded is shown. Bare stroma is exposed and intact nasal hinge is visible under surgical microscope.


After reposition of the corneal flap a bandage soft contact lens is placed on the cornea for protection under surgical microscope. without epithelial ingrowth.


Four months after surgery, the corneal flap is clear and smooth in situ without epithelial ingrowth.


(A) Facial edematous, erythematous plaques partially covered by vesicles and yellowish crusts.


(B) The lesions completely resolved.


(C) Dense eosinophilic infiltration in the dermis (HE, 40x).


(D) Higher magnification with numerous eosinophils and 'flame figures' (HE, 200x). Degranulated eosinophils forming flame figures (black arrows).


Pre- and postoperative computed tomography (CT). Preoperative CT in the bone window in the axial plane (a and b) demonstrating hypertrophy of the left sphenoid wing, orbital lateral wall, and floor of the middle fossa.


Pre- and postoperative computed tomography (CT). Pre-operative CT in the bone window in the coronal plane (c) showing development of the lateral recess of the sphenoid sinus beyond the sphenoid body into the greater wing.


Pre- and postoperative computed tomography (CT). Postoperative CT in the bone window (d-f) showing extensively drilled sphenoid wing, orbital lateral wall, floor of the middle fossa, ethmoid sinus, and sphenoid sinus. Arrow, vidian canal; arrowhead, foramen rotundum.


Intraoperative photographs. (a) Intraoperative photograph from the transcranial side showing the large bone defect of the sphenoid sinus after tumor resection. Arrow indicates suction from the endonasal side.


Intraoperative photographs. (b) Intraoperative photograph demonstrating repair of the defect with a free graft of fascia lata.


Intraoperative photographs. (c) Intraoperative photograph from the endonasal side showing tumor extending into the sphenoid sinus. SF, sellar floor; CP, carotid prominence.


Intraoperative photographs. (d) Intraoperative photograph demonstrating repair of the defect with a pedicled nasoseptal flap. Dotted line indicates the margin of the nasoseptal flap.


Brain MRI and MR angiography of this patient. (A) T1-weighted saggital magnetic resonance image shows no significant brain parenchymal abnormality. There is no evidence of subdural fluid collection or other mass lesion.


Brain MRI and MR angiography of this patient. (B) T2-weighted axial scan shows symmetric apprearence of cerebral hemisphere without remarkable findings in suprasellar cistern.


Brain MRI and MR angiography of this patient. (C) Intracranial vessels including, internal carotid arteries, middle cerebral arteries and its bifurcation, anterior cerebral arteries, vertebrobasilar arteries do not show any stenosis or occlusion.


Brain MRI and MR angiography of this patient. (D) Neck vessels, subclavian artery, common carotid arteries with bifurcation and origin of bilateral vertebral arteries are within normal limit.


The ocular appearance shows swelling of the lateral superior part and the lower eyelid of the left eye.


The radiological findings of the 2-year-old girl with an orbital mass. Orbital axial CT showing the soft tissue mass on the lateral orbital rim of the left eye.


The radiological findings of the 2-year-old girl with an orbital mass. Orbital coronal CT in the bone window showing the soft tissue mass on the lateral superior orbital rim of the left eye, with bone destruction in the lateral wall of the left orbit.


The gross picture shows two masses measuring approximately 2.5 cm x 2 cm x 1.5 cm and 2.5 cm x 1.5 cm x 1 cm in size.


Abdominal CT findings. A plain scan showing a left adrenal tumor of approximately 1.5 cm x 2.2 cm x 2.7 cm size (black arrow).


Abdominal CT findings. A plain scan showing a calcified nodule on the left side of the abdominal aorta (black arrow).


Abdominal CT findings. An enhanced scan revealing left adrenal tumor with increased calcification inside (black arrow).


Abdominal CT findings. An enhanced scan showing the mesenteric lymph nodes (black arrow).


Clinical pictures of all three cases showing multiple shiny papulo-nodular lesions over face.


Split Skin smear showing multiple acid-fast bacilli with Bacillary Index: 6.


(a) Preoperative electroencephalogram recorded at the start of the habitual seizure (sensitivity: 10 microV, time constant: 0.1 s, high cut filter: 30 Hz, reference: average). Ictal activities begin with rhythmic alpha activity at T3 and T5 (red line).


(b) Coronal view of preoperative magnetic resonance image (MRI) with fluid-attenuated inversion recovery (FLAIR) sequence demonstrates that protrusion of a part of the left temporal lobe is confirmed in the lateral fossa of the sphenoid sinus, indicating sphenoidal encephalocele (Red arrow). Coronal computed tomography (CT) at a comparable level with. Confirms the bone defect on the left lateral wall of the sphenoid sinus (white arrow). FLAIR-MRI. Clearly shows that markedly decreased accumulation of FDG is observed at the tip of the encephalocele (white arrow).


Medical image.


Coronal view of 18-F fluorodeoxyglucose (FDG)-positron emission tomography (PET) image at the hippocampus.


A few centimeters behind the sphenoidal encephalocele and at the sphenoidal encephalocele Decreased accumulation of FDG is observed around the left medial and basal temporal area (white arrows). The fusion image of FDG-PET.


(a) Postoperative MRI confirms that the sphenoidal encephalocele was resected 8 mm from the tip.


(b) Postoperative CT shows successful repair of the temporal base with nasal septum cartilage.


(c) Histopathological examination shows cerebral cortical tissue with several reactive astrocytes.


Photo showing 'wet cigarette paper' skin condition on the lower extremities.


Abdominal CT scan showing sigmoid diverticulitis (arrow) and free air (star).


Preoperative sagittal T2-weighted cervical magnetic resonance imaging depicting bony listhesis and synovial lesion.


Preoperative axial T2-weighted cervical magnetic resonance imaging depicting epidural synovial lesion with facet and neuroforaminal involvement.


Microscopic analysis of tissue sample demonstrating moderately cellular chondrocytes.


(A) Histological examination of a gingival biopsy showing subepithelial cleavage with overlying intact epithelium. A moderate perivascular infiltration can be observed consisting of lymphocytes and histiocytes, and no lichenoid infiltrate.


(B) Direct immunofluorescence microscopic image showing linear IgG (++) and C3 (++) immune deposits along the basement membrane zone on the gingival biopsy.


Direct immunoelectron microscopy showing immune deposits (arrow) strictly localized in the lamina densa. Ke, keratinocyte; LL, lamina lucida; AF, anchoring fibril.


Necrolytic migratory erythema with erosion and crust formation. . Notes:. Face.


Necrolytic migratory erythema with erosion and crust formation. Legs.


Necrolytic migratory erythema with erosion and crust formation. Perianal region.


Skin biopsy in necrolytic migratory erythema showing a large zone of necrolysis in the upper epidermis (arrow). . Notes: Hematoxylin and eosin staining; magnification x40.


Computed tomography scan of the abdomen of the patient showing a large tumor in the tail of the pancreas.


Resolution of cutaneous lesions 1 week after surgery. . Notes:. Face.


Resolution of cutaneous lesions 1 week after surgery. Legs.


Resolution of cutaneous lesions 1 week after surgery. Perianal region.


Right arm showing asymptomatic monomorphic erythmatous lesions.


Left arm showing asymptomatic monomorphic erythematous lesion.


Kinetics of skin pH in cases of PPH during treatment. Case 1 was treated by topical AC and TWI and case 2 was treated by topical AC. The mean pH values and standard deviations were calculated from the measurements of four sites on both the palms and soles. * p < 0.05 (paired t test).


The patient's drawing at 8 years old describing her visual experience. (A) Black-and-white or coloured swirls with colourful dots.


The patient's drawing at 8 years old describing her visual experience. (B) Colourful dots involving the entire visual field.


(A) The patient's family pedigree. The pedigree was drawn based on the father's description on their family members presenting symptoms suggestive of XLRP. Circles indicate female and squares indicate male. Close symbols indicate family members with symptoms and open symbols indicate unaffected individuals. The dotted circle indicates the patient as a female carrier. The strike-through symbols indicate deceased family members.


