Diffusion-weighted. Magnetic resonance imaging (MRI) of the brain.


Pathological specimens. . Notes: (A) Skin biopsy specimen taken from the lower abdomen reveals proliferation of large lymphoma cells filling the vessels of hypodermic adipose tissue. Hematoxylin and eosin staining; magnification.


Pathological specimens. (B) Numerous lymphoma cells with irregular nuclear contours and large nucleoli clustered are seen in small vessel lumens. X40. X100.


Magnetic resonance imaging (MRI) of the brain after receiving chemotherapy. . Notes: Pontine lesion on T2-weighted.


Magnetic resonance imaging (MRI) of the brain after receiving chemotherapy. Diffusion-weighted. MRI of the brain completely resolved after eight cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone therapy.


Computed Tomography of chest, abdomen, and pelvis of patients 1, 2, and 4. (A) Patient 1: splenic nodule indicated by arrow.


Computed Tomography of chest, abdomen, and pelvis of patients 1, 2, and 4. (B) Patient 1: right sided pulmonary lesion indicated by arrow.


Computed Tomography of chest, abdomen, and pelvis of patients 1, 2, and 4. (C) Patient 2: hepatosplenomegaly.


Computed Tomography of chest, abdomen, and pelvis of patients 1, 2, and 4. (D) Patient 4: right upper lobe pulmonary lesion.


Clinical features of the patients with PIK3CD mutations. Patient 1 : CT scan reveals pulmonary nodules with cavity formation, and patchy infiltration.


Clinical features of the patients with PIK3CD mutations. Patient 1. Right lung), and maxillary sinusitis.


Clinical features of the patients with PIK3CD mutations. Patient 1 ; Hematoxylin and eosin (HE) staining of renal biopsy showed no proliferation of capillary endothelial cells and mesangial cells in the glomeruli, no thickening of the basement membrane, and no glomerular sclerosis and interstitial fibrosis.


Clinical features of the patients with PIK3CD mutations. Patient 2 : CT scan reveals pulmonary nodules with cavity formation, and patchy infiltration.


Clinical features of the patients with PIK3CD mutations. Patient 2 maxillary sinusitis.


Clinical features of the patients with PIK3CD mutations. Patient 2 ; HE stains for renal biopsy showed minimal change, mild mesangial cell hyperplasia in glomerulus.


Clinical features of the patients with PIK3CD mutations. Patient 2 , similar to patient 1; Bronchoscopy shows mucosal nodule lymphoid hyperplasia from pharynx to the entire airway.


Immunohistochemical analyses for p110delta, CD3, and CD20. Compared with control , expression of p110delta (brown signal) in lung tissue.


Immunohistochemical analyses for p110delta, CD3, and CD20. Lymph node sections from patient 1.


Immunohistochemical analyses for p110delta, CD3, and CD20. 2. Significantly increased.


Immunohistochemical analyses for p110delta, CD3, and CD20. Relative to control.


Immunohistochemical analyses for p110delta, CD3, and CD20. Many inflammatory cells infiltrated around the airway and in the lung parenchyma (H, I, K, L). CD3+ T cells. Brown signal).


Immunohistochemical analyses for p110delta, CD3, and CD20. Many inflammatory cells infiltrated around the airway and in the lung parenchyma (H, I, K, L). CD20+ B cells. Brown signal) significantly increased, especially CD3+ T cells. The control lung sample was from a child's lung tumor resection, and lymph node sample was from a child with reactive lymph node hyperplasia.


The room where simple and gastrointestinal series radiography was performed.


The room where mammography and bone marrow density tests were performed.


Chest computed tomography (CT) showed patchy peripheral bibasilar ground glass opacities in both lungs.


Chest X-ray revealed widespread bilateral alveolo-interstitial infiltrates.


At presentation.


Color fundus photograph of the right eye showed chorioretinal scar along the superotemporal arcade, deep creamy lesion inferior to the scar with bleb like subretinal fluid with macular involvement as demonstrated in the optical coherence tomography.


Medical image.


Two areas of early hypofluorescence at the choroidal level which persist in the end phase with surrounding hyperfluorescence on fundus fluorescein angiography more intense inferior to the superotemporal arcade which represent the choroidal ischemia, late indocyanine green angiography showed defined areas of hypofluorescence corresponding to a scar and recent choroidal ischemia.


Lax nasolabial folds.


Increased cutaneous folds over the neck, chest, and axillary region.


Increased cutaneous folds over the back.


Marked reduction in elastic fibers in the superficial and deep reticular dermis with mild reduction of elastic fibers in the papillary dermis. Orcein stain, x10.


Extraoral photograph of patient.


Intraoral photograph of patient.


Histopathological picture.


Orthopantogram of patient.


CT scan-coronal view.


CT scan-axial view.


Intraoperative photograph of patient.


Postoperative orthopantogram of patient.


Postoperative photograph of patient.


Facials features of the patient. Our patient expressed the typical facial phenotype comprising epicanthus, midface hypoplasia, flat nasal bridge, small triangular nose with anteverted nostrils, carp-shaped mouth with full lips, and dental diastema at age 6 months.


Facials features of the patient. And 3 yr.


Photomicrograph of the peripheral blood of our case with ATR-X syndrome. It shows cells containing HbH inclusions in our patient.


Photomicrograph of the peripheral blood of our case with ATR-X syndrome.also his mother.


Photomicrograph of the peripheral blood of our case with ATR-X syndrome. And eldest sister.


Ground-glass view in lung computed tomography showing positive for COVID-19.


Peripheral blood showing schistocytes, characteristic of microangiopathic hemolytic anemia.


Patch test results (after 48 h):. Positive reaction to para-aminosalicylic acid.


Positive reaction to prothionamide.


CT scan image.


Image of the resected colon.


Image of the pathological anatomy.


Lymphangiomatosis in 38-year-old woman. . A. Coronal T2-weighted image shows large lobulated cystic mass with many septations in pelvic cavity. Preserved uterus (U) without tumor involvement is seen.


Lymphangiomatosis in 38-year-old woman. . B. Perfusion lung scan with Tc-99m macroaggregated albumin shows perfusion defect in entire right lung, which was suspected to indicate complete occlusion of right pulmonary artery.


Lymphangiomatosis in 38-year-old woman. . C, D. Transthoracic echocardiographs show heterogeneous echogenic mass with cystic component and incomplete coaptation of tricuspid valve, which resulted in tricuspid regurgitation (arrows in C). Mass extended to inferior vena cava (IVC) (arrows in D) (RA = right atrium, RV = right ventricle).


Lymphangiomatosis in 38-year-old woman. . E, F. CT coronal.


Lymphangiomatosis in 38-year-old woman. . E, F. Axial. Scans show non-enhanced mass with inferior vena cava and right atrial involvement, and hypoattenuating nodular lesion in right distal pulmonary artery (arrow in E).


Lymphangiomatosis in 38-year-old woman. . G. Gross specimen excised from inferior vena cava, right heart and right pulmonary artery was seen as an elongated, reddish, 29 cm long mass with web-like tumor extension in right pulmonary artery (asterisk).


Lymphangiomatosis in 38-year-old woman. . H. Hematoxylin & Eosin stained section of lesion shows dilated lymphatic channels with variable wall thicknesses. Based on immunohistochemical staining, tumor cells were positive for lymphatic vessel marker D2-40 (x40, insert).


Small bowel videocapsule endoscopy (PillCam SB 2, Given Imaging, Israel, magnification x8) showing linear whitish lesions surrounded by reddish mucosa.


Ascitic fluid protein electrophoresis showing M spike in the beta-globulin region.


Testicular ultrasound: The testis is large in size with heterogeneous echogenicity and poorly visualized outline.


Frozen sections: (a: left) The lesion was composed of sheets and nests separated by dense fibrous tissue. X200), (b: right) The individual cells were large round, and ,polygonal cells with defined cell borders, abundant eosinophilic cytoplasm, and . Round central nuclei. X400).


Gross evaluation of orchiectomy specimen. Cut surface revealing a well-circumscribed, non-capsulated, solid, and lobulated brown lesion.


Photos of the patient before and after 6 cycles of neoadjuvant chemotherapy. (A) Before neoadjuvant chemotherapy, the skin of the left breast was mildly inflamed; the left nipple was inverted; and a hard, palpable mass was present in the left central breast.


Photos of the patient before and after 6 cycles of neoadjuvant chemotherapy. (B) After 6 cycles of chemotherapy, the size of the mass in the left breast was significantly reduced. Drawings show the lesion of interest.


Ultrasound (US) imaging of the left breast and left axilla. (A) Before neoadjuvant chemotherapy, US examination of the left breast mass showed a hypoechoic lesion with inhomogeneous internal echoes.


Ultrasound (US) imaging of the left breast and left axilla. (B) US of left axillary lymph nodes before neoadjuvant chemotherapy showed enlargement and cortical thickening.


Ultrasound (US) imaging of the left breast and left axilla. (C) After 6 cycles of chemotherapy, the size of the mass was significantly reduced.


Ultrasound (US) imaging of the left breast and left axilla. (D) Lymph node size was reduced and the shape nearly returned to normal after chemotherapy.


Magnetic resonance imaging (MRI) before and after chemotherapy. (A) Diffusion-weighted imaging (DWI) before chemotherapy. The signal in the left breast and inner side of the right breast showed heterogeneous enhancement.


Magnetic resonance imaging (MRI) before and after chemotherapy. (B) Arterial phase of enhanced MRI before chemotherapy. Both breasts were composed of asymmetrically distributed dense glands. The whole left breast was markedly enhanced.


Magnetic resonance imaging (MRI) before and after chemotherapy. (C) Time-intensity curve of dynamic contrast enhancement of left breast mass before chemotherapy (outflow type).


Magnetic resonance imaging (MRI) before and after chemotherapy. (D) DWI after chemotherapy. The signal in the left breast and inner side of the right breast showed heterogeneous enhancement that was weaker than before chemotherapy.


Magnetic resonance imaging (MRI) before and after chemotherapy. (E) Arterial phase of enhanced MRI after chemotherapy. Compared to before chemotherapy, the size of lesions in the left breast and upper quadrant of the right breast were significantly reduced.


Magnetic resonance imaging (MRI) before and after chemotherapy. (F) Time-intensity curve of dynamic contrast enhancement in the left breast mass after chemotherapy (plateau type).


Images of core needle biopsy and histologic analysis by hematoxylin and eosin staining (100x magnification). (A) Left breast biopsy.


Images of core needle biopsy and histologic analysis by hematoxylin and eosin staining (100x magnification). (B) Right breast biopsy.


Images of core needle biopsy and histologic analysis by hematoxylin and eosin staining (100x magnification). (C) Epithelial membrane antigen (EMA) in left lymph node biopsy.


Images of core needle biopsy and histologic analysis by hematoxylin and eosin staining (100x magnification). After chemotherapy,. There were fewer cancer cells in the left breast , while interstitial fibrosis, nuclear enlargement, vacuolation, and number of cells with eosinophilic cytoplasm were increased.


Images of core needle biopsy and histologic analysis by hematoxylin and eosin staining (100x magnification). After chemotherapy.


Images of core needle biopsy and histologic analysis by hematoxylin and eosin staining (100x magnification). (F) Inflammatory cell infiltration after chemotherapy.


Human epidermal growth factor receptor 2 (HER2) expression detected by immunohistochemistry (IHC) (100x magnification) and fluorescence in situ hybridization (FISH) (400x magnification). HER2 positivity of left.


Human epidermal growth factor receptor 2 (HER2) expression detected by immunohistochemistry (IHC) (100x magnification) and fluorescence in situ hybridization (FISH) (400x magnification). Right. Breast cancers as detected by IHC.


Human epidermal growth factor receptor 2 (HER2) expression detected by immunohistochemistry (IHC) (100x magnification) and fluorescence in situ hybridization (FISH) (400x magnification). Monosomy of chromosome 17 of left.


