MRI of the brain after the lesionectomy. (C) Twelve months after onset of EPC, T1 postcontrast sequence shows no contrast enhancement around the area of encephalomalacia.


MRI of the brain after the lesionectomy. (D) Two years after onset of EPC, T2 FLAIR sequence shows stable postsurgical changes. In addition, no asymmetric brain volume loss was noted.


CT scan performed in February 2012, revealed a retroperitoneal mass.


Low-debit hemorrhage on the upper portion of the lesser curvature documented by endoscopy on November 27, 2012 between the endoscopic treatments.


HP identification (red circle) on gastric biopsy on December 7, 2012. Modified Giemsa staining. x900.


Documentation of radiotherapy response between by comparing the 18F-FDG PET-CT scans from October 2012 (left panel) and July 2013 (right panel).


Hyperechoic lumpy mass detected on transthoracic echocardiography. . Note: Apical four chamber view showing the mass in the left atrium (orange arrow).


Timeline of interventions and outcomes. . Abbreviations: ABP, arterial blood pressure; CPB, cardiopulmonary bypass; CVP, central venous pressure; CXR, chest X-ray; DOS, day of surgery; ECG, electrocardiogram; ICU, intensive care unit; PASP, pulmonary arterial systolic pressure; PEEP, positive end expiratory pressure; POD, postoperative day; TTE, transthoracic echocardiography; SpO2, pulse oximetry.


(A) Fundoscopy revealed vitreous haziness and opacity.


(B) Slit lamp exam revealed a nodular, depigmented, mass-like appearance of the iris (black arrow) and a pinkish lump in the iris (white arrow).


(A) This photograph demonstrates multiple erythematous and violaceous, well-defined, coin-sized plaques and nodules in the lower limbs.


(B) The neoplastic infiltrate was composed of small- to medium-sized pleomorphic lymphocytes with irregular nuclei, inconspicuous nucleoli, and scant cytoplasm.


(C) Immunotype was CD56.


(D) Immunotype was CD3.


(A) Vitreous opacity resolved after radiotherapy at 900 cGy.


(B) The iris masses resolved after radiotherapy at 900 cGy.


Autopsy findings. (A) Crescentic necrotizing glomerulonephritis. , x 400.


Autopsy findings. (B) Alveolar hemorrhage with neutrophil infiltration. , x200.


Autopsy findings. (C, D) DVT: neutrophils were abundant in the thrombus. Original magnification: x40.


Autopsy findings. (C, D) DVT: neutrophils were abundant in the thrombus. , x 400.


Autopsy findings. (E-G) NETs in the glomerulus. Blue: DNA stained by DAPI. Red: MPO. NETs were present in the crescent. , x 400.


Autopsy findings. (H-J) NETs in the thrombus. The detection of NETs was performed similar to the renal specimens. , x 400.


Low magnification showing a diffuse infiltration of atypical lymphoid cells in the thyroid gland (haematoxylin & eosin stain, x50).


CT showing a large heterogeneous mass of the thyroid gland.


(a) Photomicrograph of normocellular bone marrow trephine biopsy (H and E, x40). (b) Numerous histiocytes replacing the other normal bone marrow cell constituents (H and E, x100).


Photomicrographs of immunohistochemistry revealing (a) Positive cytoplasmic immunoexpression of CD68 in histiocytes (CD68, x200).


(b) CD1a-negative histiocytes (CD1a, x200).


(c) Negative immunoexpression of histiocytes for S100 (S100, x200).


(d) CD3 immunopositive expression of the lymphocytes (CD3, x200).


(a) Periodic acid-Schiff stain negative histiocytes (PAS, x200).


(b) Perl's Prussian blue staining showing unstained brown pigment in the histiocytes (Perl's stain, x200).


(a) Schizont of P. Vivax (encircled) on peripheral blood smear examination (Leishman stain, x200). (b) Bleaching of the brown-colored pigment in the histiocytes with the alcoholic ammonium hydroxide (H and E, x200).


T1-weighted sagittal image of a 2-year-old girl. Note the hypoplastic pons and cerebellum with normal appearance of the corpus callosum.


Arterial phase computed tomography. The tumor showed no clear enhancement in this phase.


Venous phase computed tomography. The tumor showed marginal uneven enhancement in this phase.