(B) Timeline of patient care. The patient's parents first noticed her seeing colourful moving dots, possibly representing visual snow, at the age of 2 years. She first came for ophthalmological evaluation at the age of 5 years due to blurred vision. The follow up was performed five times over the course of 3.5 years, where the patient displayed significant reduction of the cone function in both eyes. The mutation analysis and the X-chromosome inactivation study were performed at the age of 8 years.


Clinical image of the cutaneous eruption that developed after six cycles of nivolumab. On the back, there were widespread and numerous 3-10 mm pink to pink-brown thin flat-topped papules and plaques with scale.


Punch biopsy of a representative lesion (left upper arm). Hematoxylin and eosin staining revealed an acanthotic epidermis with hyperkeratosis and hypergranulosis. There is a band-like lymphohistiocytic infiltrate at the dermal-epidermal junction with focal squamatization of the basal cell layer and scattered necrotic keratinocytes (20 x magnification).


Clinical image after successful treatment with NBUVB. On the back, there were widespread and numerous hyperpigmented macules coalescing into patches. There was no erythema or scale.


Exfoliation of skin over the palm in a patient with hydroxychloroquine-induced erythroderma.


Exfoliation of skin over the foot in a patient with hydroxychloroquine-induced erythroderma.


Beau's lines over the fingernail in a patient with hydroxychloroquine-induced erythroderma.


Thoracic radiography revealing right pleural effusion.


Chest CT scan:multiplanar reconstructions soft tissue window-encapsulated pleural effusion with drain tube.


The radiological aspect at the time of discharge.


Thoracic radiography after 6 months revealing only minimal thickening of the inferior right pleura.


Photograph shows healing subcutaneous ulcer over thigh.


Medical image.


H and E, x400] shows normal epidermis and the dermis with inflammatory infiltrate, eosinophils and neutrophils (a) superficial dermis with destruction of the vessel walls by inflammatory infiltrate (b) (arrow).


Photograph shows healed subcutaneous ulcer over thigh with scarring.


Healed gangrene of finger. (ie, autoamputated distal phalanx).


(a-c) Hematoxylin and eosin (H&E) staining showing numerous granulomatous fragments of fibrotic and neural tissue and lymphomononuclear inflammatory infiltrate rich in eosinophils forming granulomatous nodules with necrotic center enclosing parasites with the characteristic spicula of consistent in appearance with Schistosoma mansoni.


Postoperative magnetic resonance image of the thoracolumbar spine showing the absence of anomalous contrast areas in addition to the absence of recurrence of the lesion.


Stromal keratocyte nuclei (arrow) and nerve fibers observed in Bowman's plane of the right eye in stage 3 keratoconus. Magnification 500x with 40x objective lens.


Elongated keratocyte nuclei (arrow) observed in anterior stroma of the right eye in stage 3 keratoconus. Magnification 500x with 40x objective lens.


Cluster of cells (arrow) observed in anterior stroma of the right eye in stage 3 keratoconus. Magnification 500x with 40x objective lens.


Thin dark bands (arrow) were observed in anterior stroma of the right eye in stage 3 keratoconus. Magnification 500x with 40x objective lens.


Thick dark bands (arrow) were observed in posterior stroma of the left eye in stage 2 keratoconus. Magnification 500x with 40x objective lens.


Gangrenous digits of the patient.


Ulcerated jugulodigastric node.


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


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


Lymphangitis carcinomatosis involving the right lobe and mediastinal adenopathy.


Preoperative corneal anterior surface wavefront error, RMS map (over a 6 mm diameter optical zone), right eye.


Left eye The RMS value was 2.1 in both eyes.


After 24 months from the Descemet stripping automated endothelial keratoplasty, right eye.


Left eye ; the RMS value was, respectively, 1.7 in and 1.4. . Note: The patterns showed a slight improvement in corneal profile with a mild reduction of higher-order aberrations. . Abbreviation: RMS, root mean square.


Preoperative mapping of the right breast lumps.


Remapping of the some of the excised lumps.


Display of all excised lumps.


Right breast edema, and ,bruise on the third postoperative day.


Resolved edema with good healing after 2 weeks.


Preoperative mapping of the locations of the left breast lumps.


Infection, and ,dehiscence.


Good final cosmetic outcome at 3 months.


Preoperative mapping showing previous scars, and ,current location of three new lumps.


Points of lump excision demonstrated through circumareolar incision.


Bruising, and ,edema third postoperative day.


Well-camouflaged scar 10 weeks after surgery.


Preoperative mapping showing planning of cone-wise dissection.


Edema on third postoperative day.


(A) Generalized erythematous papulosquamous lesions with whitish scales on the trunk (inlet) and erythematous papular lesion with whitish scales.


(B) Improved skin lesions with remaining widespread hypopigmentation 8 weeks after the start of therapy. Some hyperpigmented spots corresponding to hair follicles were suspected to be due to repigmentation.


Histopathology of skin lesions (H&E, x100). Interface dermatitis with perivascular and periappendageal lymphocytic infiltration, apoptotic keratinocytes, exocytosis of lymphocytes, hyperkeratosis, and parakeratosis (inlet, x400); dyskeratotic cells seen in the epidermis.


Postcontrasted CT image revealing an irregular thickening of the left side of the bladder wall (arrowheads) and a stranding of a surrounding fat tissue (arrows).


On axial T1-weighted image, the irregular thickening of the bladder wall showing isointensity (arrowheads).


The stranding of a surrounding fat tissue is also seen (arrows). On coronal T2-weighted image, the irregular thickening of the wall showing hypointensity (arrowheads). The stranding of a surrounding fat tissue is seen (arrows).


The obliteration of the normal hypointensity of the muscle layer adjacent to the mass is also seen (c) The irregular thickening of the bladder wall showing a gradual and inhomogeneous enhancement (arrowheads) on equilibrium phase of the dynamic contrast study.


The stranding of a surrounding fat tissue is also seen (arrows) (d) The both the irregular thickening of the bladder wall and the stranding of a surrounding adipose tissue was nearly disappeared on MR image without any treatment after three months.


Changes of BCVA throughout the disease course. Day -3 was the day the patient first visited our hospital, and it indicates the third day before the initiation of systemic steroid therapy. Day 0 indicates the first day of systemic steroid therapy. Day 11 indicates the 11th day after initiation of systemic steroid therapy. BCVA OD and BCVA OS indicate BCVA of the right and left eye, respectively.


Papilledema and peripapillary small hemorrhages in the right eye.


Left eye at presentation.


Normal optic disc appearence after treatment in the right eye.


The left eye.


Visual field showed a normal pattern on the right side.


With a minimal enlargement of the blind spot on the left side.


Grouped bluish-purple nodules and papules on the flexor area of the right shin.


Osteochondral outgrowth in the medial part of the tibia on a computed tomography scan.


A dense neutrophilic infiltrate with histiocytes, multinucleated giant cells and neutrophils locally forming microabscesses (hematoxylin and eosin, original magnification x 4) (A).


Enlarged area marked on previous image - microabscess with leukocytoclasis within the vessel wall (hematoxylin and eosin, original magnification x 20) (B).


Multinucleated giant cells within the inflammatory infiltrate (arrowheads) (hematoxylin and eosin, original magnification x 40) (C).


The lesions from Fig. 1 after 7 intravenous pulses of methylprednisolone - mostly postinflammatory hyperpigmentation with only a few active lesions is seen.


Case 1, left eye. Orbscan keratometric map before.


Case 1, left eye. After surgery , showing stability in topographic astigmatism.


Case 1, left eye. Toric IOL software calculation with suggested IOL position.


Case 1, left eye. Final IOL position , with IOL marks aligned according to the suggested position.


Case 3, right eye. Orbscan keratometric map before.


Case 3, right eye. And after surgery.