Human epidermal growth factor receptor 2 (HER2) expression detected by immunohistochemistry (IHC) (100x magnification) and fluorescence in situ hybridization (FISH) (400x magnification). Right. Breast cancers detected by FISH.


Pretreatment extraoral photograph revealing ulceration, crusting, and bleeding from lower lip and granulomatous lesion on gingiva.


Intraoral pretreatment photograph showing ulceration on floor of mouth and gingival inflammation.


Photomicrograph revealing chronic granulomatous lesion.


Ziehl-Neelsen stain section revealing acid-fast bacilli as red stained rod like structures.


Two months post-treatment photograph showing healed lesions.


Bone Marrow aspirate smears, Wright-Giemsa Stain 1000X.


FISH characterization of double heterologous Robertsonian translocations. Bone marrow metaphase hybridized with fluorescent DNA probes for 15q22 (PML green), 15q11.2 (SNRPN orange), Cen15 (alpha satellite aqua), chromosome 14q32 (5'IGH green, 3'IGH orange) and chromosome 13q14(RB-1 green). Note the absence of a normal chromosome 14.


Images of a dog with CRGV (Case 1) illustrating how a dark-red necrotic, cutaneous lesion in the umbilical region expanded in size over the course of approximately 48 h (a-c). Credit: Gregory Cameron MVB, AllPets Drogheda.


Images of a dog with CRGV (Case 2) illustrating an extensive, erythematous necrotic lesion involving the skin of the caudoventral abdomen and medial aspect of left hindlimb.


(B) Interphase FISH analysis of case 2 using the dual-color BCL3 probe. FISH results demonstrated two intact red/green fusion signals, and 2 red and 2 green split signals, which indicated BCL3 gene break-apart. (Yellow arrows pointed to split signals of the rearranged gene).


H&E stain of the biopsy sample. . Notes: There were medium-sized to large cells with finely dispersed chromatin, prominent nucleoli, and abundant eosinophilic cytoplasm (x400). . Abbreviation: H&E, hematoxylin and eosin.


Kidney biopsy showing a glomerulus with cellular crescent formation (H & E stain; 400x).


Kidney biopsy showing interstitial infiltrate of atypical lymphocytes (H & E stain; 100x).


Time course of hemoglobin and lactic acid dehydrogenase (LDH) values.


Clinical preoperative picture showing vestibular obliteration in the left maxillary anterior region.


Panoramic radiograph with well-defined radiolucency extending from 21, 22, and 23.


Multiplanar view illustration in sagittal, coronal, and axial sections from cone-beam computed tomography.


(a) 10x magnification reveal chronic granulomatous inflammation with central neutrophillic debri and multinucleated giant cells.


(b) Special periodic acid Schiff staining reveal septate fungal hyphae; 40x magnification.


Maximum intensity projection of 18-fluorodeoxyglucose positron emission tomography/computed tomography scan showing abnormal increased tracer uptake in the sinuses, breasts, retrosternal, and sacral region.


Preoperative profile photograph.


Preoperative orthopantomogram.


Curetted lesion.


Orthopantomogram taken on first postoperative day showing extent of surgical exploration.


Postoperative orthopantomogram taken at 3 months.


Postoperative orthopantomogram taken at 6 months.


Postoperative orthopantomogram taken at 1 year.


Clinical appearance and histological findings. A; Solitary, red-brown, well-demarcated plaque on the abdomen.


Clinical appearance and histological findings. C Nodular infiltration of large cells with eosinophilic ground-glass cytoplasm accompanied by scattered lymphocytes in the superficial and middle dermis. Lower magnification.


Clinical appearance and histological findings. Higher magnification).


Clinical appearance and histological findings. D; The large epithelioid histiocytes in the dermis were positive for CD68.


Large radiolucent area extending until the lower margin of the mandible on the right (white arrows). Vertical bone resorption toward the proximal root of 46 (black arrow).


Area of a great accumulation of foamy histiocytes.


Spindle cells and many foamy histiocytes.


Spindle cells surrounding fragments of bone trabeculae.


Orthopantomography 6 months postoperatively. The defect at the area of the surgical site as well as the post-extraction socket of 46 are distinguished. Nothing remarkable concerning the bone healing process is observed.


Duodenal biopsies. (A) Hematoxylin and eosin staining shows normal duodenal mucosa without villous atrophy.


Duodenal biopsies. (B) CgA immunostaining of the duodenal biopsy shows complete loss of EE cells.


Duodenal biopsies. (C) Normal control duodenal mucosa immunostained with CgA, showing EE cell distribution in the crypt epithelium.


Duodenal biopsies. (D) Repeated biopsy shows normal immunostained CgA duodenal mucosa.


Contrasted brain MRI revealed enhanced masses in the occipital and parietal lobes (arrow).


Pre-operative X-rays. (a): Left hip AP. Note that left hip shows osteoporotic changes.


Pre-operative X-rays. (b): Left hip lateral X-ray.


(a-c)Pre-operative left hip non-contrast magnetic resonance imaging shows the high intensity of the femoral head in the T2-weighted image.


(a and b)Intraoperative core decompression procedure under fluoroscopy.


Hemorrhagic necrosis between bone trabeculae.


Post-operative hip X-ray at postoperative 2 years.


Arrows point to symblepharon formation seen inferiorly in the right.


Left. Eyes.


Limbal stem cell deficiency in the right.


Left. Eye. Arrows point to neovascularization and conjunctivalization of the cornea. Whorled keratopathy, obscured limbal architecture, subepithelial haze, and conjunctival hyperemia are also present bilaterally.


Mutation analysis and identification of the c.1858+1G>T mutation of the CSF1R gene. (A) Sequence chromatograms from parts of the CSF1R gene of this case. It displays a splice-site mutation (c.1858+1G>T) in intron 13 of CSF1R.


Mutation analysis and identification of the c.1858+1G>T mutation of the CSF1R gene. (B) Pedigree of the family studied in this report. The affected individuals are indicated with filled squares and circles. The proband is indicated with an arrow. A plus sign indicates that DNA was examined for the CSF1R sequencing analysis.


CD8+ cells and caspase 3+ cells in the areas of invasive BD and MCC. Paraffin-embedded tissue samples were deparaffinized and stained with anti-CD8 antibody. For the areas of invasive BD.


CD8+ cells and caspase 3+ cells in the areas of invasive BD and MCC. Paraffin-embedded tissue samples were deparaffinized and stained with anti-CD8 antibody. And MCC The sections were developed with liquid permanent red. Original magnification: x200.


CD8+ cells and caspase 3+ cells in the areas of invasive BD and MCC. And anti-caspase 3 antibody. For the areas of invasive BD.


CD8+ cells and caspase 3+ cells in the areas of invasive BD and MCC. And anti-caspase 3 antibody. And MCC The sections were developed with liquid permanent red. Original magnification: x200.


Foxp3+ Tregs, CD163+ macrophages and CD206+ cells in the areas of invasive BD and MCC. Paraffin-embedded tissue samples were deparaffinized and stained with anti-Foxp3 antibody. For the areas of invasive BD.


Foxp3+ Tregs, CD163+ macrophages and CD206+ cells in the areas of invasive BD and MCC. Paraffin-embedded tissue samples were deparaffinized and stained with anti-Foxp3 antibody. And MCC The sections were developed with liquid permanent red. Original magnification: x200.


Foxp3+ Tregs, CD163+ macrophages and CD206+ cells in the areas of invasive BD and MCC. , anti-CD163 antibody. For the areas of invasive BD.


Foxp3+ Tregs, CD163+ macrophages and CD206+ cells in the areas of invasive BD and MCC. , anti-CD163 antibody. And MCC The sections were developed with liquid permanent red. Original magnification: x200.


Foxp3+ Tregs, CD163+ macrophages and CD206+ cells in the areas of invasive BD and MCC. And anti-CD206 antibody. For the areas of invasive BD.


Foxp3+ Tregs, CD163+ macrophages and CD206+ cells in the areas of invasive BD and MCC. And anti-CD206 antibody. And MCC The sections were developed with liquid permanent red. Original magnification: x200.


X-ray of the pelvis with both hip anteroposterior. Multiple osteolytic lesions in the pelvis and proximal femur showing right side neck of femur fracture.


X-ray of shoulder anteroposterior and lateral view diffuse lesion involving the whole humerus and scapula.


X-ray of knee anteroposterior and lateral view. Both distal femur and proximal tibia showing wide spread diffuse osteolytic lesions.


Morphology and Gram's staining of P. Sputorum. Culture blood samples were transferred to Columbia blood plates and incubated in the 5% CO2 incubator at 37 C for. 24 h.


Morphology and Gram's staining of P. Sputorum. 48 h. Gram's staining showed that P.


Morphology and Gram's staining of P. Sputorum. Sputorum is (C) a gram-negative bacilli.


Phylogenetic analysis. Phylogenetic trees based on 16S rRNA gene sequences indicated the phylogenetic positions of isolates 1 and 2 and of other Pandoraea species. Burkholderia sordidicola S5-BT12826 was used as the outgroup. Bootstrap values (>70%) are shown for appropriate nodes. The scale bars represent the number of nucleotide substitutions per site.


MRI on initial relapse reveals a new lesion in the subcortical white matter of the right parietal lobe with high signal on the FLAIR sequence (arrows.


Mild contrast enhancement (arrow.


MRI 2 months after demonstrating a resolution of the lesion of the right parietal lobe.


Absence of gadolinium enhancement.


On month 4, MRI demonstrates a new 2-cm lesion in the left cerebellar hemisphere with high signal on FLAIR (arrow.


A speckled pattern of contrast enhancement on the post-gadolinium image (arrow.


On a follow-up MRI scan 12 months after the initial relapse, FLAIR images reveal complete resolution of the signal abnormalities in the left cerebellar hemisphere.


In the right parietal lobe.


Pretreatment radiological images. Computerized tomography scan.


Pretreatment radiological images. Intravenous urography showing thickening of the right lateral aspect of the urinary bladder wall (arrow).


Pretreatment cystoscopy. A nonulcerated nodular bulge is seen on the right lateral wall of the bladder mucosa (arrow).


Posttreatment images. Computerized tomography scan.


Posttreatment images. Cystoscopy showing completely unremarkable bladder wall and mucosa.


(A) Brain MRA revealed diffuse right posterior cerebral territory infarction, 7 days after vaccination.


(B) Accidentally, stage IV pancreatic cancer was found on abdominal CT.


(C) Blood smear, 9 days after vaccination.


Laboratory data and clinical course of the patient with vaccine-induced immune thrombotic thrombocytopenia.


Trend in the anti-A titer in the patient. TPE - Therapeutic plasma exchange.


Trends in hemoglobin and serum creatinine.


Histiocyte proliferation in the bone marrow of patient in remission of acute lymphoblastic leukemia (ALL); magnification, x1,000.


Hemophagocytosis in bone marrow; magnification, x1,000.


Skin biopsy revealed diffuse infiltration by histiocytes positive for CD45 and CD68 and negative for S100 and CD1a. Hematoxylin-eosin stain; magnification, x10.


Clinical course and neutrophils count in relationship with drugs administration.


Graphs showing serum ferritin and CRP concentrations after initiation of anakinra for all four cases. (A) Ferritin concentration (in micrograms per litre).


Graphs showing serum ferritin and CRP concentrations after initiation of anakinra for all four cases. (B) CRP concentration (in milligrams per litre).


(a, d, g) Fundus photographs of case 1, case 2 and case 3 respectively, showing presumed congenital simple RPE hamartoma close to fovea without any hemorrhage or exudation in the surrounding retina.


(b, e, h) EDI-OCT images showing hyperreflective surface of the lesion with total abrupt optical shadowing of the deeper layers. Choroidal thickness is normal.


(c, f, i) FAF imaging showing marked, uniform hypoautofluorescence of the lesions with isoautofluorescent perimeter.