Tumor was composed of small, elongated cords or tubules, in a tightly packed arrangement (hematoxylin and eosin; magnification, x10).


Myxoid stroma was interspersed among the tubular cells (hematoxylin and eosin; magnification, x40).


Tumor cells were smaller and cube-shaped or oval, with single small eosinophilic nucleoli and low-grade nuclei (hematoxylin and eosin; magnification, x40).


Myxoid stromal staining by acidic mucus (alcian blue; magnification, x40).


CK7 showed positive expression in tumoral cells (magnification, x20).


EMA showed positive expression in tumoral cells (magnification, x10).


Both the fetuses A and C were thin and pale while the fetus B was heavy and red.


(A) The umbilical cord of recipient's (a) was dark while that of donor's (b and c) were pale. The hatched lines indicated relatively symmetrical triplet placenta portions of the single placental disc.


(B) There were two types of anastomosis in MC placenta: the superficial AAA (red arrow) and deep AVA (black arrow).


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


Healthy donor) blood CD8- TCRgammadelta- T-cells, monocytes, and dendritic cells (B). Panel (B) shows CD4 surface membrane expression levels for CD8- TCRgammadelta- T-cells, monocytes, and dendritic cells for the different anti-CD4 antibody clones tested in the patient (black histogram) compared to a representative healthy donor (gray histogram) and an isotype control (red dash line), and the staining for a negative population (CD8+ T-cells) in the patient (green line) and the healthy control (blue line). DCs, dendritic cells.


Treatment management and evolution of the platelet count and the lactate dehydrogenase level from diagnosis and day 90. The patient gave her written consent for publication of the case report.


Multiple nodular opacities are present bilaterally in lungs.


Section A shows dense, monotonous population of centrocyte-like cells while part B demonstrates positivity for CD 21.


Section A shows mono-morphos small cell lymphoid infiltrate with slightly irregular nuclear contours and moderate pale cytoplasm (centrocyte-like morphology) infiltrating the lamina propria with focal infiltration of the epithelial structures while section B demonstrates CD20 diffusely positive in a monotonous population of B-cells.


Computed tomography scan abdomen showing splenic and renal infarcts.


Large vegetations on tricuspid valve noted during surgery.


T1-weighted MRI scans with contrasts showing. Axial.


Coronal.


Sagittal images of the lesion.


Immunohistochemical stains of the biopsied tissue. CD68.


Immunohistochemical stains of the biopsied tissue. S100.


Immunohistochemical stains of the biopsied tissue. CD1a+ stains (original magnification, x100).


Electron micrograph of the biopsied tissue. Electron micrograph was of compromised quality as the thin sections were recovered from fixed paraffin embedded tissue. Membrane bound electron lucent vesicles suggestive of a component of Birbeck granules are seen within the histiocytes. The typical cross-striated rod domain is not as evident.


(a and b) Extraoral examination of left mandibular swelling that was firm to hard diffuse soft tissue swelling extending anteroposteriorly from midline to the left angle of the mandible and inferiorly extended 2 cm below the inferior border of the mandible.


(c) Intraoral view showing the unilateral (left) involvement of the lesion.


(a) Cone beam computed tomography reconstructed panoramic image showing diffuse radiolucency in the left body of mandible extending superiorly to the alveolar crest and inferiorly to lower border; anteriorly to apex of 33 and posteriorly till the region of 36.


(b) Cone beam computed tomography coronal section showing radiolucent lesion in the left body of mandible extending through buccal and lingual cortex, minimal mucosal thickening of the right and left maxillary sinus floor is seen.


(c) Cone beam computed tomography sagittal section revealed radiolucency extending from 33 to 38 with erosion of the mandibular nerve canal.


(d) Cone beam computed tomography axial section showing asymmetry on left side with loss of buccal and lingual cortical plates and no evidence of expansion of the cortical plates.


(a) Gross surgical specimen showing the erosion and perforation of the buccal and lingual cortical plates. Cut surface of the tumor showing lingual invasion below the inferior border of mandible.


(b): Photomicrograph showing presence of mixture of spindle- and round-shaped cells arranged in fascicles separated from normal epithelium by grenz zone (H&E stain, x40).


(c) Photomicrograph showing tumor cells infiltrating the bone (H&E stain x40).


(d): Photomicrograph showing round to spindle shaped tumor cells with hyperchromatic nuclei (H&E stain, x400).