(P)-showing the peripheral excised specimen. (C)-Showing the central excised specimen.


42-year-old female with a history of chronic iron deficiency anemia and menorrhagia for several years and later diagnosed with cystic lymphangioma of the small bowel mesentery. Transabdominal ultrasound. Sagittal.


42-year-old female with a history of chronic iron deficiency anemia and menorrhagia for several years and later diagnosed with cystic lymphangioma of the small bowel mesentery. Transverse scans demonstrate a bulky uterus with a subserosal fibroid (white arrows) seen in both sagittal and transverse planes.


42-year-old female with a history of chronic iron deficiency anemia and menorrhagia for several years and later diagnosed with cystic lymphangioma of the small bowel mesentery underwent pelvic ultrasound for investigation of menorrhagia and was found to have a complex cystic right adnexal mass. Transabdominal ultrasound demonstrates a cystic lesion with numerous thin septae (curved arrows) and good through transmission (straight arrows).


42-year-old female with a history of chronic iron deficiency anemia and menorrhagia for several years and later diagnosed with cystic lymphangioma of the small bowel mesentery. Axial T2 images (a and b) demonstrate tethering of right ovary (arrows) to the uterus posteriorly.


42-year-old female with a history of chronic iron deficiency anemia and menorrhagia for several years and later diagnosed with cystic lymphangioma of the small bowel mesentery. (a) Coronal fast imaging with steady-state precession (FISP) demonstrates a multiloculated cystic lesion with numerous septae (straight arrows), lacking mass effect.


42-year-old female with a history of chronic iron deficiency anemia and menorrhagia for several years and later diagnosed with cystic lymphangioma of the small bowel mesentery. (b) Sagittal T2 (13 months later) of lesion, shows increase in size of lesion with thin-walled septae (straight arrows) and insinuating around the mesenteric vessels (curved arrow). Note the uterine fibroid with evidence of cystic degeneration (hollow arrow).


42-year-old female with a history of chronic iron deficiency anemia and menorrhagia for several years and later diagnosed with cystic lymphangioma of the small bowel mesentery. Corresponding axial T1. In-phase.


42-year-old female with a history of chronic iron deficiency anemia and menorrhagia for several years and later diagnosed with cystic lymphangioma of the small bowel mesentery. Out-of-phase MR images demonstrate the cystic lymphangioma (straight arrows) with signal intensity loss on the out-of-phase image. Compared to the in-phase image, indicative of microscopic lipid content of chylous fluid.


Clinical photographs of oral melanoacanthoma. . Macular brown pigmentation with irregular margins involving. Upper, and ,lower attached, and ,free gingivae.


Clinical photographs of oral melanoacanthoma. Upper labial mucosa.


Clinical photographs of oral melanoacanthoma. Lower labial mucosa.


Microphotograph of the stained biopsy tissue. . Microphotograph of hematoxylin and eosins stained tissue shows the parakeratinized, hyperplastic, stratified squamous epithelium with acanthosis, and long rete ridges. Many benign dendritic melanocytes with dendritic processes can be seen distributed in the epithelium, as well as melanin deposits in the lamina propria.


Microphotograph of Melan-A stained biopsy tissue. . Microphotograph of Melan-A stained biopsy tissue shows melanotic hyperplasia in the epithelium.


Follow-up clinical photograph. . An eight-month-follow up visit revealed that the brown pigmentation had faded gradually.


Sclerosing mesenteritis at ultrasonography. The thickened and hyperechoic mesentery is well evident.


Sclerosing mesenteritis at histology. Fibrosis with dense collagen, fat necrosis, and chronic inflammation are evident.


Port-wine angioma in the right cervicodorsal region of the patient compromising scapular region and shoulder. The angioma extends to the homolateral pectoral region (not seen in this picture).


(a) Sagittal cervicodorsal T2-weighted MRI revealing the AVM from C5-D2, with multiple flow voids compromising the whole thickness of the spine and severe intensity changes up to well above in the first cervical spinal segment.


(b) Axial plane T2-weighted MRI at the level of C7.


(a) Early arterial phase DSA in the right cervical region, showing a high-flow compact spinal AVM nidus with a main feeding trunk (white arrow) and multiple smaller ones.


(b) Venous phase of the same angiogram, displaying multiple abnormal varicoceal draining veins extending well above the compact nidus in the cervical region.


Intraoperative photography before the microsurgical resection, showing prominent tortuous vessels in the subarachnoid space.


(a) Ten days postoperative sagittal MRI showing complete removal of the AVM and significant improvement of the hyperintensity in the cervical spinal cord [Figure 2.


(b) Same postoperative MRI in the axial plane at the level of C7 demonstrating no flow voids inside the spinal cord.


(c) Seven weeks postoperative angiogram showing no residual AVM nidus.


Temporary management of the wound. (a) Exposed extensor tendon over dorsal aspect of proximal phalanx of left middle finger.


Temporary management of the wound. (b) Transient coverage of wound with cadaveric skin graft. The white arrow indicated exposed tendon.


Finger reconstruction by using the SPBRA flap. (a) Preoperative defect of the left middle finger (antero-posterior view).


Finger reconstruction by using the SPBRA flap. (b) Preoperative defect of the left middle finger (lateral view).


Finger reconstruction by using the SPBRA flap. (c) Flap design.


Finger reconstruction by using the SPBRA flap. (d) Postoperative view.


Preoperative magnetic resonance imaging. The T2-weighted sagittal image (left) shows a large hyperintense retroclival cystic mass extending into interpeduncular and suprasellar cisterns, causing compression and posterior displacement of brain stem.


Preoperative magnetic resonance imaging. The T1-weighted postgadolinium sagittal image (middle) shows a nonenhancing mass.


Preoperative magnetic resonance imaging. Diffusion weighted image (right) demonstrates a mass lesion in interpeduncular cistern without restricted pattern.


Intraoperative transnasal endoscopic view after fenestration of the cyst into adjacent cisterns.


Postoperative magnetic resonance imaging. The T2-weighted axial.


Postoperative magnetic resonance imaging. Sagittal. Images show cyst shrinkage and decompression of brain stem.


(a) Variable shaped and sized large amorphous basophilic deposits (H and E, x200). (b) Closer view of calcification at dermis and epidermis (H and E, x400).


Black calcium deposits with three forms of calcification.


Predominance of large amorphous calcium.


The predominance of minute fine granules (Von kossa stain, x400).


Sarcoidosis. Inflammation comprising noncaseating epithelioid granulomas (asterisk, inset) and lymphocytes expands the tubulointerstitial compartment of the kidney and spares the glomerulus (mid-lower).


TINU. Mature lymphocytes and few eosinophils are noted in the mildly edematous interstitium; glomeruli are normal.


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


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


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


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


(A) Left ventricular outflow tract view of the pre-operative CT angiogram showing the masses (Yellow arrows) and the thickening of the non-coronary cusp of the aortic valve (White arrow).


(B) An XX view of the aortic valve with indicating the mass on the left cusp of the aortic valve (Yellow arrow).


(A,B) 3D reconstructed and printed models of the mass.


OCT and infrared images show multiple serofibrinous retinal detachments in the right. Eye and a thickened choroid measured with EDI-OCT.


Left.


OCT and infrared images show multiple serofibrinous retinal detachments in the right.


Late-phase fluorescein angiography shows tiny leakage points with limited leakage in the subretinal space.


Late-phase fluorescein angiography shows tiny leakage points with limited leakage in the subretinal space. And discrete staining of the left optic disc.


Fundoscopic images three weeks after initial presentation show multiple yellow deposits scattered around the vascular arcades.


See arrows), with corresponding mild hyperautofluorescence.


Three months after initial presentation, there was total resolution of the exudative retinal detachments in the right.


Eye with normalization of choroidal thickness and an almost complete resorption of the vitelliform lesions.


Autofluorescence was normal (E, F).