Enhancement of nasopharyngeal MRI scanning at different stages of treatment. (A) Initial enhancement MRI scanning revealed heterogeneous enhancement shadow filling in the left maxillary sinus at diagnosis.


Enhancement of nasopharyngeal MRI scanning at different stages of treatment. (B) After two cycles of V-CDOP chemotherapy, enhanced MRI scanning showed an excellent initial response with a substantial decrease in the size and intensity of nasopharyngeal lesions.


Enhancement of nasopharyngeal MRI scanning at different stages of treatment. (C) After four cycles of V-CDOP, MRI scanning revealed no significant change.


Enhancement of nasopharyngeal MRI scanning at different stages of treatment. (D) After radiotherapy and two cycles of RV-CDOP, subsequent enhancement MRI scanning revealed a reduction in the size of nasopharyngeal lesion.


Enhancement of nasopharyngeal MRI scanning at different stages of treatment. (E) Repeated enhancement MRI scanning after autologous hematopoietic stem cell transplantation (ASCT) showed increased abnormal signal shadows in the maxillary sinus, which was considered an inflammatory reaction. The nasopharyngeal lesions were indicated by yellow arrows.


Histopathological features of the plasmablastic lymphoma (PBL) patient. (A) PBL consists of large atypical cells, which cause destroyed architecture (H&E; scale bar, 500 mum).


Histopathological features of the plasmablastic lymphoma (PBL) patient. (B) The higher power view shows large-sized atypical cells with lymphocytic or plasmacytoid morphology, accompanied by obvious nucleoli and pathological mitotic features (H&E; scale bar, 100 mum).


Histopathological features of the plasmablastic lymphoma (PBL) patient. (C) The proliferation index was high with a Ki-67 expression of almost 95% (scale bar, 200 mum).


Histopathological features of the plasmablastic lymphoma (PBL) patient.


Histopathological features of the plasmablastic lymphoma (PBL) patient. The immunohistochemical profile showed the neoplastic cells were strongly positive for the plasma cells markers CD38 (scale bar, 100 mum).


Histopathological features of the plasmablastic lymphoma (PBL) patient. MUM-1 (scale bar, 200 mum), positive for CD138 (scale bar, 100 mum).


Histopathological features of the plasmablastic lymphoma (PBL) patient. (G) EBER in situ hybridization showed positive staining of plasmablasts (scale bar, 100 mum).


Histopathological features of the plasmablastic lymphoma (PBL) patient. The malignant cells did not express CD20 (scale bar, 100 mum).


Histopathological features of the plasmablastic lymphoma (PBL) patient. And PAX-5 (scale bar, 100 mum).


Baseline EKG shows a normal sinus rhythm.


Parasternal long-axis view of pericardial effusion on echocardiogram.


Following pericardiocentesis, EKG shows a normal sinus rhythm.


Computed tomography (CT), chest. Disseminated atypical pulmonary infiltrates (day +145 after alloHSCT).


Computed tomography (CT), chest. Chest CT following antimycotic therapy (day +170).


Computed tomography (CT), chest. Disease progression after three courses of rituximab, and ,two courses R-CHOP (day +228).


Computed tomography (CT), chest. Complete remission (CR) after five courses of brentuximab vedotin and three courses of third-party EBV-specific T-cells.


Histopathology and immunohistochemistry of pulmonary tumor biopsies. AlphaCD20.


Histopathology and immunohistochemistry of pulmonary tumor biopsies. MiB1.


Histopathology and immunohistochemistry of pulmonary tumor biopsies. AlphaLMP1.


Histopathology and immunohistochemistry of pulmonary tumor biopsies. AlphaCD30.


Patient 2, axillary lymph node with AITL: (A) Partial nodal architecture effacement by a monomorphic lymphoid population and increased numbers of eosinophils, H&E, 100x.


(B) Neoplastic population of monomorphic follicular helper T cells with small to medium-sized nuclei and clear-to-pale cytoplasm in a polymorphous background of neutrophils and increased numbers of eosinophils with scattered CD30+ immunoblasts (circled, IHC not shown), H&E, 400x.


(C) Increased numbers of neoplastic helper T cells, CD4, 100x.


(D) Increased numbers of neoplastic follicular T helper cells (dim) with scattered neutrophils (strong), CD10, 100x.


(E) Increased numbers of neoplastic helper T cells, PD-1, 100x.


(F) Expanded dendritic meshwork, CD23, 100x.


Patient 3, cervical lymph node with T-ALL. (A) Relatively monomorphic infiltrate of neoplastic lymphocytes with irregularly shaped, hyperchromatic, small to medium-sized nuclei with inconspicuous nucleoli, 400x.


Patient 3, cervical lymph node with T-ALL. (B) CD34-negative, (CD34-positive blood vessels as internal control), 100x.


Patient 3, cervical lymph node with T-ALL. (C) CD10-negative, 100x.


Patient 3, cervical lymph node with T-ALL. (D) TdT-positive (nuclear), 100x.


Patient 3, cervical lymph node with T-ALL. (E) CD1a-positive, 100x.


Patient 3, cervical lymph node with T-ALL. (F) Ki-67 with 80% proliferation index, 100x.


Diagnosis of Legionella pneumophila infection using mNGS. (A) The majority of reads mapped to the L. Pneumophila genome with coverage of 28.12.


Diagnosis of Legionella pneumophila infection using mNGS. (B) The majority of reads mapped to the L. Pneumophila genome with coverage of 13.35.


(A,B) Gram stain of bronchoalveolar lavage fluid (BALF) with arrows indicating Legionella pneumophila, magnification x1,000.


(D) Gram stain of L. Pneumophila colonies (magnification x1,000).


Control abdominal CT showing left adrenal gland metastasis.


Computed tomographic scan imaging: mass in upper pole of left kidney.


Surgical specimen. Tumor in capsule of upper renal pole.


Microscopic examination of the tumor. A) Hematoxilyn-eosin staining demostrating high-grade sarcomatoid cells.


Microscopic examination of the tumor. B) Immunohistochemistry showing difuse actin expression in smooth muscle fiber cytoplasm. Renal capsule (arrow).


Head CT without contrast, day of admission.


T1 axial MRI with contrast, day of admission.


Computed tomography scan. Computed tomography scans showed an enlarged retroperitoneal lymph node of the posterior inferior vena cava.


Computed tomography scan. And rapidly enlarged lymph node after chemotherapy.


Histological examination of biopsy. (A) pleomorphism with bizarre multinucleated tumor cells and high frequency mitosis (hematoxylin and eosin, x100).


Histological examination of biopsy. (B) Tumor cells showed strong reactivity for desmin (desmin, x200).


Microscopic findings in the antemortem specimens. . Notes: Hematoxylin and eosin staining for computed tomography-guided lung tumor biopsy specimens.


Microscopic findings in the antemortem specimens. Visceral pleura specimens using video-assisted thoracoscopic biopsy. Revealed adenocarcinoma.


Microscopic findings in the antemortem specimens. Immunohistochemical analyses showed that tumor cells were positive for TTF-1.


Microscopic findings in the antemortem specimens. And NAPSA.


Microscopic findings in the antemortem specimens.negative for CK 5/6.


Microscopic findings in the antemortem specimens. , CgA.


Microscopic findings in the antemortem specimens. And SYP . Abbreviations: CgA, chromogranin; CK 5/6, cytokeratin 5/6; NAPSA, Napsin A; TTF-1, thyroid transcription factor-1.


Chest computed tomography (CT) images. . Notes: CT performed before gefitinib treatment showed a mass shadow in the right S10 (red circle) and right hilar lymphadenopathy (A and B).


Chest computed tomography (CT) images. One month after gefitinib therapy, these shadows were reduced (C and D).


Chest computed tomography (CT) images. However, only a few months after gefitinib therapy (on the present admission), chest CT showed atelectasis in the right middle and lower lobes (E and F).


Antemortem and postmortem specimens analysis. . Notes: Antemortem . Hematoxylin and eosin staining (A and B).


Antemortem and postmortem specimens analysis. . Notes: Antemortem . Hematoxylin and eosin staining (A and B). Double immunohistochemical staining of CDH1 (in blue) and VIM (in brown) (B and F).


Antemortem and postmortem specimens analysis. . Notes: Antemortem . Immunohistochemical staining of HGF (C and G).


Antemortem and postmortem specimens analysis. . Notes: Antemortem . MET gene translocation (fluorescence in situ hybridization, red signal: MET gene probe, green signal: Centromere enumeration probe 7) (D and H).


Antemortem and postmortem specimens analysis. Postmortem specimens. Analysis. . Abbreviations: CDH1, E-cadherin; HGF, hepatocyte growth factor; VIM, vimentin.


Antemortem and postmortem specimens analysis. Postmortem specimens. Analysis. Double immunohistochemical staining of CDH1 (in blue) and VIM (in brown) (B and F).


Antemortem and postmortem specimens analysis. Postmortem specimens. Analysis. Immunohistochemical staining of HGF (C and G).


Antemortem and postmortem specimens analysis. Postmortem specimens. Analysis. MET gene translocation (fluorescence in situ hybridization, red signal: MET gene probe, green signal: Centromere enumeration probe 7) (D and H).


(A) Plain abdominal radiograph (erect view).


(B) Plain abdominal radiograph (supine view).


Some of the pebbles passed by the child per rectum.


Photograph of the patient's subcutaneous hemorrhage.


Hess chart (orbital Burkitt lymphoma: an aggressive presentation).


Orbital magnetic resonance imaging of axial.


Coronal. At the first medical examination. White arrows indicate a tumor of the lacrimal gland.


Pathologic examination and tissue immunostaining of the tumor. Hematoxylin, and ,eosin stain (original magnification x400).


Pathologic examination and tissue immunostaining of the tumor. Staining with CD20 (original magnification x400).


Pathologic examination and tissue immunostaining of the tumor. Staining with MiB1 (original magnification x400).


Pathologic examination and tissue immunostaining of the tumor. Staining with CD10 (original magnification x400).


Pathologic examination and tissue immunostaining of the tumor. Staining with Bcl-6 (original magnification x400).


Pituitary MRI (sagittal plane) in the three patients reported in this study. In case 1,. The bright-spot of posterior pituitary on T1WI was absent.


Pituitary MRI (sagittal plane) in the three patients reported in this study. Recurred after 3-month dabrafenib treatment (white arrowheads).


Pituitary MRI (sagittal plane) in the three patients reported in this study. In case 2,. The bright-spot of posterior pituitary was absent.


Pituitary MRI (sagittal plane) in the three patients reported in this study. Recurred after 1-month dabrafenib treatment (white arrowheads).


Pituitary MRI (sagittal plane) in the three patients reported in this study. In case 3, (E) decreased bright-spot of posterior pituitary on T1WI (white arrowhead) and infundibular thickening (red arrowhead) were observed.


Pituitary MRI (sagittal plane) in the three patients reported in this study. (F) After 1-month dabrafenib combined with trametinib treatment, the brightness was higher (white arrowhead) with recovered infundibulum (red arrowhead).


Result of bone marrow examination showed slightly increased foamy histiocytosis (H&E staining, x200).


Magnetic resonance imaging of the spine showed compression fractures of the T5 , L3.


L4. Vertebral bodies on a T1-weighted image. Involvement of the metaphysis and diaphysis, with relative sparing of the epiphysis, was observed.


(A, B) Compression fractures were observed by a computed tomography scan of the patient's chest at T5, T7-8, T12, and L3-4 spines.


(C) In addition, computed tomography imaging identified cardiomegaly and multiple prominent lymph nodes in both axillae.


(D) Irregular sclerotic change was observed in both femur necks.


Histopathological examination of axillary lymph nodes revealed diffuse infiltration of lipid-laden histiocytes. H&E staining, x200.


H&E staining, x400).