Round- and spindle-shaped tumor cells showing negativity for (a) desmin (IHC stain, x400); (b) smooth muscle actin (internal positive control; vessel wall) (IHC stain, x400); (c) S-100 (internal positive control; nerve) (IHC stain, x400), (d) CD1a (IHC stain, x400). The cells were positive for (e); leukocyte common antigen (lymphoid lineage marker) (IHC stain, x200); and (f) CD20 (B-cell marker) (IHC stain, x200).


Computed tomography appearance at the time of initial development of encephalopathic changes.


Three dimensional reconstruction of coronal T2 sequences obtained with magnetic resonance imaging revealing the extensively confluent subcortical white matter signal hyper-intense change.


A) Axial T2 weighted image reveals extensive confluent hyper-intense signal abnormality throughout the subcortical white matter with no obvious signal change within the cortex.


The white box within the left semi-centrum ovale subcortical white matter represents the voxel used for generating magnetic resonance spectroscopy, shown in figure two; B) magnetic resonance spectroscopy of the subcortical white matter revealing an abnormally high peak for creatinine and choline downstream and to the left of the main central NAA peak with a small yet abnormal presence of a lactic acid peak upstream from the NAA peak.


MRI findings of CM in our patients. Abnormally enlarged perivascular spaces in the basal ganglia bilaterally (white arrows) in Axial T2-weighted images (WI).


MRI findings of CM in our patients. Choroid plexus (white arrows) at the admission in Axial gadolinium-enhanced T1-WI.


MRI findings of CM in our patients. Bilateral choroid plexitis (white arrows) after ten days of antifungal therapy, in Axial gadolinium-enhanced T1-WI.


MRI findings of CM in our patients. (D) Absence of choroid plexitis after steroids therapy in Axial enhanced T1-WI.


Clinical course of the patient. . Abbreviations: HD, high dose; DEX, dexamethsone; Cy, cyclophosphamide; FLC, free light chain; IgG, Immunoglobulin G.


Platelet count evolution of patient 1.


Platelet count evolution of patient 2.


A known case of acute T cell lymphoblastic leukemia on treatment underwent allographtic stem cell transplantation. His hemogram was as follows: Hemoglobin 10.2 g/dL, red blood cell 2.22 10^6/uL (N 4.50-6.50), white blood cells=200/cmm (N 4000-10000) Neutrophils 21.6% Lymphocytes 47.4%, Monocytes 30.6%, Eosinophils 0.4%, Basophils 0%. He was on steroid therapy. He presented with pain in the shoulders bilaterally. Bone scan revealed diffuse uptake of radiotracer in the head of shoulder bilaterally suggesting osteonecrosis.


A 67-year-old known case of chronic myeloid leukemia had backache. Plain radiograph was normal. Bone scan revealed D12 vertebra showed linear uptake suggesting osteoporotic collapse. Whole body study revealed diffuse increased tracer localization in the axial and appendicular skeleton. Hyperactive bone marrow was probably responsible for such a pattern that simulated metabolic bone disease. Please note diminished tracer localization in the kidneys.


Right pleural effusion with associated basilar atelctasis.


Moderate right pleural effusion.


Kidney function during hospitalization. This graph demonstrates the progressive rise in BUN and creatinine during hospitalization until a peak of 10.2 where hemodialysis was started.


LM - macrophage infiltration.


EM - subendothelial deposits.


IF - FIBRIN.


IF - IgG.


Axial.


Coronal T1-contrast. Image shows contrast enhancement dural-based tumor with cystic component size 7 x 5 cm resulting in midline shift of approximately 1.6 cm and third ventricular obliteration.


Axial T2 image showing hypointense cystic component (c).


Microscopic examination revealed the proliferation of neoplastic meningothelial cells with pale eosinophilic cytoplasm forming solid nests, associated with a dense chronic inflammatory infiltrate rich in lymphocytes and some plasma cells (a) (H&E, x20).


Both tumor cells and lymphocytes are positive with vimentin (b) (x20).


Negative glial fibrillary acidic protein in tumor cells excludes the diagnosis of glioma with xanthomatous changes (c) (x40).


CD3 staining in lymphocytes dispersed between tumor cells (d) (x20).


Immediate postoperative computed tomography scan showing total removal of tumor with some certain extent of midline shift (a).