Chest radiographs July 2006. The right costophrenic angle is blunted, but no other abnormalities were noted at this point.


Chest radiographs. Blunting of the right costophrenic angle has progressed, and a mass is observed in the thoracic wall.


Chest plain CT scans at the first examination by the previous hospital (July 2007). A small amount of pleural effusion is present on the right side. Pleural masses are noted in the right anterior mediastinum and anterior and lateral thoracic regions, and irregular pleural thickening extends from the right mediastinum to the anterior thoracic wall.


Computed tomography scan shows a large cystic-based tumor with a wall of uneven thickness. The tumor, with an unclear boundary between the stomach and spleen,. Compressed the stomach to the right upper quadrant, leading to gastric lumen narrowing.


Computed tomography scan shows a large cystic-based tumor with a wall of uneven thickness. Extended backward, and ,compressed the pancreas.


Computed tomography scan shows a large cystic-based tumor with a wall of uneven thickness. Almost occupied the entire abdominal cavity.


Endoscopy shows local eminence of the gastric mucous membrane and reveals superficial veins, indicated by the black arrow.


(A) Pathological analysis demonstrated a gastrointestinal stromal tumor with a mixture of polygonal and spindle cells (hematoxylin and eosin; magnification, x200).


(B) The cells appeared atypical (hematoxylin and eosin; magnification, x400).


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


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


Fusiform swelling of tubercular dactylitis: Note the healing sinus.


Axillary scrofuloderma with satellite lesion in anterior axillary fold.


Radiological features: Lytic destruction distal to proximal phalangeal physis.


Progressive radiological healing after 6 month of ATT.


Imaging and Histopatological features of MB2. MRI. Axial T2-weighted image.


Imaging and Histopatological features of MB2. Sagittal T1-weighted image. Show a nodular mass originating from the vermis and bulging into the fourth ventricle.


Imaging and Histopatological features of MB2. Apparent diffusion coefficient (ADC) map (c) shows lack of diffusion restriction.


Imaging and Histopatological features of MB2. Perfusion weighted imaging (d) reveals hyperperfusion within the lesion.


Imaging and Histopatological features of MB2. (e) Tumor is characterized by pleomorphic cells with large nuclei, prominent nucleoli and moderate eosinophilic cytoplasm.


Imaging and Histopatological features of MB2. (f) Large cells show immunoreactivity for synaptophysin.


Imaging and Histopatological features of MB2. (g) N-Myc oncogene amplification (green spots) detected in neoplastic nuclei (blue) and centromere 8 signals (red spots) using CEP8/BAC as FISH probes. Red arrow: N-Myc amplified cell. White arrow: N-Myc dyploid cell.


Molecular characterization of MB1 and MB2. Histograms showing mRNA levels of the indicated genes in MB1.


Molecular characterization of MB1 and MB2. MB2. Compared to normal cerebella (average of n = 7) as control (CTR). Genes are grouped and depicted in different colors, depending on the molecular subgroups, which they identify (SHH, WNT, GROUP 3, GROUP 4). The values of Relative Quantification are expressed in log10 scale.


Gene expression analysis of MB1 and MB2. Histograms show mRNA levels of the indicated genes in MB1 and MB2 compared to normal cerebella (average of n = 7) as control (CTR). In detail. GLI family members. The values of Relative Quantification are expressed in linear scale for panels.


Gene expression analysis of MB1 and MB2. Histograms show mRNA levels of the indicated genes in MB1 and MB2 compared to normal cerebella (average of n = 7) as control (CTR). Sonic Hedgehog pathway (Hh) molecules and direct targets. And log scale for panel.


Gene expression analysis of MB1 and MB2. Histograms show mRNA levels of the indicated genes in MB1 and MB2 compared to normal cerebella (average of n = 7) as control (CTR). (c) Cyclins.


Gene expression analysis of MB1 and MB2. Histograms show mRNA levels of the indicated genes in MB1 and MB2 compared to normal cerebella (average of n = 7) as control (CTR). Myc genes, and ,Stemness molecules.


Gene expression analysis of MB1 and MB2. Histograms show mRNA levels of the indicated genes in MB1 and MB2 compared to normal cerebella (average of n = 7) as control (CTR). Differentiation molecules.


Gene expression analysis of MB1 and MB2. Histograms show mRNA levels of the indicated genes in MB1 and MB2 compared to normal cerebella (average of n = 7) as control (CTR). Epigenetic modifiers.


Heatmap and results of an unsupervised hierarchical clustering derived from the -DCt values of the analyzed genes in MB1 and MB2 (Case FA) and in adult (n = 4, A1, A2, A3, A4), childhood (n = 4, Ch1, Ch2, Ch3, Ch4) and infant (n = 4, I1, I2, I3, I4) SHH-MBs. Nodal numbers indicate bootstrap values obtained by resampling the data.


Suprarenal mass with hypodense areas displacing the right kidney postero-inferiorly (CT Abdomen axial view).


CT Abdomen (coronal view).


Huge mass measuring 16 cm x 14 cm x 11 cm, weighing 1610.6 g, comparing to the normal right adrenal gland (4.0 cm x 3.5 cm x 1.3 cm).


Normal right adrenal measuring 4.0 cm x 3.5 cm x 1.3 cm.


(A) Dedifferentiated area composed of diffuse sheets of pleomorphic cells displaying large irregular nuclei with vesicular chromatin, inconspicuous nucleoli and moderate eosinophilic cytoplasm.


Numerous bizarre and multinucleated cells are seen (H&E, x40); (B) Fluorescence in situ hybridization (FISH) analysis for MDM2 gene using MDM2/CEP 12 probe (green signal) (VYSIS), shows many nuclei with amplified signals (red signal), ie, consistent with MDM2 gene amplification.


Fundus photographs. Right eye.


Left eye).


Goldmann visual field perimetry findings. Left eye.


Right eye) obtained before the first operation in 2010. Fundus examination showed predominant optic disc atrophy in the right eye. Goldmann perimetry findings showed bitemporal hemianopia, and in detail, complete temporal loss and inferonasal defect in the right eye and defects in the temporal half of the left eye.


MRI images of the patient's head obtained before the first operation in 2010 and before the second operation in 2017. Before the first operation in 2010, the MRI sagittal.


MRI images of the patient's head obtained before the first operation in 2010 and before the second operation in 2017. Coronal section. Showed a giant cystic mass approximately 4 cm in diameter extending from the intrasellar region to the sphenoid sinus and the suprasellar region.


MRI images of the patient's head obtained before the first operation in 2010 and before the second operation in 2017. Before the second operation in 2017, the MRI sagittal.


MRI images of the patient's head obtained before the first operation in 2010 and before the second operation in 2017. Coronal section. Showed a giant cystic mass larger than 8 cm in diameter in the suprasellar region (T1-weighted image).


Histopathological finding of the tumor tissue collected at the first operation. Hematoxylin, and ,eosin stain.


Immunostaining for ACTH). Immunostaining of the tumor tissue, which was collected intraoperatively, showed adrenocorticotropic hormone (ACTH)-positive cells.


Baseline laboratory evaluation for polycythemia.


Photograph showing sparse, thin, light, blond hair over the scalp, scanty eyebrows, and eyelashes.


Midline diastema between maxillary anterior teeth.


Orthopantomogram showing retained primary teeth and multiple missing teeth.


Well-defined brownish hyperkeratotic plaque with an erythematous rim located on the right lateral malleolus.


Histopathological findings revealed papillated psoriasiform epidermal hyperplasia, compact hyperkeratosis, and mounds of parakeratosis with neutrophils. There was absence of a granular layer, with pale and vacuolated keratinocytes in the superficial epidermal layer and scattered necrotic keratinocytes. Hematoxylin-eosin. Original magnification x100.


Clinical photograph showing crusted papules on the back.


Clinical photograph showing crusted papules around the elbows.


Clinical photograph showing ulcer on buttock and nodules with crusting.


Clinical course of a patient.