Immunohistochemical examination of the previous bone marrow biopsy in March 2009 showed that the infiltrating histiocytes were positive for CD68.


Negative for S100, CD1a.


BRAF.


Fragmented red cell had appeared in the peripheral blood and presented severe hemolytic anemia.


Transition of Tumor marker was linked with the treatment effect. EC epirubicin + cyclophosphamide, LET letrozole, PTX paclitaxel.


Transition of RBC and Plt counts was linked with the treatment effect. But in course of treatment, RBC transfusions were performed quite frequently. RBC red blood cell, Plt platelet.


(A) Biochemical parameters of a patient with acute liver failure caused by metamizole. Liver transplantation was performed at day 16.


(B) Liver biopsy obtained at day 4, Sirius Red staining. Collapse and condensation of the preexisting reticulin framework.


(C) Liver biopsy obtained at day 4, hematoxylin and eosin staining. Dropout of extensive areas of liver cells with few surviving hepatocytes mainly in the periportal area and severe lobular inflammation.


(D) Liver biopsy obtained at day 4, hematoxylin and eosin staining. The lobular infiltrate consists of mainly lymphocytes and histiocytes; eosinophils are not present.


Endoscopic examinations. . Notes: Gastroscopy showed multiple superficial mucosal lesions of duodenum and diffuse mucosal bleeding.


Endoscopic examinations.colonoscopy indicated active oozing of blood from ileocecal junction.


Mesenteric arterial angiography. . Notes: Initial angiography (A) showed a hemorrhage spot in the initial branch of the superior mesenteric artery (indicated by arrow).


Mesenteric arterial angiography. Selective arterial embolization with gelatin sponge was performed and final angiography (B) demonstrated no signs of arterial bleeding (indicated by arrow).


FDG-PET/CT showed a primary lesion at the dorsum of the left foot (SUV: 13.6), extensor muscles, and subcutaneous fat tissue. CT, computed tomography; FDG, fluorodeoxyglucose; PET, positron emission tomography.


FDG-PET/CT showed a mass filling the uterine cavity and metastatic lymph node (SUV: 9.1). CT, computed tomography; FDG, fluorodeoxyglucose; PET, positron emission tomography.


Complete remission after immunochemotherapy was showed on uterine and crural region on FDG-PET/CT (SUV: 2). CT, computed tomography; FDG, fluorodeoxyglucose; PET, positron emission tomography.


The surgical specimen showed that the tumor was a well-delineated solitary mass, and that the actual size was ~17 x 12 cm. The section of the tumor showed a pale and solid mass, which is relatively tough.


Pathological images showed spindle cells with involvement of the pancreas, duodenal serosa, and serosa of the gallbladder. No lymph node metastasis was found.


Image of the dilated fundus of the right eye shows an elevated amelanotic yellow-creamy lesion located in the posterior pole (greater diameter of 4 disc diameter [DD]) with focal round pigmented lesion of 1 DD located superotemporally to the optic nerve. There is also a more peripheral amelanotic lesion extending from 6 to 9 o'clock clockwise inferotemporally.


Macular optical coherence tomography (OCT) examination shows the elevated choroidal lesion (*) associated with exudative changes (subretinal fluid [#] and intraretinal cysts [^]).


An ultrasound of the right eye shows diffuse choroidal thickening (*). There is also a small elevated lesion (#) (<2 mm) located at the macula.


The choroid biopsy shows a dense lymphoplasmacytic infiltrate composed of a majority of small lymphocytes with a slightly irregular nucleus, occasional blasts, and a minor component of cells with plasmacytic features, for example, eccentric nuclei and perinuclear halo.


Right vallecular mass (arrow) with epiglottis displaced posteroinferiorly patient's consent obtained for the use of the image.


CT neck. Sagital cut.


Axial cut) showing homogenously enhanced soft tissue density mass with mass effect displacing epiglottis (*) posteroinferiorly.


Post debulking and biopsy of the mass.


The vallecular tissue has benign stratified squamous epithelium with the underlying stroma diffusely infiltrated by neoplastic lymphoid cells (H&E, 200x). The neoplastic cells are monotonous and medium cell size. The inset: They are composed of centrocytes displaying cleaved nuclei, inconspicuous nucleoli and scanty cytoplasm. Some mitotic figures are present (arrow). Reactive small lymphocytes are interspersed in between the neoplastic cells (H&E, 400X).


Peripheral smear.


Microscopic examination of the liver.


Microscopic examination of bone marrow.


Antegrade enteroscopy showed jejunal nodularity in the jejunum which was biopsied.


Adenocarcinoma which is tubular, moderately differentiated, infiltrating into the deep muscle layer. A; H&E, magnification x40.


Adenocarcinoma which is tubular, moderately differentiated, infiltrating into the deep muscle layer. B; H&E, magnification x100.


Computed tomography (CT) and fluorodeoxyglucose positron-emission tomography (FDG-PET) scans. . Notes: (A) CT performed before rituximab-idelalisib treatment initiation, showing a large left cervical lymph node conglomerate extending from upper jugulocarotid territory to left supraclavicular territory, sheathing the jugulocarotid vascular system, lymph-node invasion of the left parotid lodge, and multiple left supraclavicular adenopathies.


Computed tomography (CT) and fluorodeoxyglucose positron-emission tomography (FDG-PET) scans. (B) FDG-PET performed after 3 weeks of rituximab-idelalisib treatment, revealing the absence of lymph-node hypermetabolism in the cervical region associated with the presence of several inflammatory hypermetabolic mediastinal lymph nodes supporting a complete response.


Computed tomography (CT) and fluorodeoxyglucose positron-emission tomography (FDG-PET) scans. Complete response was maintained and confirmed by FDG-PET performed at 3 months.


Computed tomography (CT) and fluorodeoxyglucose positron-emission tomography (FDG-PET) scans. 6 months. After treatment initiation.


Histological examination of a cervical lymph node, revealing the transformation of SLL into a DLBCL with an ABC phenotype. . Notes: (A) HES staining, OM 1.1x, showing lymph node and periganglionic infiltration.


Histological examination of a cervical lymph node, revealing the transformation of SLL into a DLBCL with an ABC phenotype. (B) HES staining, OM 39.1x, showing infiltration with large cells with a large nucleus, containing a large nucleolus and some images of mitosis.


Histological examination of a cervical lymph node, revealing the transformation of SLL into a DLBCL with an ABC phenotype. (C) CD20 immunostaining, OM 19.6x.


Histological examination of a cervical lymph node, revealing the transformation of SLL into a DLBCL with an ABC phenotype. (D) Ki67 immunostaining, OM 40.7x, showing an index of proliferation at 40%. . Abbreviations: SLL, small lymphocytic lymphoma; DLBCL, diffuse large B-cell lymphoma; ABC, activated B cell; HES, hematoxylin-eosin-saffron; OM, original magnification.


X-ray of the left hand of the patient with hypokalemic periodic paralysis. . It showed a bone at the age of 13 years and 6 months.


A photograph showing:. Right periorbital swelling with mild erythema, ecchymosis, subconjunctival hemorrhage, dilated, and ,tortuous episcleral veins.


Showed a restricted ocular motility.


Computed Tomography Scan of the orbits:. Axial section.


Coronal reconstruction of the venous phase of computed tomography angiography: The arrow is pointing to dilated right superior ophthalmic vein thrombosis and enlarged extraocular muscles.


Brain MRI (T1 Gadolinium-enhanced):. Axial section.


Coronal section,. T1 coronal section: the arrow is pointing to the partial extension of thrombus into the right cavernous sinus.


Sagittal section: the arrow is pointing to right SOVT.


Coronal section.


Lymphocyte counts during corticosteroid therapy. Total lymphocytes count was measured at diagnosis (05/2014) until the end of patient follow-up. Steroid treatment, started on May 2014, led to severe lymphopenia; but, immunosuppressive therapy withdrawal on March 2015 resulted in normal lymphocyte count. The intermittent line indicates the lower range of normal lymphocyte count.


Clinical phenotype in a patient with NF-kappaB1 deficiency. (A) Skin biopsy showing a dense cellular infiltrate by Langerhans cells. Magnification 200x.


Clinical phenotype in a patient with NF-kappaB1 deficiency. Hematoxilin-eosin; (B) Skin biopsy with Langerhans cells infiltrating epidermis and subcutaneous tissues, positive to CD1a. Magnification 200x.


Clinical phenotype in a patient with NF-kappaB1 deficiency. Immunohistochemistry CD1a; (C) Panoramic view of bone marrow with many histiocytes with granular cytoplasm. Magnification 40x. Inside images: high power view of histiocytes between hematopoietic cells. They were intensely positive with acid-alcohol techniques (Ziehl Nielsen). Magnification 400x.


Clinical phenotype in a patient with NF-kappaB1 deficiency. Hematoxilin-eosin and Ziehl Nielsen; (D) Panoramic view of duodenal biopsy with villi shortened and lamina propria expanded by many granular histiocytes that stained positive with Ziehl Nielsen to detect Acid-resistant bacilli (inside). Magnification 200x. Hematoxilin-eosin. Inside Ziehl-Nielsen.


Clinical phenotype in a patient with NF-kappaB1 deficiency. Magnification 200x (E) Post-contrast coronal T2-weighted MRI of the abdomen showing mesentery enhancement.


Clinical phenotype in a patient with NF-kappaB1 deficiency. (F) Small bowel biopsy showing myenteric plexus with lymphoplasmocitoid inflammatory cells. Magnification 200x.


Magnetic resonance imaging of the patient. (A and B) Gadolinium (Gd)-enhanced T1-weighted image of cerebellum when the patient was 26 years old. The patient had multiple cerebellar hemangioblastomas.


Magnetic resonance imaging of the patient. (C) Gd-enhanced T1-weighted image of the lower thoracic cord. A small hemangioblatoma with a syrinx is shown.


Magnetic resonance imaging of the patient. (D) T2-weighted image of the lower thoracic cord.


Magnetic resonance imaging of the patient. (E) T1-weighted image of the abdomen. A renal cyst and multiple pancreatic cysts are shown.


Optic fundi before radiosurgery. (A) Left healthy side.


Optic fundi before radiosurgery. (B) Right lesion side.


Magnetic resonance images before radiosurgery. (A) Gadolinium (Gd)-enhanced T1-weighted image, sagittal.


Magnetic resonance images before radiosurgery. (B) Gd-enhanced T1-weighted image, axial.


Magnetic resonance images before radiosurgery. (C) Gd-enhanced T1-weighted image, coronal. Yellow arrows show the tumor.


Magnetic resonance images before radiosurgery. (D) Three-dimensional planning MRI for radiosurgery. The light blue color indicates the tumor enveloping the optic nerve.


Gadolinium-enhanced magnetic resonance images at 18 months after the stereotactic radiosurgery. (A) Sagittal image.


Gadolinium-enhanced magnetic resonance images at 18 months after the stereotactic radiosurgery. (B) Axial image.


Gadolinium-enhanced magnetic resonance images at 18 months after the stereotactic radiosurgery. (C) Coronal image.


A 64-year-old man with a 3-month history of painful swelling and redness of the left upper arm. Cutaneous manifestation of primary cutaneous extranodal NK/T-cell lymphoma, nasal type. (A, B,) There was erythematous to violaceous swelling, nodules, and ulceration with a crust on the left arm.


Magnetic resonance imaging and contrast-enhanced computed tomography findings of the left upper arm in a case of primary cutaneous extranodal NK/T-cell lymphoma, nasal type. Fat-suppressed T2-weighted.


Magnetic resonance imaging and contrast-enhanced computed tomography findings of the left upper arm in a case of primary cutaneous extranodal NK/T-cell lymphoma, nasal type. Contrast-enhanced fat suppressed T1-weighted. MRI images showed diffuse soft tissue infiltration and subcutaneous edema, with intermediate to subtle low-signal-intensity areas in the T2-weighted image (arrows in A) and heterogeneous enhancement (arrows in B) in the medial aspect of the left upper arm.