Magnetic resonance imaging axial T1-contrast scan 6 months after operation showing no recurrence (b).


Abdominal Computed Tomography scan image of the patient with HPRC: The abdomen CT scan with contrast of the patient showing a well defined homogeneous hypodense mass of 1.3x1.9 cm in the right kidney.


H&E histological slide of the patient's papillary renal cell carcinoma, Fuhrman grade III: Low powered magnification (50X) showing characteristic papillary architecture. Non neoplasticrenal parenchyma is seen on left (A).


H&E histological slide of the patient's papillary renal cell carcinoma, Fuhrman grade III: Low powered magnification (50X) showing characteristic papillary architecture. Occasional papillary structures demonstrate typical foamy histiocytes in fibrovascular cores upper left portion (100X) (B).


H&E histological slide of the patient's papillary renal cell carcinoma, Fuhrman grade III: Low powered magnification (50X) showing characteristic papillary architecture. High power magnification showing neoplastic papillary structures lined by eosinophilic cuboidal epithelial cells with ovoid nuclei and conspicuous nucleoli (400X) (C).


Clinical course of our patient. Anti-FVIII, anti-FVIII activity; aPTT, activated partial thromboplastin time; CS, corticosteroids; FVIII, coagulation factor VIII; Ig, immunoglobulin; RTX, rituximab.


Representative images of the axillary lymph node biopsy histological examination. (A) Lymph node showing reactive follicular hyperplasia. The reactive follicle comprises germinal center surrounded by a thin mantle zone. The interfollicular area contains numbers of mature plasma cells. Hematoxylin and Eosin staining x400.


Representative images of the axillary lymph node biopsy histological examination. (B) Lymph node showing reactive follicular hyperplasia and mature plasma cells. CD79a staining.


Representative images of the axillary lymph node biopsy histological examination. IgG.


Representative images of the axillary lymph node biopsy histological examination. IgG4. Staining. Numerous IgG4+ cells are present between follicles. The IgG4+/IgG+ cell proportion is over 40%, with more than 200 IgG4+ cells per high power field.


CT images showing the giant suprarenal lesion abutting the spleen but with no invasion of the kidney or the renal vein.


Cut specimen of the excised lesion showing areas of scattered hemorrhages.


Histopathology revealing characteristic zellballen nests of cells separated by fibro vascular stroma.


Postoperative images. Axial postcontrast T1WI (a and b) showing subtotal removal of the intraventricular mass lesions.


Coronal noncontrast magnetic resonance imaging (MRI) shows a homogeneous soft tissue abnormality occupying the sella and sphenoid sinus.


Coronal contrast magnetic resonance imaging (MRI) shows homogeneous enhancing soft tissue abnormality occupying the sella and sphenoid sinus.


Sagittal magnetic resonance imaging (MRI) with contrast; large homogeneous mass occupying the sella turcica, sphenoid sinus, and prepontine cistern; the infundibulum is minimally deviated to the right and normal pituitary appears to be elevated and is seen underneath the optic chiasm.


Coronal.


Sagittal. Magnetic resonance imaging (MRI) noncontrast showing transsphenoid resection of the majority of the large sellar/suprasellar mass.


Sagittal contrast enhanced magnetic resonance imaging (MRI) shows resection of the majority of the sellar/suprasellar mass with thickening and nodular enhancement along the clivus. (a) Recurrence of the mass.


Sagittal contrast enhanced magnetic resonance imaging (MRI) shows resection of the majority of the sellar/suprasellar mass with thickening and nodular enhancement along the clivus. After repeat endoscopic resection of the lesion (b).


Computed tomography scan of the abdomen/pelvis showing cecal mass.


Enlarged prostate The scan shows a prostatic space-occupying lesion with unclear rectal boundaries and an absence of the bladder seminal vesicle angle.


Trend of lab values over time in a patient with diabetic retinopathy treated with bevacizumab and subsequent thrombotic microangiopathy. Bev, bevacizumab; Cr, creatinine; dl, deciliter; eGFR, estimated glomerular filtration rate; mg, milligram; ml, milliliter; min, minute.


Biopsy findings in patient 1 with diabetic retinopathy and nephropathy treated with bevacizumab and subsequent thrombotic microangiopathy. (A) One glomerulus showed segmental luminal obliteration by insudates and lipid, with adherence to Bowman's capsule consistent with segmental glomerulosclerosis (arrowhead, methylene blue stain, 400x).