T1-weighted images showing hypo to isointense lesion from D11 to L2.


T2-weighted images with hyperintense lesion from D11 to D12.


Post contrast image showing patchy enhancement with few non enhancing areas likely hemorrhage or necrosis.


Brain MRI. A Post-contrast sagittal T1-weighted and b axial T1-weighted images showing homogenous enhancement of sellar lesion in favor of a pituitary macroadenoma. In the a image, a metallic artifact is visible. C; Isointense sellar lesion in T2-weighted acquisition.


Magnetic resonance imaging abdomen showing the testis.


Testis showing dermoid cyst.


Magnetic resonance imaging (MRI) scan of lumbosacral spine showing enhancing T1 intermediate three soft tissue nodulations along the cauda equina at L2, L4, and L5-S2 filling the thecal sac.


MRI scan of lumbosacral spine showing T2 hypointense three soft tissue nodulations along the cauda equina at L2, L4, and L5-S2 filling the thecal sac. At S2 level the soft tissue mass was scalloping the canalicular cortex.


Histopathological examination of the operative specimen shows large granuloma with multinucleate giant cells lining zones of necrosis (a).


Within the granuloma are numerous septate branching hyphae of Apsergillus spp highlighted by Gomori methenamine silver stains (b).


Magnetic resonance imaging. (A) Axial T2-weighted image showing T2 hyperintense lesion in the pancreatic tail (*) with proximal ductal dilatation (dotted red arrow).


Magnetic resonance imaging. (B) Reformatted T2-weighted image showing the communication between the lesion and the collection (solid red arrow).


Magnetic resonance imaging. (C) Reconstructed volume-rendered image showing the dilated and the relation of the collection.


Intraoperative image. (A) Collection bulging through the transverse colon.


Intraoperative image. (B) After complete mobilization of the pancreatic tail and the spleen.


Intraoperative image. (C) Opening of the fistula between the lesion and the pancreatic duct (solid black arrow).


Photomicrograph of H&E of resected specimen. (A) High-power field (40x) showing presence of ovarian stroma.


Photomicrograph of H&E of resected specimen. (B) High-power field (40x) showing the presence of adjacent pancreatic acinar tissue (black solid arrow) and dilated pancreatic duct with inspissated mucinous material (dotted black arrow).


Photomicrograph of H&E of resected specimen. (C) High-power field (100x) showing corpora albicans.


Photomicrograph of H&E of resected specimen. (D) High-power field (40x) showing dilated pancreatic duct.


Serial chest CT findings and pulmonary functions of the patient. (A) Initial CT at the time of diagnosis of ILD showed perilobular consolidations and fibrosis in posterior aspects of the lower lobes, and forced vital capacity (FVC) was 3.05 L.


Serial chest CT findings and pulmonary functions of the patient. (B) CT performed just before the rituximab injection showed the increased extent of fibrosis. However, the patient did not complain of respiratory symptoms including cough or dyspnea, and FVC was slightly improved by 4.6% compared to baseline.


Serial chest CT findings and pulmonary functions of the patient. (C) CT performed immediately after the second rituximab injection showed an increased extent of fibrosis and perilobular consolidations. The patient developed mild dyspnea, and FVC declined by 11% from the latest one.


Initial brain MRI showing a cystic mass in the left frontal region, presented on axial plain, T1-weighted image (a-c).


Control brain MRI, after initial biopsy and conformation on diagnosis; supratentorial recurrent tumor mass in the left frontal region with the cystic part in the superior frontal gyrus was revealed, presented on T2-weighted image on coronal.


Axial plain.


Control brain MRI, 6 months after initial diagnosis, after childbirth revealed a supratentorial recurrent tumor mass in the left frontal region with the cystic part in the superior frontal gyrus, presented on T1-weighted image with contrast enhancement on coronal.


Microphotography of a pathohistological section showing histological and immunohistochemical features of a tumorous tissue stained with. Hematoxylin, and ,eosin, original magnification of x100.


Synuclein, original magnification of x100.


Proliferation index Ki67, original magnification of x200. Tumor consisted out of atypical astroglial cells and high mitotic activity. Extensive microvascular proliferation of individual blood vessels was described, as well as focal points of tumor necrosis. Ki67 proliferation index higher was than 50%. According to the WHO classification, it corresponded glioblastoma multiforme, WHO Grade IV.


(a-f) Control MRI 2 years after initial diagnosis revealed expansive neoplastic masses in the right frontal region, left frontal region with rectal and orbital gyri and pericallosal area affected and in left temporal region, along with necrotic zones.


Ruptured vesicle in healing phase with scar formation in the neck.


Scaring of bulbar conjunctiva on the right eye.


Multiple intact bullae on hard palate with erythematous irregular ulcers.


(a) Generalized desquamative gingivitis involving maxilla.


(b) Generalized desquamative gingivitis involving mandible.


(a) Direct immunofluorescence showing linear deposition of immunoglobulin A (IgA) at the basement membrane (Direct immunofluorescence, x 100).


(b) Direct immunofluorescence showing linear deposition of immunoglobulin A (IgA) at the basement membrane (Direct immunofluorescence, x 100).


Healing of oral lesion after medication.


Intraoperative views (opening of the dura mater, left side), showing the shunt location and the single draining vein (white arrow).


Which is disconnected with bipolar coagulation (black arrow: disconnected vein).


The draining vein is degenerated with shunt disconnection (black dashed arrow) (d).


(a) Muscle biopsy showing small fibers in the perifascicular portion of the biopsy (right side) with normal sized fibers in the central portion of the fascicle (left side). Perifascicular atrophy is pathognomonic for dermatomyositis. There are also blue discolored degeneration/regeneration fibers scattered throughout the biopsy. Paraffin embedded section, H&E,x175.


(b) A distorted frozen section shows small round mononuclear inflammatory cells in the upper right quadrant of the picture. H&Ex175.


Schematic picture showing the time line of treatment procedure.


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


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


Photograph of completely healed wrist wound taken 2 months later.


Gross features of placenta show multiple well defined rubbery nodules located on the chorionic plate.


Microscopic examination of one nodule showing a well demarcated vascular lesion resembling capillary hemangioma (H&E x 10).


The lesion is covered by a trophoblastic layer (H&E x 40).


Numerous capillary sized vascular channels (H&E x 40).


(A) Slit-lamp examination photograph of the left eye of a 39-year-old female. A white milky mass is noted in the center of the cornea with mild ciliary injection. The patient had suffered from trichiasis for more than 30 years.


(B) Ultrahigh-resolution optical coherence tomography image of the left eye. The image shows homogeneous material above Bowman's layer. The material occupied the epithelial layer and caused thinning of the layer. In contrast, Bowman's layer was intact throughout the entire pathological region.


Immunohistochemistry of the corneal tissue excised from the left cornea. . Notes: Homogeneous material was positive with hematoxylin and eosin staining.


Immunohistochemistry of the corneal tissue excised from the left cornea. And Congo red.


Immunohistochemistry of the corneal tissue excised from the left cornea.was depicted as apple-green under polarized microscopy.


Immunohistochemistry of the corneal tissue excised from the left cornea. The mass region was also positively stained by the antilactoferrin antibody (D).


Immunohistochemistry of the corneal tissue excised from the left cornea. The control that lacked the first antibody was negative (E).


The first magnetic resonance imaging (MRI) of November 2018. T1 axial.


Sagittal scans) showed a homogeneous lesion (arrow) of 12 x 13 mm at the fibula's head level.


The second MRI in axial (c) scan, performed after oxygen-ozone therapy, documented a slight increase of the tumor size.


It is evident a change in tumor intensity, which had become inhomogeneous, and with a rim of contrast enhancement (d).


Histopathology section of duodenal mucosa demonstrating moderate degree of villous atrophy and chronic inflammatory infiltrate in the lamina propria (Hematoxilin & Eosin staining x 200 magnification)z.


Echocardiography showed characteristic kinetic disturbances in the apical heart region.