Magnetic resonance imaging and contrast-enhanced computed tomography findings of the left upper arm in a case of primary cutaneous extranodal NK/T-cell lymphoma, nasal type. Enhanced CT images . Of the left humerus. Also showed diffuse soft tissue infiltration (arrows in C), and ,mixed subcutaneous nodules (arrowheads in D.


Magnetic resonance imaging and contrast-enhanced computed tomography findings of the left upper arm in a case of primary cutaneous extranodal NK/T-cell lymphoma, nasal type. . Of the left humerus. Also showed diffuse soft tissue infiltration (arrows in C), and ,mixed subcutaneous nodules (arrowheads in D, and . . With poorly enhancing peripheral rims and relatively radiolucent central areas.


Left axillary lymphadenopathies and cutaneous involvement in a case of primary cutaneous extranodal NK/T-cell lymphoma, nasal type. A and B, Axial contrast-enhanced CT images showed small discrete subcutaneous nodules with poorly enhanced peripheral rims and relatively radiolucent central areas (arrowheads) in the left anterior chest wall, and multiple conglomerated lymphadenopathies in the left axilla (arrows).


Left axillary lymphadenopathies and cutaneous involvement in a case of primary cutaneous extranodal NK/T-cell lymphoma, nasal type. C and D, These nodules and axillary lymphadenopathies showed high fludeoxyglucose (FDG) uptake in PET-CT images.


Left axillary lymphadenopathies and cutaneous involvement in a case of primary cutaneous extranodal NK/T-cell lymphoma, nasal type. E, Coronal maximum-intensity-projection PET image showing multiple 18 F-FDG-avid lesions.


Left axillary lymphadenopathies and cutaneous involvement in a case of primary cutaneous extranodal NK/T-cell lymphoma, nasal type. F, Follow-up PET image after seven months showing regression of multiple 18 F-FDG-avid lesions. The remaining high-FDG-uptake lesion in the left upper lung (arrow) was caused by pneumonic infiltration.


Pathological specimens. Atypical lymphoid cell infiltration in the dermis and subcutaneous deep fat layer, with extensive necrosis.


Pathological specimens. Angiodestruction by tumor cells.


Pathological specimens. C, Immunohistochemical staining showing that lymphoma cells were positive for CD56.


Pathological specimens. D, Granzyme B.


Pathological specimens. E, Epstein-Barr virus in situ.


T1-weighted images (T1WI) with contrast of magnetic resonance imaging (MRI) show a uniformly enhanced intramedullary tumor with contrast at C2 level (a).


In T2-weighted images (T2WI), significant edema was noted down to T1 level (b).


In T2* sequence of MRI, low intensity area was noted within.


Anterior to the tumor , which suggested intratumoral/intramedullary hemorrhages from the tumor.


Computed tomography (CT) images of sagittal.


Coronal. Section demonstrate a clearly circumscribed hypervascular tumor sized in 13 x 9 x 11 mm with a tortuous vessel posteriorly to the tumor.


T1WI with contrast in MRI demonstrated complete resection of the tumor (a).


In T2WI, high-intensity area significantly improved over time [ postoperative day (POD) 6.


POD 11.


POD 18).


Computed tomography of the chest showed multiple, bilateral ill-defined nodular opacities. Yellow arrow pointing to a 1.3 x 0.9 cm nodule with central cavity in the right upper lobe.


Positron emission tomography showing right upper lobe nodule with cavitation. Yellow arrow pointing to the cavity.


Initial abdominal computed tomography (CT) scan sagittal.


Axial. Views demonstrating dilated stomach, proximal and mid small bowel segments, with a transition point at the jejunal area in the left lower quadrant, consistent with mechanical small bowel obstruction.


(a-d) Immunohistochemical analysis of malignant lymphoma infiltrating mucosa and submucosa of small Intestine. The Ki-67 showed a markedly increased proliferative index, with 90% of lymphocytes staining positive.


(a) Positron emission tomography (PET)/CT scan from her skull to mid-thigh, which indicated no hypermetabolic lesions suggestive of active malignancy in the skull base or neck.


(b and c) Brain magnetic resonance imaging (MRI) demonstrated a single ill-defined, irregular, right fronto-parietal enhancing lesion surrounded by vasogenic edema, with associated mass effect and midline shift.


(a, b) Post-operative MRI demonstrated the resection of the right frontoparietal mass with small air fluid level and residual blood product seen at the tumor bed.


Histopathologic evaluation of the lesion biopsy confirmed the diagnosis of metastatic EATL involving the brain.


CT head showing enlarged right frontal scalp mass. Axial view non-contrast.


CT head showing enlarged right frontal scalp mass. Axial view with contrast.


CT head showing enlarged right frontal scalp mass. Coronal view with contrast.


MRI showing scalp mass, vasogenic edema, and midline shift. Axial view T1 no contrast.


MRI showing scalp mass, vasogenic edema, and midline shift. Axial view T1 with contrast.


Nuclear medicine bone scan with 99mTc-hydroxymethylene diphosphonate (HMDP) and SPECT showed multiple areas of uptake concerning for malignancy. Uptake shown in right posterior iliac bone.


Histopathologic staining showing monotonous infiltrate composed of small cells with irregular nuclei, condensed chromatin, and inconspicuous nucleoli.


Peripheral blood smear obtained on day 12 of illness shows normocytic normochromic red cells. Moderate thrombocytosis is noted with marked anisocytosis in platelets. Giant platelets are also noted. (May-Grunwald-Giemsa, 400x).


Chest X ray posteroanterior view, day 13 of evolution.


Cervical CT image. . Note: Cervical CT showed several inhomogeneous nodules (indicated by the arrows) near the cervical vessels. . Abbreviation: CT, computed tomography.


Hematoxylin and eosin staining of the thymoma. . Notes: (A) Tumor cells were arranged in a nodular pattern. The infiltrated stroma contained large numbers of lymphocytes with formation of lymphoid follicles. Scale bar is 800 mum. (Original magnification x100.


Hematoxylin and eosin staining of the thymoma. ) (B) Epithelial tumor cells were oval shaped with occasionally atypia or mitotic activity. Scale bar is 300 mum. (Original magnification x200.


Hematoxylin and eosin staining of the thymoma. ) (C) Eosinophilic granulocytes infiltrated the tumor nodules and the surrounding stroma. Scale bar is 300 mum. (Original magnification x200.


Hematoxylin and eosin staining of the thymoma. ) (D) High magnification showed the infiltrated eosinophilic granulocytes and the proliferating LCs. Nuclear grooves (indicated by the arrow) could be observed in some LCs. Scale bar is 100 mum. (Original magnification x100. ). Abbreviation: LCs, Langerhans cells.


Immunohistochemical staining of the thymoma. . Notes: Proliferation of epithelial tumor cells were stained by CK (pan).


Immunohistochemical staining of the thymoma. , CK5/6.


Immunohistochemical staining of the thymoma.P63.


Immunohistochemical staining of the thymoma. Proliferated LCs were positive for CD1a.


Immunohistochemical staining of the thymoma. And S100.


Immunohistochemical staining of the thymoma. Mature B lymphocytes were positive for Pax-5 (F). Scale bar is 800 mum. (Original magnification x100. ). Abbreviation: LCs, Langerhans cells.


(A) Top-10 up-regulated (green color, top) and top-10 down-regulated (red color, bottom) molecular pathways in the patient's tumor.


Line width for each pathway is proportional to the pathway activation level (PAL), scale for PAL values is presented on the right; (B) Gene expression level of Regorafenib targets. Targets included in the "KEGG Pathways in cancer" pathway are highlighted in red.


"KEGG Pathways in cancer" signaling pathway shown as an interacting network. This pathway was hyperactivated in the patient's tumor tissue. Green arrows indicate activation, red arrows-inhibition. Transcript nodes are shown in ovals. The color depth of transcript nodes reflects the extent of node activation (logarithms of the case-to-normal (CNR) expression rate for each node, in which "normal" is a geometric average between expression levels in normal tissue samples). Molecular targets of regorafenib are indicated by black arrows. Visualization was implemented using Oncobox software. The PI3Ks-AKT signaling axis is marked in blue ellipse.


Orbital computed tomography. . Notes: (A) Coronal section.


Orbital computed tomography. (B) Transverse section. Showing a mass lesion in the right lacrimal gland, with regular borders and internal heterogeneity, determining an inferior and medial deviation of orbital structures.


Pleomorphic adenoma with a malignant component of myoepithelial carcinoma (right inset). . Notes: Peripherally, there is infiltration by chronic lymphocytic leukemia/small lymphocytic lymphoma (left inset).


(A) A large, lobulated, and heterogenously enhancing mass occupies the right retroperitoneal space (arrow).


(B) Intraoperative findings: a 9.4 x 6.3 x 5.1 cm sized smooth round mass (arrow) surrounded by light grayish membrane is attached to right retroperitoneal wall close to the right adnexa (arrowhead).


Microscopic features of retroperitoneal leiomyosarcoma. (A) Low magnification of tumor showing intersecting fascicles (H&E, x100).


Microscopic features of retroperitoneal leiomyosarcoma. (B) Tumor cells show strong reactivity for smooth muscle actin (smooth muscle actin, x400).


CT contrast (delayed phase) showing infiltrative mass in the lower pole of the left kidney with lower enhancement compared to normal surrounding renal tissue. Left para-aortic lymph node involvement can be seen.


CT image showing several non-calcified lung nodules and widened mediastinum due to metastasis to mediastinal lymph nodes (pink arrow).


Chest X-ray showing several non-calcified lung nodules and widened mediastinum due to metastasis to mediastinal lymph nodes.


Asymmetrical dystonic posturing on both sides (left more than right) with significant swelling and redness in the dorsum of the left foot.


Chest CT showed a 4-cm left-breast mass with central necrosis.


Left panel: Core biopsy section from the left-breast mass shows invasive ductal carcinoma (x400 magnification). Right panel: Core biopsy section from the left infraclavicular lymph node shows metastatic breast carcinoma cells in the lymphoid tissue (x200 magnification).


The pathophysiologic process that produces the immune-related storm in thymoma has not yet been fully clarified. Some possible vicious cycles involve enhanced T-cell activity against antigens present in the thymus and in the "innocent" bystander organs, whereby growing amounts of preexisting autoreactive T-cells are unleashed from the medulla, breaking the immune-equilibrium existing in the normal thymus. In particular, the immature CD4+CD8+ double positive cells move to single positive CD4+ helper T-cells (binding MHC class II) and CD8+ cytotoxic T-cells (binding MHC cIass I) involved in the adaptive immunity while a negative selection leads to apoptosis of self-reacting T clones. In thymic neoplasia the immature thymic lymphocytes may escape quality control by DC prompting T-cell hyperactivation and autoimmune manifestations. DC, dentritic cell; APC, antigen presenting cell; MHC, major histocompatibility complex.


Hematoxylin-eosin (HE) immunostaining (IHC): fibrous septa within the tumor separate the lymphoepithelial elements (4x).


HE IHC: aggregates of large epithelial cells with a clear cytoplasm interspersed between lymphoid cells (20x).


CK 19 IHC: dense epithelial cell network (10x).


PD-L1 IHC (Clone 22 C3): Membranous positivity of the epithelial cells (20x).


TdT IHC: lymphocytes consist predominantly of immature T-cells.


CD8 IHC: immune-positivity of CD8 on immature lymphocytes (10x).


Longitudinal slices of computed tomography scans at baseline.


Post treatment. Showed a decrease of the mediastinum mass with intralesional hypondensity (red arrows) and pleural nodules (yellow arrows), defined as partial response according to iRECIST criteria.


(a) Preoperative T1-weighted contrast-enhanced axial cranial magnetic resonance imaging showing a right frontoparietal mass lesion and perilesional edema.