Biopsy findings in patient 1 with diabetic retinopathy and nephropathy treated with bevacizumab and subsequent thrombotic microangiopathy. (B) Few glomeruli demonstrated segmental duplication of glomerular basement membranes (arrowhead, Jones methenamine silver stain, 400x).


Biopsy findings in patient 1 with diabetic retinopathy and nephropathy treated with bevacizumab and subsequent thrombotic microangiopathy. (C) Ultrastructural analysis revealed segmental subendothelial electron lucent widening, with very early duplication of basement membrane material (arrowheads, 20,000x). The light and ultrastructural findings were consistent with chronic thrombotic microangiopathy.


Biopsy findings in patient 2 with diabetic retinopathy and nephropathy treated with bevacizumab and subsequent thrombotic microangiopathy. (A) Immunofluorescence microscopy revealed scattered arterioles which displayed strong amorphous intraluminal and vessel wall staining for fibrinogen (400x).


Biopsy findings in patient 2 with diabetic retinopathy and nephropathy treated with bevacizumab and subsequent thrombotic microangiopathy. (B) Examination of hematoxylin-eosin (H&E)-stained sections from the frozen tissue demonstrated that the fibrin staining corresponded with changes of arteriopathy, including mucoid intimal thickening (arrowhead) and considerable luminal narrowing, consistent with acute thrombotic microangiopathy (400x).


Biopsy findings in patient 2 with diabetic retinopathy and nephropathy treated with bevacizumab and subsequent thrombotic microangiopathy. (C) Glomeruli showed changes of diffuse and nodular diabetic glomerulosclerosis (600x).


Biopsy findings in patient 2 with diabetic retinopathy and nephropathy treated with bevacizumab and subsequent thrombotic microangiopathy. (D) Ultrastructural analysis revealed glomerular basement membranes which showed prominent subendothelial electron lucent widening with accumulation of flocculent debris (20,000x). Overall, the findings were consistent with acute thrombotic microangiopathy.


Biopsy findings showing arteriopathy and chronic thrombotic microangiopathy in patient 3. (A) There is severe arterial sclerosis, associated with focal global glomerulosclerosis, periodic acid-Schiff (PAS) stain, 200x.


Biopsy findings showing arteriopathy and chronic thrombotic microangiopathy in patient 3. (B) Non-sclerosed glomeruli reveal irregular thickening and segmental remodeling of the capillary loops, with occasional double contours (yellow arrowheads), PAS stain, 400x.


Biopsy findings showing arteriopathy and chronic thrombotic microangiopathy in patient 3. (C) There is dull reactivity for fibrin along the glomerular capillary walls on immunofluorescence microscopy, fluorescein isothiocyanate (FITC) stain, 200x.


Biopsy findings showing arteriopathy and chronic thrombotic microangiopathy in patient 3. (D) On electron microscopy, glomerular capillary walls reveal subendothelial widening by electron lucent material (red arrowhead), 10,000x.


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


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


Case 2. A; FISH analysis on metaphase and interphase with an LSI ETV6/RUNX1 ES Dual Color Translocation Probe Set (Vysis).


Case 2. B; SNP array revealed the highest level of amplification located within the RUNX1 locus.


Sheets of polygonal intermediate trophoblasts are seen in a background of fibrin deposition (x400).


Colonic mucosal inflammation on colonoscopy of the patient.


Oocysts of Cryptosporidium parvum in modified Kinyoun acid-fast stain.


Axial MRI (a) of the brain demonstrates an enhancing lesion in the sella turcica and suprasellar space with extension to the left side of the sella and along the tentorium.


Coronal.


Sagittal. Gd-enhanced T1-weighted images demonstrate the lesion extending into the suprasellar space abutting the optic chiasm. The mass extends into the cavernous sinuses bilaterally with encasement of the bilateral cavernous carotid arteries. It also extends inferiorly on the left side into Meckel's cave.


Photomicrographs of tumor sections with H&E staining a; Monotonous lymphoid cells, which have irregular hyperchromatic nuclei with irregular nuclear contours, displace nests of pituitary cells.


Immunohistochemical staining with CD20 b; The tumor cells stained positive for immunohistochemical staining with CD20, demonstrating that they are a clonal proliferation of B cells.


Follow-up axial and coronal MR imaging at 3 months.