Levocardiography in the right anterior oblique position shows the picture of an octopus pot, which is characteristic for Takotsubo cardiomyopathy.


Photomicrograph showing poorly formed nests of epitheloid malignant melanocyctic cells with intracellular and extracellular melanin production at x 10.


Photomicrograph showing poorly formed nests of epitheloid malignant melanocyctic cells with intracellular and extracellular melanin production at x 40.


Photomicrograph showing malignant cells at the dermoepidermal junction and infiltrating into the deeper tissues.


Photomicrograph showing malignant cells invading around benign intestinal glands of the upper anal area at x 10.


Abdominal ultrasonography showed two tumors extending into the common bile duct. Doppler ultrasound showed a blood flow signal within the tumor.


Abdominal CT showed two enhanced tumors (diameter, 4 cm) in the inferior and middle bile duct. Yellow arrows indicate the tumor locations.


Magnetic resonance cholangiopancreatography demonstrated a cystic dilatation of the extrahepatic bile duct (Todani's CBD classification: type 4-A).


Endoscopic retrograde cholangiopancreatography showed two tumors, and biopsy of one of the tumors confirmed adenocarcinoma.


The resected specimen demonstrated tumors in the inferior and middle bile ducts. Arrow indicates the papilla of Vater.


CT scan chest showing mass lesion in the apical segment of right lower lobe (Case 2).


Immunohistochemical (ABC technique, x400) examination shows cytoplasmic positivity for desmin in the spindle cells.


Immunohistochemical (ABC technique, x100) examination shows positivity for MyoD 1 in the nuclei of spindle cells.


Admission chest radiograph, without any abnormality.


The epidermis with focal parakeratosis.


The epidermis with superficial and deeper extension full of inflammatory infiltrates, numerous lymphocytes and a few eosinophils.


Case 2. Noncontrast computed tomography showing a heterogeneously hyperdense lesion in the midline posterior fossa with small peripheral cysts (black arrow) (a). A mild extension to the left cerebellopontine angle can be noted.


Case 2. Axial T2-weighted magnetic resonance images showing the lesion to be heterogeneously hyperintense (b).


Case 2. Axial and sagittal postcontrast magnetic resonance images showing intense, homogeneous enhancement of the lesion (c and d).


Case 3. Axial plain magnetic resonance imaging showing a left sided extra-axial cerebellopontine angle lesion which appears isointense and heterogeneously hyperintense on T1 and T2 sequences, respectively, with compression and deformation of the brainstem (a and b).


Case 3. Axial postcontrast magnetic resonance images showing homogeneous enhancement of the lesion (c).


Ultrasonography of the right kidney. . Notes:. Giant complex cystic-solid mass (10.1x8.0 cm) with inhomogeneous liquid dark area, and ,high-echo stripes on the medial aspect of the right kidney.


Ultrasonography of the right kidney. Colored blood-flow signals displayed on the margins of the mass, which was located close to the right kidney.


Enhanced computed tomography (CT) scan showing a cross-sectional view of the urinary system. . Notes: (A) Fusion of both renal lower poles and hydronephrosis due to a large, well-circumscribed mass located medial to the right renal hilum.


Enhanced computed tomography (CT) scan showing a cross-sectional view of the urinary system. (B) Spherical cystic-solid mass (9.5x8.7 cm) of heterogeneous density with CT-attenuation values of 18-35 HU, likely arising from the anteromedial aspect of the right half of the horseshoe kidney.


Enhanced computed tomography (CT) scan showing a cross-sectional view of the urinary system. (C, D) Renal CT angiogram showing compression of the renal artery and narrow renal veins.


Magnetic resonance imaging of the abdomen, coronal view. . Notes: (A) Large unilocular hilar mass (8x7 cm) in the right kidney with high signal intensity on T2-weighted images.


Magnetic resonance imaging of the abdomen, coronal view. (B) The mass is isointense on T1-weighted images. The horseshoe-kidney anomaly can also be observed.


Histological examination of the tumor. . Notes: (A) Low-power view showing nests of tumor cells (H&E, 200x).


Histological examination of the tumor. (B) Pools of mucin lined by malignant glandular epithelium with complex architecture in high-power view (H&E, 400x).


Immunohistochemical analysis showing that the tumor cells were positive for CK20. . Notes:. 200x.


Immunohistochemical analysis showing that the tumor cells were positive for CK20. 400x.


Immunohistochemical analysis showing that the tumor cells were positive for CK20. CDX2, 200x.


Immunohistochemical analysis showing that the tumor cells were positive for CK20. CDX2, 400x.


Immunohistochemical analysis showing that the tumor cells were positive for CK20. Villin, 200x.


Immunohistochemical analysis showing that the tumor cells were positive for CK20. Villin, 400x.


Preoperative axial.


Sagittal.


Coronal. T1-weighted MRI with gadolinium enhancement showing a heterogeneous enhancing mass in the right frontal lobe.


Axial (D) T1-weighted MRI with gadolinium enhancement performed 2 years after the first surgery showing no residual or recurrent tumors.


Axial (E) T1-weighted MRI with gadolinium enhancement performed 6 years after the initial presentation showing the first recurrence.


Photomicrographs (magnification x200) of oligodendroglial cells in the brain tumor Hematoxylin-eosin staining showed proliferation of tumor cells with relatively round nuclei and a loose, myxoid-like background (A, D).


Photomicrographs (magnification x200) of oligodendroglial cells in the brain tumor Immunohistochemical staining showed positive results for CD56.


Photomicrographs (magnification x200) of oligodendroglial cells in the brain tumor. And Olig2 Scale bars: 100 mum.


The metastatic bone marrow tumor Hematoxylin-eosin staining showed proliferation of tumor cells with relatively round nuclei and a loose, myxoid-like background (A, D). Normal hematopoietic tissue replaced by a malignant tumor (D).


The metastatic bone marrow tumor Immunohistochemical staining showed positive results for CD56.


The metastatic bone marrow tumor. And Olig2 Scale bars: 100 mum.


CT scan of the pelvis (A) showing an osteoblastic lesion in the left sacral wing (arrowhead).


PET-CT scan . Proximal appendicular skeleton. White arrows.


Bone scintigraphy. Showed multiple high-uptake bony lesions throughout the axial, and . . Black arrows).


Occipitofrontal head circumference of the patient. The measurement of 43.5 cm at age 7 was in the 1.00 percentile and below -3 SD.


Reverse DNA sequence chromatography for the patient and her parents. (A) c.883-4_890del.


Reverse DNA sequence chromatography for the patient and her parents. (B) c.1684C>G.


A 30-year-old female with palpable subcutaneous nodular swelling in the areola from 2 months ago. Local examination shows a nodular swelling (line arrow) with adjacent cord like swelling (solid arrow) in the areolar region of the left breast.


Sonography of the left breast shows two cystic lesions, one in the subcutaneous plane (solid arrow).


The other in the fatty breast parenchyma (line arrow) , both showing multiple curvilinear echoes with a dilated interconnecting tubular channel.


A, Follow-up ultrasound showed prominence of lymphatic channels with linear echoes (arrow), and loss of twirling movement (dead worms).


B, the color motion artifact was not seen.


Scheimpflug imaging (Pentacam, Oculus) of the corneal front surface in patient 1.


Scheimpflug imaging (Pentacam, Oculus) of the corneal front surface in patient 2.


Scheimpflug imaging (Pentacam, Oculus) of the corneal front surface in patient 3.


Scheimpflug imaging (Pentacam, Oculus) of the corneal front surface in patient 4.


A well-circumscribed patch of tightly coiled woolly hair.


HPE of scalp showing normal hair follicle and appendages.


Day 3 of hospital admission, before initiation of systemic steroid therapy. Numerous small studded pustules on an erythematous background with numerous erythematous macules and papules coalescing into plaques are noted in various body parts.