(b) Preoperative T1-weighted contrast-enhanced coronal cranial magnetic resonance imaging showing a right frontoparietal mass lesion and perilesional edema.


(c) Preoperative T1-weighted contrast-enhanced sagittal cranial magnetic resonance imaging showing a right frontoparietal mass lesion and perilesional edema.


Postoperative axial cranial computed tomography image showing tumor removal with normal postoperative changes and persisting preexisting perilesional edema.


Intra-operative photograph showing a cherry red lesion arising from the lower medulla oblongata.


Admission chest x-ray showing bilateral consolidation.


(a) Occluded right ICA with absent flow seen on color-duplex. Right ECA has adequate flow although severe atherosclerosis is evident based on turbulent color flow images.


(b) Color-duplex images of left carotid system with >70 % critical stenosis in proximal left ICA and a patent left ECA.


Patient's hemoglobin trend during hospitalization and peripartum period. Patient's hemoglobin trend during hospitalization and peripartum period shows a mild increase in hemoglobin after starting eculizumab.


Patient's creatinine trend during hospitalization and peripartum period. Patient's creatinine trended down during hospitalization after starting eculizumab with a return of creatinine back to baseline in the peripartum period.


Patient's platelet count trend during hospitalization and peripartum period: Patient's platelets showed a steady increase after the patient was started on eculizumab.


Comparative clinical photograph of the patient. At the time of presentation.


Comparative clinical photograph of the patient. , after preoperative radiotherapy.


Comparative clinical photograph of the patient. , after surgery.


Comparative clinical photograph of the patient.after postoperative radiotherapy.


Computed tomography scan of head and neck sagittal.


Bone window (b) shows erosion of the posterior arch of atlas and occipital bone.


Axial.


Coronal. View showing moderately enhancing soft tissue lesion in the nape of neck, extending from skull base to thyroid gland level.


Photomicroscopy of the excised tumor showing vascular neoplasm consisted of sheets and groups of spindle and oval shaped cells (pericytes) in between thin wall blood vessels in some areas with stag horn pattern low power.


High power view).


Immunohistochemistry demonstrating CD34.


Vimentin. Positive tumor cells.


Computed tomography scan done at 2 month, sagittal.


Axial. View demonstrating near total decompression of the craniovertebral junction with minimal residual tumor.


MRI of the left foot and ankle. Contrast-enhanced T1-weighted sagittal image.


MRI of the left foot and ankle. Shows diffuse decreased heterogeneous signals in bone tissues and diffuse contrast enhancement in all foot bones in the fat-suppressed sagittal image.


Epithelial clusters admixed with lymphocytes in the background (Diff Quik, x4).


Epithelial cell clusters with abundant cytoplasm and small nuclei; numerous lymphocytes are present in the background (Pap, x20).


Microvesicular cytoplasm: Characteristic of sebocytes (Diff Quik, x40).


Microvesicular cytoplasm: Characteristic of sebocytes (Pap stain, x40).


On close inspection of the back, multiple closely grouped papular lesions can be appreciated over the back, giving a rough, cobblestone-like texture to the skin.


Special staining with colloidal iron showed amorphous blue-colored mucin deposition throughout the dermis, which in correlation with the histopathological picture is diagnostic for scleromyxoedema. Counter stain used: Hematoxylin (Colloidal iron stain: x10).


Clinical appearance of lesion.


Traumatic deep bite interfering with the lesion during occlusion.


Pre-operative scaling.


Occlusal correction.


Full thickness flap elevation facial to tooth 11, 21 using crevicular incision.


Excision of lesion.


Suturing with 3-0 silk suture.


Superficial erosion of bone upon reflection of full thickness flap.


Excised tissue.


Photomicrograph showing features of peripheral ossifying fibroma.


Satisfactory healing seen after 45 days.


Langerhan's giant cells seen in tuberculosis lymphadenitis.


Initial presentation of the patient with temporal herpes zoster.


Perioral bullous impetigo, herpetiform vesicles on the nose.


Increased facial edema and necrotic herpes zoster lesions.


Pre-angioplasty MRI image showing high-grade proximal renal artery stenosis.


Hyperintense lesions of PRES.


CT scan showing an axillary node transiently controlled with radiotherapy in June 2009. . Abbreviation: CT, computed tomography.


Fundus pictures of the right.


Left eye. Showing bilateral optic disc edema suggestive of papilledema.


Intraoperative situs:. About 5 x 6 cm, and ,further distal 3 x 2 cm covering defect with exposed atrophic tend.


Surgical cleaning.


Deposition of gentamycin mini chains.


Negative pressure wound therapy.


Postoperative results:. 9 days.


20 months after surgical intervention.


CT angiogram image showing abnormal origin of RPA from ascending aorta (AAO). . Abbreviations: SVC, superior vena cava; MPA, main pulmonary artery; DAO, descending aorta; LPA, left pulmonary artery.


MRI findings of distant metastasis. . Notes: MRI carried out before the patient received CIK cells. (A) MRI shows liver metastasis, and red arrows indicated metastatic focus.


MRI findings of distant metastasis. . Notes: MRI carried out before the patient received CIK cells. (B) Pelvic metastasis was detected by MRI (red arrows). . Abbreviations: CIK, cytokine-induced killer; MRI, magnetic resonance imaging.


MRI findings after 4 cycles of CIK cells plus chemotherapy. . Note: Liver.


MRI findings after 4 cycles of CIK cells plus chemotherapy. Pelvic. Metastasis showing significant improvement (red arrows). . Abbreviations: CIK, cytokine-induced killer; MRI, magnetic resonance imaging.


Case 1. Bone marrow (BM) biopsy at progression showing morphological (hematoxylin and eosin, H&E) lymphoid cells.


Case 1. Original magnification x20) negative for CD5 , original magnification x20).


Case 1. Positive for CD20 , original magnification x20).


Case 1. CD30 ; original magnification x20).


Case 1. Immunohistochemical positivity for EBV (by using Monoclonal Mouse Anti-Epstein-Barr Virus, LMP) of diffuse large B-cell lymphoma in lymph node biopsy (, original magnification x20).


Case 1. BM aspirate (; original magnification x10).


Noncontrast axial head CT of patient on initial presentation.


T1 post-gadolinium axial MRI of patient on initial presentation.


T1 post-gadolinium axial MRI of patient obtained within 48 hours of first resection surgery.


Noncontrast axial head CT obtained on readmission 2 months after initial presentation and surgery.


T1 post-gadolinium axial MRI obtained on readmission 2 months after initial presentation and surgery.


(a) Axial T2 W image of case 1 showing multiple subcortical cysts and hyperintense white matter changes.


(b) Sagittal T2W images of case 2 showing multiple temporal and frontal cysts and white matter changes.


(c) Axial T1W image of case 3 showing characteristic cystic subcortical white matter appearing hypointense on T1.


A diffuse extraoral swelling in the lower one-third of face extending to submandibular region.


Lateral view of the swelling.


Panoramic radiograph showing generalized bone loss.


Posterior-anterior chest radiograph, showing a normal study.


Computed tomography of neck with contrast, axial section demonstrating enlarged lymph nodes without any enhancement or necrosis.


Computed tomography, coronal section demonstrating enlarged lymph node pushing the submandibular gland to one side.


Computed tomography of neck with contrast, sagittal section demonstrating lymph node enlargement at level Ib, II, III and V.


Positron emission tomography/computed tomography images showing fluoro-2-deoxyD-glucose avid supra, and ,infra diaphragmatic lymph nodes, and ,focal fluoro-2-deoxyD-glucose avid in spleen.


Positron emission tomography/computed tomography images after chemotherapy showing complete metabolic and near complete anatomical resolution of supra/infra diaphragmatic lymph nodes and splenic deposits.


Perfusion.


Blood pool. Images showed increased tracer uptake in both lungs.


Delayed images (C) also showed increased activity in the lungs and poor uptake in the skeleton.


(A, B) A white-yellowish plaque in the bladder by cystoscopy.


(C) Sheets of large macrophages with granular eosinophilic cytoplasm and mixed inflammatory cell infiltration using heamatoxylin and eosin staining (magnification: 400x).


(D) Michaelis-Gutmann bodies using von Kossa staining (400x).


Pre-treatment computed tomography (CT) image with intravenous (IV) contrast, demonstrating bilateral pleural effusions (white arrows) and moderate-sized pericardial effusion (black arrows), prior to thoracentesis, pericardiocentesis, or chemotherapy. Black asterisk = atelectatic lung.


Post-treatment CT image after two cycles of fludarabine and cytarabine and four cycles of decitabine alone. White arrow = residual small right pleural effusion. No left pleural effusion or pericardial effusion. White asterisk = liver.


Dermatitis around the stoma before hematopoietic stem cell transplantation.


Pretransplant lesions.


A; Widefield Optos imaging of the right eye of a patient with von Hippel-Lindau disease demonstrates a retinal hemangioblastoma in the superotemporal quadrant with associated dilated feeding and draining vessels.


B; Widefield fluorescein angiography of the right eye reveals fluorescein uptake and leakage from the hemangioblastoma with peripheral retinal nonperfusion in the superotemporal quadrant anterior to the tumor.


Optical coherence tomography of the right eye reveals intraretinal fluid extending from the hemangioblastoma towards the temporal macula.


Showing aggregates of mast cells containing mixed black and orange color round cytoplasmic granules and a giant segmented basophil in. (wright's stain x 100).


Brown color round granular cytoplasmic staining demonstrated by tryptase immunohistochemical staining on PB smear representing mast cells in. (x100).


Demonstrating basophils at various stages of maturation,giant binuclear basophilic metamyelocyte, aggregates of mast cells with mixed black and orange color round cytoplasmic granules and Pelger-Huet anomalies in (a) (Wright's stain, x100).


Showing diffuse granular staining by peroxidase stain in peroxidase positive basophils and absence of staining in aggregates of cells that representing myeloperoxidase negative mast cells in the BM in (b) (Peroxidase stain, x100).


Sagital contrast-enhanced T1 image showing the relation between the mass and the cerebellar tentorium (left).


Axial contrast-enhanced T1 image showing the tumor's dimensions (right).


The clinical course for the C1q nephropathy patient. (A) Selected urinalysis results and clinical course for the patient. Proteinuria and urinary occult blood have been negative for >18 months since administration of rituximab, indicating long-term remission. No relapse occurs after withdrawing maintenance dose of corticosteroid. The course of steroid treatment is shown for corresponding time points in.


The clinical course for the C1q nephropathy patient.


The clinical course for the C1q nephropathy patient. (C) Urinary protein/creatinine ratios during the care provided by us.


Pathology evaluation for the C1q nephropathy patient. (A) Hematoxylin-eosin staining shows increased number of cells in glomerulus. No glomerular crescent, focal segmental glomerular sclerosis, and fibrosis are noted. However, renal tubule dilation and vacuolar degeneration of epithelial cells are present, and renal interstitium is slightly infiltrated with inflammatory cells, indicating a minimal change disease (MCD).


Pathology evaluation for the C1q nephropathy patient. (B) Periodic acid-Schiff (PAS) staining shows no remarkable cellular proliferation of mesangium and stroma.


Pathology evaluation for the C1q nephropathy patient. (C) Periodic Schiff-methenamine (PASM) staining shows normal capillary loops and no significantly thickened basement membrane.


Pathology evaluation for the C1q nephropathy patient. (D) Immunofluorescent staining confirms large amount of C1q deposition.


Pathology evaluation for the C1q nephropathy patient. (E,F) Transmission electron microscopy shows vacuolar degeneration of epithelial cells, podocyte foot processes effacement, proliferation of mesangium and stroma, and thin basement membrane.