6 months. Post-surgery, chemotherapy, and radiation therapy demonstrate decreased size of the sellar mass, suggesting response to the treatment regimen.


Periodic acid-Schiff staining of bone marrow aspirate from the 3 patients at the time of admission. Patient 1 had acute myeloid leukemia.


Periodic acid-Schiff staining of bone marrow aspirate from the 3 patients at the time of admission. Patient 2 had chronic myeloid leukemia.


Periodic acid-Schiff staining of bone marrow aspirate from the 3 patients at the time of admission. Patient 3 had acute myeloid leukemia.


Periodic acid-Schiff staining of bone marrow aspirate from the 3 patients at the time of admission. (D) Patient 3 experienced complete remission after the chemotherapy.


Neuroimaging findings for Patient 1. (A) Chronic subdural hematoma (red arrows) was detected in the bilateral frontotemporal lobes after head trauma.


Neuroimaging findings for Patient 1. (B) After 4 weeks of atorvastatin treatment, the left-side hematoma was slightly absorbed.


Neuroimaging findings for Patient 1. (C, D) Absorption of the hematoma after 8 weeks and 12 weeks of conservative treatment using atorvastatin plus low-dose dexamethasone.


Neuroimaging findings for Patient 2. (A) A 72-year-old man with chronic myeloid leukemia was diagnosed as having right frontotemporal chronic subdural hematoma (red arrow).


Neuroimaging findings for Patient 2. (B) The hematoma was significantly absorbed after 2 weeks of conservative treatment.


Neuroimaging findings for Patient 2. (C) New bleeding in the subdural space was detected via magnetic resonance imaging at the 4-week follow-up.


Neuroimaging findings for Patient 2. Obvious absorption was observed after 10 weeks.


Neuroimaging findings for Patient 2. Near disappearance was observed after 20 weeks of conservative treatment.


Neuroimaging findings for Patient 3. (A) Computed tomography revealed bilateral chronic subdural hematoma (red arrows).


Neuroimaging findings for Patient 3. (B) After 2 weeks of atorvastatin treatment plus low-dose dexamethasone, magnetic resonance imaging revealed an increase in the hematoma, with significant enhancement of the dura mater (green arrows) post-injection of contrast agent.


Neuroimaging findings for Patient 3. (C, D) After chemotherapy, subdural mass was significantly absorbed in 8-14 weeks.


Neuroimaging findings for Patient 3. (E) A 5 months follow-up MRI exhibited no hematoma in the subdural space.


Conal T-cell receptor (TCR) rearrangement of blast cells. Clonal gene rearrangement was observed in TCR beta VJII . In panel (A), the arrow indicates the monoclonal peak of TCR beta VJII.


Conal T-cell receptor (TCR) rearrangement of blast cells. TCR delta VD/DD/DJ. Fragments. In Panel (B), the arrow indicates the monoclonal peak of TCR delta VD/DD/DJ.


Left) Photomicrograph of the lymph node revealing necrotic lymphatic filled with coiled adult worms of microfilaria (H&E, x100); Right) Peripheral blood smear showing Wuchereria bancrofti (microfilarial) worm (Leishman stain, x200).


MRI of the face with contrast medium revealed the presence of an 8.3 x 4.8-cm heterogeneous mass lesion involving both nasal airways with obstruction and destruction of the nasal septum. There is extension into the underlying hard palate and into the left ethmoid, sphenoid, left maxillary sinuses, soft palate and uvula.


Sections demonstrate a dense, diffuse, pandermal proliferation of atypical lymphoid cells with eosinophilic cytoplasm, hyperchromatic nuclei, irregular nuclear membranes and inconspicuous nucleoli. Extensive apoptosis, prominent angiocentricity, focal epidermotropism and dermal necrosis are noted. The tumor cells were strongly immunoreactive for TIA-1, granzyme, CD8, CD2, CD56 and cytoplasmic CD3. A few cells were immunoreactive for CD5 and CD4. EBER in situ hybridization was positive in the majority of the neoplastic cells. The cells were negative for CD57. The findings are consistent with ENKL of the nasal type.


A 3 x 3-cm, erythematous, violaceous, well-circumscribed nodular lesion on the left thigh.


(a) Preparation of natural tooth pontic.


(b) Etching of pontic with 37% phosphoric acid.