Histopathology of skin biopsy revealing spongiotic epidermis with focal parakeratosis, exocytosis, and spongiotic vesicles, along with papillary dermal edema, superficial dermal perivascular inflammatory infiltrate, and mixed dermal interstitial inflammation with eosinophils (H&E, x10). The arrow points to the "papillary dermal edema and superficial dermal perivascular inflammatory infiltrate".


Day 4 of hospital admission, after initiation of systemic steroid therapy. Significant regression of skin eruptions noted.


Right thigh pre-sirolimus initiation.


Right thigh 10 weeks post sirolimus initiation.


The axial brain fluid-attenuation inversion recovery (FLAIR) images.


Sagittal T2-weighted images , demonstrating a "heart-shaped" appearance area of hyperintensity located in the tegmentum of the caudal midbrain.


(A) The brain diffusion-weighted image (DWI) of the patient is shown. Note the "heart or V"-shaped lesion showing increased intensity in the tegmentum of the caudal midbrain.


(B) The brain apparent diffusion coefficient map MRI (ADC) of the patient is shown. The "heart or V"-shaped lesion shows low intensity on ADC, consistent with acute infarction.


1.5T Brain MRI, axial T2-weighted images.


Coronal T2-weighted images. Shows the symmetric enlargement and increased signal intensity of both inferior olives (arrow).


Seborrheic keratosis over penis, scrotum and right upper thigh.


Histopathology (low power view).


Histopathology (high power view).


Histopathology (high power)-horn cyst.


Angioedema of lips noted on admission in ED. . Photograph was printed with patient's permission.


Chest X-ray showing bilateral reticulo-nodular infiltrates involving the middle and lower zones and some parts of the upper zones.


High-resolution computed tomography (HRCT) chest showing diffuse ground glass changes with interlobular septal thickening with mosaic attenuation and multiple enlarged calcified mediastinal and hilar lymph nodes.


Lung biopsy showing large non- caseating granulomas with tightly packed central area composed of epithelioid cells, multinucleated giant cells and T- lymphocytes.


Further magnification of the granuloma revealing the characteristic 'asteroid bodies'.


Computed tomography (CT) aortogram showing stenosis of left subclavian artery with almost complete block at distal part and proximal left axillary artery.


Computed tomography of the abdomen showing gastric and duodenal distention (red arrows) suggestive of small bowel obstruction and narrowing of the angle between the superior mesenteric artery and the abdominal aorta.


Computed tomography of the abdomen showing gastric and duodenal distention (red arrow) indicating obstruction at the level of the superior mesenteric artery.


Upper gastrointestinal series. Impression of the third part of the duodenum suggestive of superior mesenteric artery syndrome (red arrow).


Sagittal T1 fat suppressed post contrast sequence shows the pelviabdominal mass demonstrating heterogeneous enhancement and the characteristic swirled appearance.


Frontal chest radiograph (CXR):. Initial CXR on presentation demonstrates complete opacification of the left hemithorax with resultant mediastinal shift to the right, and ,cut-off of the left main bronchus (black arrow).


CXR post left chest wall/pleural biopsy. Left pneumothorax (white arrow) with the left intercostal drain in-situ (black arrow). Associated surgical emphysema of the left chest wall (white stars).


(a-c) Axial, sagittal and coronal contrast-enhanced computed tomography images demonstrate left pleural-based masses which enhance heterogeneously (solid black arrows) with patchy hypodense regions suggestive of necrosis. There is an associated large complex left pleural effusion (white star), atelectasis of the left lung and mediastinal shift to the right. There were no associated intra-tumoural calcifications. Figure 2A - Note the extra-thoracic extension of the mass anteriorly via the intercostal spaces (white arrow) and another pleural-based mass that is inseparable from the pleural pericardial reflection (broken black arrow).


Axial computed tomography image of the chest on bone window demonstrates the absence of associated bony erosions (white arrow).


Slit-lamp images of the 31-year-old proband's cornea, showing intraepithelial cysts in the periphery of the cornea sparing the central corneal epithelium, seen with both direct.


Indirect. Illumination.


The proband's 56-year-old mother.


35-year-old brother. Demonstrated diffuse intraepithelial corneal microcysts on retro-illumination.


(a) Localized xanthoma on the right arm and right trunk limited by transverse and vertical watershed with minimal spillover and lymphedema of the right upper limb.


(b) Localized xanthoma of the right upper back limited by vertical and horizontal watershed with some spilling over.


Chest X-ray. Chest X-ray shows bilateral scattered infiltrates, denser with partial consolidation in the right upper lobe bordering the minor fissure.


Computed Tomography Chest. CT Chest shows multiple patchy consolidations throughout both lungs, some of which are cavitating and are located primarily at the periphery.


Petechial skin changes on lower extremities. Scattered, non-blanching, hemorrhagic macules on the bilateral lower extremities.


Petechial skin changes on upper extremities. Scattered, non-blanching, hemorrhagic macules on the hands.


Purpuric skin manifestations. Diffuse, non-blanching, palpable, hemorrhagic papules on the bilateral lower extremities.


PET-CT scan of the whole body demonstrated the fluorodeoxyglucose (FDG)-avid mass (maximum standard uptake volume (SUVmax 2.6).


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


Multilocular radiolucency with many radiopaque spots of driven snow appearance.


Computed tomography reconstructed image of the lesion.


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


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


MRI of sacrococcygeal mass prior to initial resection. Axial view of fat-saturated T2-weighted.


MRI of sacrococcygeal mass prior to initial resection. Contrast-enhanced T1-weighted sequences demonstrate a lobulated expansile mass confined to the soft tissues affixed between the gluteal muscles.


MRI of sacrococcygeal mass prior to initial resection. The mass on sagittal view is. T2 hyperintense well-encapsulated within the post-sacral soft tissues without invasion into the sacrococcygeal space.


MRI of sacrococcygeal mass prior to initial resection. Heterogeneously enhancing with central necrosis.


Restaging of recurrent soft tissue mass prior to and following resection. (A) Pre-resection sagittal view with contrast-enhanced T1-weighted image showing a multilobulated mass extending from the first through fourth coccygeal segments bordered by a thin plane of fat interposed between the tumor and coccyx without evidence of coccygeal invasion (black arrow).


Restaging of recurrent soft tissue mass prior to and following resection. (B) Status post-coccygectomy and resection cavity (black arrow) of the previously described associated lobulated mass.


Clinical findings. A, b Patient 1. Diffuse hair loss started covering her whole scalp 6 months after starting secukinumab for the treatment of moderate type psoriasis vulgaris (a).


Clinical findings. Hair loss was stopped and the patient recovered from alopecia by the supplementation of 10 mg oral prednisolone (b).


Clinical findings. C, d Patient 2. Alopecia diffusa started after 2 months of brodalumab treatment for moderate type psoriasis vulgaris (c).


Clinical findings. The patient's medication was changed to ustekinumab, and her hair recovered without the administration of oral immune suppressants (d).


Coronal fluid-attenuated inversion recovery with gadolinium contrast recorded by a 3T MRI scanner during.


6 months after. Full recovery from metronidazole-induced encephalopathy. The white arrows mark the hyperintense signal changes in the bilateral dentate nuclei.


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


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


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


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


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


T1-weighted image (sagittal section) with the dermal sinus tract (pointed by the blue arrow).


This sequence (axial section) shows the spinal cord as seen at T6, T11, and T12, respectively.


T2-weighted image (sagittal section) showed the presence of abscesses.


The dermal sinus tracts as seen intraoperatively (labeled by the blue arrow) leading to thecal sac and epidural abscess.


Staging CT scan. . Coronal CT scan showing multiple abdominal agglomerated masses with cystic components revealing evidence of peritoneal carcinomatosis.


Total dose distribution. . Left: Color wash coverage to the peritoneal cavity with homogeneous distribution on a dose of 24 Gy (light green) and a boost of 36.3 Gy delivered to the residual lesions (red). Right: acceptable dose distribution in both kidneys.