Clinical course of the patient. Cytomegalovirus (CMV) copy numbers in folds of 105 in gray shown as drawn through line; administration of hyperimmune globulines (IVIG), cyclosporine (CsA), prednisolone, rituximab (depicted by crosses) and antiviral medication (ACV: acyclovir; FOS: foscarnet; GCV: ganciclovir; LMV: letermovir; VACV: valacyclovir) as indicated above, dectection of UL56 wild type (WT) is depicted as empty circle and UL56 C325Y as black circle respectively.


Axial T2-weighted MRI image showing a solid expansile lesion.


Ultrasonography showing subcutaneous fluid collection in the anterior aspect of the left arm root.


Ovoid hypoechoic nodule, located in the lateral quadrant of the right breast. Category BI:RADS 3.


Computed axial tomography scan view showing secondary haematogenous implant in the pericardial fat.


Computed axial tomography scan view showing secondary haematogenous implant in the right subcutaneous tissue of the breast.


Computed axial tomography analysis after resection of secondary haematogenic implant.


Fundus examination of both eyes showing peripapillary, subhyaloid and vitreous hemorrhage at initial presentation. . Notes:. Right eye.


Fundus examination of both eyes showing peripapillary, subhyaloid and vitreous hemorrhage at initial presentation. Left eye.


Fundus examination of both eyes showing spontaneous partially resolved hemorrhage after 6 weeks. . Notes:. Right eye.


Fundus examination of both eyes showing spontaneous partially resolved hemorrhage after 6 weeks. Left eye.


It shows changes consistent with severe colitis due to both graft versus host disease and cytomegalovirus infection.


The peripheral blood smear shows an increased number of medium- to large-sized blastoid cells with polymorphous nuclei and basophilic cytoplasm (Wright-Giemsa stain, x1,000).


(A) Giemsa-banding karyogram of bone marrow cells: 45-47,XY,-9,-11,der(14)t(11;14)(q13;q32),-22,+2~3mar. M1 and M2 indicate marker chromosome 1 and 2, respectively. And R on the karyogram.


(C) Diagrammatic representation of der(11)t(3;11)(q25;p15)t(11;14)(q13;q32). The arrows indicate breakpoints in chromosomes 3, 11, and 14.


FISH analysis using a dual-color dual-fusion BCL1(green)/IGH(orange) probe.


1 BCL1 and 2 IGH (R) signals. The corresponding chromosomes are marked as F.


Multiple pulmonary cavities in case 2. The patient succumbed to massive hemoptysis.


Renal biopsy of case 3 showing glomerular crescent and focal necrosis. Areas of interstitial fibrosis are seen.


Computed tomography (CT) scan head without contrast showing ex vacuo dilatation of left lateral ventricle.


Examination of peripheral blood smear.


Bone marrow biopsy.


Left great toe partially amputated with an ulcer.


Contrast-enhanced computed tomography abdomen revealed a 5.2 x 3.5 x 5.8 cm hypervascular mass lesion replacing left adrenal, suggestive of pheochromocytoma.


Gross appearance of left suprarenal mass.


Its cut section.


Diffuse infiltration of the lung parenchyma by small lymphocytes, monocytoid cells and plasma cells (magnification, x20).


Computed tomography findings following 6 cycles of chemotherapy.


Coronal T1-weighted MRI reveals thickening of the left vocal cord (black arrow).


Histologically, the tumor is composed of spindle-shaped myofibroblasts in collagenous and inflammatory background (hematoxylin-eosin stain, original magnification x400).


Reactivity in the cytoplasm of the myofibroblasts with smooth muscle actin (original magnification x400).


Grossly, the tumor was firmly attached to the left true vocal cord and presented to be nodular, measuring in diameter 1.7 x 1.1 x 0.7 cm.


Platelet count plot from day 1 to day 60 depicting the drop and return to baseline X-axis: duration in days. Y-axis: platelet count x 105/mul.


Indocyanine green angiography showing irregular perfusion of the choroid.


Gingival enlargement in the right upper anterior region between the lateral incisor and the canine.


Intraoral, periapical radiograph of the region showing no bony involvement.


Micrograph at low magnification showing plasma cell infiltrate and elongated rete ridges.


Low power microscopy showing abundant plasma cells in the connective tissue.


High power microscopy showing plasma cells with eccentrically placed nucleus.


Immunohistochemistry for kappa chains.


Immunohistochemistry for lambda chains.


A; Karyotype of the patient displaying the t(12;14)(q23.2;q32.3). Arrows mark the translocation breakpoint regions on the derivative chromosomes. Note that der(12) is duplicated, leading to a partial trisomy 12.


B; Karyotype evolution (about three years later). Additional aberrations include a del(3)(p21), monosomy 13 and add(17)(p11). For detailed information see also Table 1.


C; FISH with the Cytocell IGH Breakapart probe on metaphase and interphase nuclei. The normal chromosome 14 generates a red-green fusion fluorescence signal. Der(14) yields only a red fluorescence signal with the distal green-labeled probe being translocated on der(12). A second green fluorescence signal is present due to the der(12) duplication. On the upper right side, a normal interphase with two red-green fusion signals is shown, next to an interphase bearing the translocation (lower right). A white arrow marks the fusion signal from the normal chromosome 14.


Translocation breakpoints and derivative chromosome composition. Horizontal gray arrows indicate the transcriptional direction of the depicted genes. Vertical black arrows indicate breakpoints (BP). A; Breakpoint region on chromosome 12. The breakpoint took place 86.5 kb distal of the ASCL1 gene.


Translocation breakpoints and derivative chromosome composition. Horizontal gray arrows indicate the transcriptional direction of the depicted genes. Vertical black arrows indicate breakpoints (BP). B; The IGH locus on chromosome 14. The breakpoint took place within the pentameric repeat region of Switch mu. Dots indicate the IGH enhancer elements.


Translocation breakpoints and derivative chromosome composition. Horizontal gray arrows indicate the transcriptional direction of the depicted genes. Vertical black arrows indicate breakpoints (BP). C; Composition of der(12) and sequence around the breakpoint. The enhancer element is part of the translocated IGH sequence and is juxtaposed to ASCL1. D der(14) and breakpoint sequence. The C12orf42 gene is translocated to chromosome 14.


Validation of the ASCL1 overexpression. A; Comparison of the BM expression of ASCL1 between the CLL patient with the t(12;14) translocation and healthy controls as well as CLL with normal karyotype, mono- and biallelic del(13) and trisomy 12 respectively. Results are displayed as log2 fold change. HB2M was used as housekeeping control. Comparisons of the ASCL1 expression in the patient versus all other groups were highly significant (ANOVA p-value = 5.12E-10). Comparisons between normal BM and all other groups were not significant.


Validation of the ASCL1 overexpression. B; Immunohistochemistry for ASCL1 on a peripheral blood cytospin of the patient bearing the t(12;14). Note the strong nuclear reaction in the center.


Validation of the ASCL1 overexpression. In contrast to that a sample from a B-CLL control (c) showed no antibody reaction. Nuclei are counterstained with hematoxylin.


Magnetic resonance imaging. Preoperative imaging revealed isointense lesions on T1-weighted.


Magnetic resonance imaging. T2-weighted imaging , compressing the spinal cord.


Magnetic resonance imaging. Axial enhanced T1-weighted imaging (C) revealed enhanced lesion located at midline premedullary cistern and lateral medullary cisterns (arrows), compressing the brainstem (asterisk).


Magnetic resonance imaging. Sagittal enhanced T1-weighted imaging (D, E) showed multiple nodular lesions continuously creeping through the tentorium and meninges of sellar region, skull base, and C1-C6.


Magnetic resonance imaging. Postoperative-enhanced MRI (F) proved the spinal and lower region of clivus of the tumor was totally removed.


Timeline of the case presentation.


Pathological findings. Hematoxylin and eosin (magnification, x100) (A) showing lymphoplasmacytes infiltrated the tumor stroma, overshadowing the meningioma component.


Pathological findings. Immunohistochemistry testing showed epithelial membrane antigen positive (arrowheads) (magnification, x400).


Pathological findings. , CD20 positive (arrowheads) (magnification, x400).


Pathological findings.CD138 positive (arrowheads) (magnification, x400) In conclusion, pathological findings indicate a lymphoplasmacyte-rich meningioma.


Axial fluid attenuated inversion recovery (FLAIR).


Axial T2-weighted images. Show extensive hyperintense.


Axial T1-weighted image. Shows hypointense lesions in the subcortical and periventricular white matter bilaterally. There is also compression of the posterior horn of the lateral ventricle due to mass effect.


There is no remarkable contrast enhancement on T1-weighted postcontrast images (d).


Axial FLAIR image (e) reveals that there is no lesion in the pons.


The clinical picture of the right thigh after 2-months of conservative treatment.


The lesion of the thigh after surgical biopsy (visible skin sutures) that confirmed the diagnosis.


The same skin surface after 4 months of chemotherapy.


Hematoxylin and eosin staining (extension x200). Skin biopsy showing subcutaneous tissue with neoplastic infiltrate. The neoplastic cells range in size and have irregular, hyperchromatic nuclei. The characteristic feature is the rimming of the neoplastic cells surrounding individual fat cells.


(a) Left leg with multiple subcutaneous swellings and few ulcerated nodules.


(b) Axial computed tomography: Homogeneously enhancing relatively hypodense left suprarenal mass with loss of fat plane in anterior pararenal space.


(c) Axial computed tomography: Heterogeneously enhancing left inguinal lymph nodal mass.


Leiomyosarcoma arising from the intrapancreatic common bile duct. The tumor infiltrates the full thickness of the common bile duct, extends into its lumen and invades the pancreas. Tumor cell necrosis, high cellularity, many mitotic counts, pleomorphism, and nuclear atypia are present in the neoplasm (H&E, x10).


Leiomyosarcoma arising from the intrapancreatic common bile duct (Desmin, x10).


Leiomyosarcoma arising from the intrapancreatic common bile duct (smooth muscle actin, x20).


T1-weighted magnetic resonance imaging image showing a well-defined hypodense lesion in the left parietal lobe with rim enhancement, disproportionate perilesional edema, and midline shift of 8 mm.


CT scan demonstrating a cecal mass.


Intraoperative image of the mass as it appears under micro-laryngoscopy.


Low-power view of the tumor composed of pleomorphic malignant spindle cells. Note the overlying nonatypical squamous mucosa on the top right aspect of the image (HE, x10).


High-power view of the tumor showing marked nuclear pleomorphism with frequent mitoses (black arrow) (HE, x40).


Right Foot edema with peripheral Cyanosis.


Right Forefoot Gangrene.


Clinical photograph of I. O lesions.


Orthopantomogram of the patient showing patchy radiolucency with irregular margins in the left anterior region extending as poorly defined radiolucency into the body of mandible region.


H & E stained sections in x5 magnification showing diffuse presence of round cells in deep connective tissue.


H & E stained sections in x10 magnification showing diffuse presence of two different morphologies of cell populations in deep connective tissue.


H & E stained sections in x40 magnification showing diffuse presence of two different morphologies of cell populations in deep connective tissue.


Cytokeratin-high molecular weight negative staining of the tissue cells.


Cytokeratin 7 negative staining of the tissue cells.


P63 mild positivity of tumor tissue cells.


Histopathological and immunohistological findings of the lymph nodes tissues samples. Hematoxylin, and ,eosin staining showed malignant spindle cells (200x), which displayed immunohistochemical positive staining for CK, SMA, CD34, CD99, and ,Bcl-2, and ,negative for Des, S-100.


Histopathological and immunohistological findings of the lymph nodes tissues samples. . Catenin. (B) IHC of our patient did not reveal supported ALK gene mutation (200x). . Abbreviations: IHC, immunohistochemistry; ALK, anaplastic lymphoma kinase.


Family tree of patient.


(From right) Skin colour of patient, her mother, second brother and father.


(From right) Venous blood in ethylenediaminetetraacetic acid (EDTA) tube of healthy control (normal colour), patient (dark brown colour), patient's mother (normal colour), patient's second brother and patient's father (dark brown colour).