(c) Splinting of natural tooth pontic to abutment tooth by composite resin.


(a) Postoperative clinical view after 1 year.


(b) Postoperative radiographic view after 1 year.


(a) Ultrasonography abdomen showing omental caking and peritoneal thickening.


(b) Computed tomography image revealing ascites, hepatosplenomegaly, and thickened peritoneum.


(c) Contrast-enhanced computed tomography image shows ascites, bilateral pleural, and mild pericardial effusion.


(a) Cellular smear showing numerous myeloid cells in various stages of maturation, occasional group of erythroid cells (red arrow), and scattered megakaryocytes (Giemsa, x200). (b) Large multinucleated and multilobulated megakaryocytes (Pap, x400). (c) Cell block section revealing scattered megakaryocytes along with numerous myeloid series cells (H and E, x200). (d) Bone marrow biopsy shows markedly hypocellular marrow with diffuse fibrosis of marrow spaces (H and E, x200). Inset shows megakaryocytes. (e) Fibrotic areas show increase in reticulin with extensive intersection (reticulin, x200). (f) Masson's trichrome stain showing diffuse blue-stained coarse bundles of collagen (MT, x200).


Hyperechoic area 1.3 cm x 1.2 cm with hypoechoic collection of 6 mm seen on starting hormone replacement therapy for the first time.


Hypoechoic collection occured each time on starting hormone replacement therapy.


Hysteroscopy showed normal study.


Clinical presentation of VZV disease in GATA2-haploinsufficient patient (A) An erytematous, vesicular skin rash on the back of patient 1 with GATA2-haploinsufficiency, 4 days after the onset of VZV disease.


(B) Targetoid lesions on the left arm of the same patient, 7 days after the onset of illness.


(C) A chest X-ray 8 days after the onset of illness, showing diffuse alveolar involvement with a miliary pattern of pulmonary opacities.


(D) Histograms showing perforin expression in CD56+CD16+ lymphocytes from patient 1 (gray), patient 2 (black), an individual with heterozygous A91V PRF1 mutation (green), a healthy control (blue) and isotype control (red dotted line) as assessed by intracellular flow cytometry.


Bilateral longitudinal leukonychia affecting several nail plates.


Normal nail plates after treatment.


Acne and facial hair.


Enlarged penis with scant pubic hair. In a 6-year-old boy, showing signs of precocious pseudo-puberty as shown on both cases.


Advanced bone age of Case 2 (C).


Ultrasound of the testicles of Case 1.


Case 2.


Macroscopic anatomy findings of the left testis from the patient of Case 1.


Case 2 Note a well circumscribed yellowish-brownish mass inside the testis.


Evolution of bone marrow histology from 1994 to 2019. In 1994, MPN in chronic phase with ET morphology: normocellular bone marrow with enlarged megakaryocytes with hyperlobulated nuclei.


Evolution of bone marrow histology from 1994 to 2019. , reactive for CALR immunostaining.


Evolution of bone marrow histology from 1994 to 2019. In 2016, progression to fibrotic phase as post-ET Myelofibrosis: hypercellular bone marrow with dense clusters of atypical megakaryocytes.


Evolution of bone marrow histology from 1994 to 2019. , reactive for CARL immunostaining.


Evolution of bone marrow histology from 1994 to 2019. In 2019, APL-blast crisis with hypergranulated promyelocytes.


Evolution of bone marrow histology from 1994 to 2019. , staining positive for CALR together with a megakaryocyte.


(A) Patchy mucosal erythema, edema and loss of vascular pattern of the descending colon.


(B) Granularity of the ascending colon with post-inflammatory polyps.


Brain biopsy neuropathology. (A) Biopsy appeared hypercellular, with a dense macrophage infiltrate.


Brain biopsy neuropathology. (B) Infiltrating population was confirmed as macrophages by immunohistochemistry to CD68.


Brain biopsy neuropathology. (C) Luxol fast blue stain demonstrating virtually total myelin loss.


Brain biopsy neuropathology. (D) Immunohistochemistry demonstrated relative preservation of axons; these were separated by infiltrating macrophages, and show irregularity, representing damage.


Brain biopsy neuropathology. (E) Immunohistochemistry to GFAP showing reactive astrocytes.


Brain biopsy neuropathology. (F) Immunohistochemistry to CD3 demonstrated sparse T cells (arrow).