Histopathology findings.


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


Clinical.


Radiologic. Evidence of bilateral genu valgum.


MR images showing solitary intrinsic lesion centred around the pre-central gyrus, confirmed to be metastatic deposit of MPM on histological assessment.


MR images showing solitary intrinsic lesion centred around the pre-central gyrus, confirmed to be metastatic deposit of MPM on histological assessment. /. Post-gadolinium T1-weighted images.


MR images showing solitary intrinsic lesion centred around the pre-central gyrus, confirmed to be metastatic deposit of MPM on histological assessment. . T2-weighted image.


Postoperative MR images confirming gross total resection.


Postoperative MR images confirming gross total resection. /. Post-gadolinium T1-weighted images showing some hyperintense material in the cavity that does not enhance compared to pre-contrast sequence.


Postoperative MR images confirming gross total resection. . T2-weighted image.


HES 200x.


Anti-CD31 100x.


HES 40x.


CD31 40x.


Intraoperative photographic documentation: The whole greater omentum covered with calcifications and the necrotic areas.


Nasal hypoplasia with very small nostrils.


Trans-nasal dilation catheters couldn't pass through the nostrils.


CT- Scan of bilateral choanal atresia.


Sublabial approach for choanal atresia.


Postoperative photo with endotracheal tubes fixed sublabially.


Changes of the pre- and post-operative meningioma. Before.


Changes of the pre- and post-operative meningioma. After. The first surgery, 2008-06.


Changes of the pre- and post-operative meningioma. After. The second surgery, 2009-01.


Changes of the pre- and post-operative meningioma. After. The third surgery, 2016-05.


Changes of the pre- and post-operative meningioma. After. The fourth surgery, 2019-09. The red arrow points to the tumor.


Changes of meningioma at different shooting angles of MRI. Meningioma recurred on 2020-07-23.


Changes of meningioma at different shooting angles of MRI. The lesions in the left cerebellopontine angle area enlarged on 2020-10-28.


Changes of meningioma at different shooting angles of MRI. The residual lesions lessened on 2020-12-24.


Changes of meningioma at different shooting angles of MRI. The residual lesions continuously reduced on 2021-06-09. The red arrow points to the tumor.


The treatment timeline of the patient with multiple recurrent meningiomas.


(a-c) Initial clinical views of Actinomyces-associated lesions from buccal and palatal aspects. The erythematous and desquamative appearances of gingival tissue are seen.


(d) The panoramic image of the patient shows slight alveolar bone resorption.


(a-c) The appearance of gingival tissues after the treatment of Actinomyces-associated lesions.


Clinical presentation before cetuximab.


After six.


12 weeks of therapy.


CT scan performed at baseline.


12 weeks of therapy , highlighting the anterior-posterior diameter of the tumor.


Biopsy of the patient's skin lesions. Haematoxylin and eosin stain reveals subepidermal bulla as well as fibrin net, numerous eosinophils, perivascular mixed infiltrate, and well-preserved dermal papillae within the bulla cavity.


Cutaneous melanoma lesion with surrounding vitiligo.


Clinical picture of ruptured bullae, erosions, and crusts of mild bullous pemphigoid exacerbation on low-dose corticosteroid treatment.


Axial MRI without contrast along the maxillary sinus showing bilateral sinusitis yet more on the left side with hypo intense margins that goes radiologically with fungal infection with heavy metals deposition and hyper intense center that represents bacterial nature.


Blue arrow along non contrast MRI T2 WIs highlighting mild form of left optic neuritis.


Chemosis of conjunctiva and total ophthalmoplegia with ptosis elevated by the examiner's finger.


Vulva showed a huge polypoidal mass measuring 20x10cm in the left vulva and 8x3cm in the right vulva.


Postoperative picture showing primary closure of wound.


Extensive erosions over the back of patient 1.


Hemorrhagic cheilitis and mucositis seen in patient 1.


Extensive denuded areas over buttocks of patient 3.


endoscopic ultrasound demonstrates a 3.3 x 1.6 cm relatively echogenic mass seeming to arise from the gastric submucosa in the area of the gastric lesion most consistent with benign lipoma.


coronal post-contrast CT images show a well-circumscribed, smoothly marginated, ovoid intramural (submucosal) mass of uniform fat attenuation, arising from the lesser curvature of the body of the stomach with endoluminal extension. The mass measures 1.5 x 1.5 x 3.0.


Papulonodular lesions over the face with crusting.


Conjunctival nodule with congestion in the right eye.


Bone marrow aspirate smears showing a reactive marrow with few extracellular and intracellular histoplasma within macrophages (Leishman stain, x100).


Histopathological section of the conjunctival specimen showing numerous macrophage aggregates with Period Acid Schiff (PAS)-positive histoplasma (PAS stain, x100).


HS of the posterior thigh.


Psoriasiform rash that developed on her back.


Preoperative magnetic resonance imaging showing a 35-mm sized mass in the left cerebellum that showed low intensity on T1-weighted image.


High intensity with perifocal oedema on T2-weighted image.


Heterogeneous enhancement on T1-weighted image with gadolinium administration.


Tumour containing proliferating signet ring cells floating in abundant mucin.


Emergency 3D-CT scan showing occipital fistula (blue arrow).


Preoperative evidence of non-purulent subcutaneous nodule with skin fistula.


Excision of the entire abscess capsule.


Evidence of cystic adhesion to dura and confluence of sinuses.


Histological examination confirmed the diagnosis of dermoid tumor.


Pre-operative MR images shows a mass hypo- or isointense relative to the brain on T1-weighted and heterogeneously hyperintense on T2-weighted images with enhanced after administration of gadolinium developing from the facial hiatus to the foramen lacerum of 3.8 x 3.3 x 2.8 cm.


Intraoperative image showing the lesion arising from the greater petrosal nerve. GPN: greater petrosal nerve; Pet. B. : petrous bone; Tu: tumor.


Microscopic and immunohistochemical examination showing nuclear hyperchromasia and pleomorphism of the schwannoma (a).


Vimentin, is biphasic containing both Antoni A (black arrow) and Antoni B (white arrow) tissue.


The cellularity of the tumor, positive for S-100.


Computed tomography (CT) of the paranasal sinuses. . Notes: Axial.


Computed tomography (CT) of the paranasal sinuses. Coronal. CT scans show an isodense mass (red triangle) originating from the left ethmoid and sphenoid sinuses. Bony destruction (red arrow) is well demonstrated.


Magnetic resonance images of the cavernous sinus. . Notes: Axial T1 weighted images (WI).


Magnetic resonance images of the cavernous sinus. T2WI. Show the mass (red triangle) with homogeneous isointensity originating from the left ethmoid sphenoid sinuses and extending to the cavernous sinus and orbital apex.


Magnetic resonance images of the cavernous sinus. Axial.


Magnetic resonance images of the cavernous sinus. Coronal. Contrast enhanced + fat suppressed T1WI show enhancement of the mass with significantly high signal intensity of marginal inflammatory secretion (red arrow).


Photomicrographs of the surgical specimens from the left ethmoid and sphenoid sinuses. . Notes: (A) Low magnification reveals diffuse small round cells (hematoxylin and eosin, original magnification x20).


Photomicrographs of the surgical specimens from the left ethmoid and sphenoid sinuses. Immunohistochemistry staining was. Diffusely cytomembrane-, and ,cytoplasmic-positive for vimentin (original magnification x20).


Photomicrographs of the surgical specimens from the left ethmoid and sphenoid sinuses. Diffusely cytoplasmic-positive for desmin (original magnification x20).


Photomicrographs of the surgical specimens from the left ethmoid and sphenoid sinuses. Diffusely nuclear-positive for myogenin (original magnification x40).


Positioning.


Skin markings for ultrasound image acquisition of vastus lateralis cross-sectional area.


Muscle thickness (with ultrasound probe oriented longitudinally to the muscular belly).


Timed Up and Go Test. Instructions.


Execution.