Abnormal band (X) was seen in between HbA2 and HbS at alkaline pH.


A; Sagittal STIR (short T1 inversion recovery) of the left hip joint before treatment with HBO shows geographical subarticular area of high-signal intensity in the head of femur involving 45% of the femoral head (stage IC, severe). No detected structural collapse of the head.


B; Sagittal STIR of the left hip after treatment shows that decrease in the subarticular is of high-signal intensity involving about 25% of the femoral head (stage IB, moderate) denoting improvement of the condition.


A; Sagittal T2 fat suppressed image of the left shoulder before treatment with hyperbaric oxygen shows subarticular geographical areas of high-signal intensity involving about 45% of the head of the humerus (stage IC, severe). No detected structural collapse of the head. Also noted geographical high-signal intensity in the proximal shaft.


B; Sagittal T2 fat suppressed image of the left shoulder after treatment shows nearly stable appearance of subarticular areas of high-signal intensity in the head of the humerus. However, significant improvement is noted in the proximal shaft with absence of high-signal intensity.


A; Sagittal STIR (short T1 inversion recovery) of the left hip joint before treatment with hyperbaric oxygen shows geographical subarticular areas of high-signal intensity in the head of the femur involving 35% of the femoral head with no definite collapse (stage IC, severe).


B; Sagittal STIR of the left hip after treatment shows an increase in the areas of high-signal intensity involving now about 45% of the femoral head with subchondral cystic changes (stage IIC, severe) denoting worsening of the condition.


A glomerulus showing cellular crescent. The underlying glomerular tuft shows segmental necrosis with fibrin exudation and presence of few karyorrhectic debris (periodic acid - Schiff stain, x400).


Course of the illness and successful response to tacrolimus.


Wright-stained bronchoalveolar lavage fluid smears. . Notes: (A-D) Arrows indicate extracellular "tachyzoites", also known as "trophozoites", which can be propagated within the nucleated cells. No intracellular parasites are present. Magnification x1,000.


Salivary parenchyma harboring a well-circumscribed, fascicular proliferation of spindle shaped cells (hematoxylin and eosin stain, original magnification x 25).


Tumor cells infiltrating the adjacent parenchyma (hematoxylin and eosin stain, original magnification x 200).


Tumor cells showing mild nuclear atypia with multinucleated giant cells and mitosis (hematoxylin and eosin stain, original magnification x 400).


H-caldesmon positivity of the tumor cells (original magnification x 400).


Coronary angiography of an essential thrombocythemia case with acute myocardial infarction. Examination results of the. First.


Coronary angiography of an essential thrombocythemia case with acute myocardial infarction. Second time admissions.


Clinical photograph of the patient at birth.


Fundus image of the right eye at 57 days after birth. Note the wide avascular retina with markedly progressed tractional changes.


Brain magnetic resonance imaging performed on day 217. . A: Axial T1-weighted section showing enlargement of lateral ventricles with a frontal large cyst.


Brain magnetic resonance imaging performed on day 217. . B: Parasagittal T1-weighted section showing a distinct enlargement of lateral ventricle and global reduction of white matter volume.


Changes in platelets count and ACE concentration during the course of ERT.


CT scan showing recurrence of the tumor in the vaginal stump (June 2016).


CT scan showing complete remission of the lung lesions (July 2017).


FNAC right lung lesion showing myeloblasts with auer rods suggestive of granulocytic sarcoma right lung.


Panel A: computed tomography of thorax shows a soft tissue density lesion in the right lung measuring with a pleural-based nodule in the apical basal segment of right lower lobe. Panel B: computed tomography of thorax shows near total resolution of the soft tissue density lesion following chemotherapy and radiation.


Depigmented patches on the bilateral knees.


A depigmented patch on the upper eyelid.


Transvaginal ultrasound indicating a large 10x8x7 cm3 sized cystic mass at the center of the pelvic cavity, with internal septation and no apparent solid portion.


An abdominopelvic computed tomographic scan after enhancement shows a 10x8 cm sized cystic mass in the left ovary, with internal septation (arrow) and a solid portion (arrowhead), which is enhanced by contrast media.


(A) Histological specimen shows large aggregates of tumor cells with abundant eosinophilic to clear cytoplasm, with a granular appearance and vacuolization (H&E, x200).


(B) Immunohistochemical staining shows the tumor cells exhibiting a diffuse positive reaction for inhibin (brown) (x200).


(C) Immunohistochemical staining shows a diffuse positive reaction of the tumor cells for calretinin (dark red) (x100).


Pre-op MRI Brain, T2W coronal section showing a well-defined lobulated hyperintense mass lesion in atrium of the right lateral ventricle causing mass effect in form of dilated occipital horn of right lateral ventricle.


Post-op MRI Brain, T1W axial section showing a well-defined lobulated non-enhancing cystic lesion in right parietal lobe communicating with right lateral ventricle with dilated occipital horn.


CT angiography of thorax showing two pulmonary AVM, anterior one being larger and posterior one being smaller.


Numerous telangiectatic vessels over lips and tongue.


Bleeding spots along with telangiectasia over nasal mucosa.


Family tree of first-degree relatives of patient.


Abdominal CT demonstrating a large, heterogenous para-aortic mass (5x2 cm) with attenuation score of 35 HU between the celiac and superior mesenteric artery.


Renal arteriography showed stenosis (> 70%) of the left renal artery.


Histology of the biopsied specimen revealing characteristic organoid or zellballen nest of cells.


TAMA. HE and immunostaining of the skin.


Oral mucosa. Samples in magnification.


Chest X-ray showing massive left side pleural effusion and right upper zone nodular opacity (small air pocket in left apex is due to previous aspiration).


Cytological examination of the pleural fluid showing numerous atypical plasma cells with binucleate forms and plasmablasts.


(a) Computed tomography scan of the chest with contrast showing bilateral effusion with pleural infiltration, right upper lobe involvement, soft tissue lesion in the posterior mediastinum.


(b) Computed tomography scan of the abdomen showing lytic lesions in pelvis and sacrum.


Bone marrow biopsy showing extensive replacement of marrow by sheets of atypical plasma cells, with binucleate and plasmablasts.


Pelvic CT scan with contrast. T = tumor, B = bladder, R = rectum, C = per-urethral catheter. Arrows indicate left and right ureter.


Evolution of neuroendocrine markers.


Panoramic radiograph showing well defined periradicular radiolucency.


The 12-lead electrocardiogram of the patient upon admission to the intensive care unit. Sinus rhythm, low-voltage R-wave, and intraventricular conduction disturbance in all leads were seen.


Microscopic examination from the endomyocardial biopsy of the right ventricle. Characteristic infiltrations of multinucleated giant cells in the myocardium (open circle) were seen.


The change in the hemodynamic status around the onset of the atrioventricular block. HR heart rate, ABP arterial blood pressure, PAP pulmonary artery pressure, P
E
tCO
2 end-tidal carbon dioxide tension, PaCO
2 arterial carbon dioxide tension, SvO
2 mixed venous oxygenation saturation, PCPS percutaneous cardiopulmonary support, CO cardiac output. (1) The onset of the complete atrioventricular block. (2) The start of the ventricular pacing. After the onset of the complete atrioventricular block, the decrease of BP and the increase of PAP and PaCO2 continued until the point when the blood flow and the gas flow of the PCPS were augmented. The hemodynamics of the patient improved along with the recovery of the ventricular contraction by the ventricular pacing.


(a) The growth over the left tonsil.


(b) CT scan shows the growth on the left tonsil.


T-cell receptor V beta gene repertoire analysis. Naive, effector, and memory CTLs are shown in the upper, middle, and lower panels, respectively. Peripheral blood mononuclear cells were analyzed by flow cytometry using the Beta Mark TCR Vbeta repertoire kit (Beckman Coulter, Tokyo, Japan) according to the manufacturer's instructions. Naive CTLs were defined as the CD8+CD27+CD45RA+ population, effector CTLs were defined as the CD8+CD27-CD45RA+ population, and memory CTLs were defined as the CD8+CD45RA- population. Vb, V beta; Mo, months after starting dasatinib.


Head computed tomography (CT) scan revealing a large left extra-axial cystic lesion that was being monitored before current symptomatology.


Head computed tomography (CT) scan showed the pre-existing cystic lesion in the left cerebellopontine angle with a slight right brainstem deviation, without associated edema (
2A), as confirmed by magnetic resonance imagining (MRI) (
2B).


Bronchial arterial angiography shows the absence of bleeding event.


Chest X-ray. (A) The chest X-ray shows total atelectasis of left lung after concluding the embolization of bilateral bronchial artery. There was no evidence of active bleeding, but blood clot was detected and removed using bronchoscope.


Chest X-ray. (B) After the removal of blood clot, an improvement in lung collapse was observed.


Preoperative axial.


Coronal.


Sagittal. MRI scans showing a heterogeneous T1 contrast enhancing lesion involving the right Meckel's cave and the lateral wall of the cavernous sinus corresponding in the histopathological analysis to an Epstein-Barr-virus-associated B-cell lymphomatoid granulomatosis.


LYG lesion was isointense in native T1.


Medical image.


CISS. Sequences.


Showed no diffusion restriction. In preoperative MRI scans.


Axial contrast enhanced T1-weighted MRI immediately postoperative confirmed a successful removal of the lesion.


There was no evidence of LYG relapse. 6 months after surgery.


Histological tissue sections showing transmural vascular infiltration of lymphocytes,. Epithelioid cells.


Histiocytes. Characteristic of LYG.


A largxe adrenal medullary mass. (a) Mass on upper pole of kidney.


A largxe adrenal medullary mass. (b) Cut section: Grayish yellow hemorrhagic mass compressing adrenal cortex superiorly and kidney lie on the either sides.


Photomicrograph (a) zellballen nest pattern of tumor cells with hemorrhage and cystic change. X100) (b) bizarrely pleomorphic tumor cells with prominent nucleoli, and ,intranuclear inclusions, and . Amphophilic granular cytoplasm. X400).


Intraoral swelling - facial view.


Intraoral swelling - occlusal view.


OPG showing no evidence of bone involvement.


Occlusal radiograph showing no evidence of bone involvement.


Histopathological view of lesion (hematoxylin and eosin X40).


Histopathological view of lesion (hematoxylin and eosin X200).


Excised specimen.


Intraoral view after excision with sutures.


Positron emission tomography/computerized tomography sagittal scan showing a big hypermetabolic uterine mass (yellow arrow) with maximum standardized uptake value 16.2 g/ml bw.


High resolution sonography (10MHz) of the testicle showing the classical striated pattern.


Color Doppler study showing increased vascularity of the lesion.


CT chest with contrast showing bilateral pulmonary opacities.


CT abdomen and pelvis showing bowel wall thickening.


Gastric biopsy showing small lymphocytic infiltration with glandular involvement in the H&E stain.


Transbronchial biopsy specimen showing lymphocytic Infiltration on H&E staining.


Biopsy of soft tissue lesions. . Notes:. ALK staining, original magnification: x200.


Biopsy of soft tissue lesions. CD30 staining, original magnification: x200. . Abbreviations: ALK, anaplastic lymphoma kinase; CD, cluster of differentiation.


Post-vaccination platelet count.


Montage image of the left retina shows optic disc pallor (arrowhead). Extensive superficial retinal hemorrhages are seen (arrows) and the retinal veins are dilated and tortuous consistent with central retinal vein occlusion. Few cotton wool spots are seen superotemporal to the optic disc (asterisk). Macular edema can also be made out.


Histopathological examination with dense aggregates of inflammatory cells comprising predominantly of plasma cells (H&E, 40x).


Microscopic findings for the biopsied specimen before the chemotherapy regimen was chosen. T cell/histiocyte-rich large B cell lymphoma.


Picture of the local injection site.


PET/CT imaging after CAR-T cell infusion. The lesion is significantly smaller than before. The position indicated by the arrow is the location of the lesion.