Brain biopsy neuropathology. (G) A few CD79a-positive B cells were also present. Magnifications as shown on scale bars.


(A) (Above, left). Glomerular basement membrane irregular thickening and segmental spikelike projections were observed by periodic acid-silver methenamine staining.


(B) (Above, middle). Granular fuchsinophilic protein was found to be subepithelial using Masson's trichrome staining.


(C) (Above, right). Electron micrograph demonstrating a few electron-dense deposits in the subepithelial basement membrane and fusions of most foot processes.


Depositions of IgG. (below, left).


C3. (below, middle) are shown by immunofluorescence microscopy.


(F) (Below, right). PLA2R1 is negative.


Endoscopic findings in a 77-year-old woman with dysphagia. (A) Upper gastrointestinal endoscopy showed a large, rounded mass with smooth normal overlying mucosa, which is seen extending longitudinally along the lower esophagus, 30-34 cm from the incisor teeth.


Endoscopic findings in a 77-year-old woman with dysphagia. (B) EUS shows a well-demarcated, hypoechoic mass in the esophagus wall, clearly margined from the surrounding adventitia.


Chest contrast-enhanced computed tomography at diagnosis. (Coronal plane).


Chest contrast-enhanced computed tomography at diagnosis. (Sagittal plane) CT scan revealed a well-defined homogeneous soft tissue mass at the lower esophagus (red arrow).


Images during endoscopic submucosal dissection. Endoscopic submucosal tunnel dissection is performed without any complication. (A) Initial incision of the mucosa after injection.


Images during endoscopic submucosal dissection. Endoscopic submucosal tunnel dissection is performed without any complication. (B) Exposure of the tumor.


Images during endoscopic submucosal dissection. Endoscopic submucosal tunnel dissection is performed without any complication. (C) The wound after ESD.


Images during endoscopic submucosal dissection. Endoscopic submucosal tunnel dissection is performed without any complication. (D) Complete closure of the mucosal incision site with endoclips.


Images during endoscopic submucosal dissection. Endoscopic submucosal tunnel dissection is performed without any complication. (E) On the external surface of the resected specimen.


Images during endoscopic submucosal dissection. Endoscopic submucosal tunnel dissection is performed without any complication. (F) On the cut surface of the resected specimen.


Pathological images of the resected specimen. (A) The histological section shows lymphoid hyperplasia in the lamina propria and submucosa (H&E stain, orig. Mag. X200).


Pathological images of the resected specimen. Immunohistochemistry revealed that the lymphoma cells are positive for CD20.


Pathological images of the resected specimen. CD19.


Pathological images of the resected specimen. PAX5.


Pathological images of the resected specimen. BCL2.


Pathological images of the resected specimen. Negative for CD3.


Pathological images of the resected specimen. CD5.


Pathological images of the resected specimen. CD10.


Pathological images of the resected specimen. Cyclin D1. (orig. Mag. X200).


CT scan 3d-reconstruction of the baseline tumor lesions. Coronal plane.


Sagittal plane). L1Vol1 = left thigh mass; L2Vol1 = lesion of the left dorsal muscles next to D11 vertebral body; L3Vol1 = lesion of the left dorsal muscles next to L5 vertebral body; L4Vol1 = lesion of the left gluteus muscles; L5Vol1 = lesion of the left iliopsoas.


Clinical presentation of the left thigh mass during patient's treatment history. Before chemotherapy (March 2019).


Clinical presentation of the left thigh mass during patient's treatment history. After second cycle of chemotherapy, and ,before crizotinib (April 2019).


Clinical presentation of the left thigh mass during patient's treatment history. After 7 days of crizotinib.


Clinical presentation of the left thigh mass during patient's treatment history. After 3 months of therapy (August 2019).


Clinical presentation of the left thigh mass during patient's treatment history. After 7 months of therapy (December 2019).


Complete regression of multifocal local recurrence in the left thigh. (A) Post-contrast MR T1 fat saturated axial image of upper left thigh shows some irregular enhancing nodules in the anterior compartment (asterisk).


Complete regression of multifocal local recurrence in the left thigh. (B) The same sequence obtained three months later in the same area reveals complete nodules disappearance.


Contrast-enhanced computed tomography (CECT) of the abdomen at the time of admission. Axial view.


Coronal view showed multiple liver masses.


Three months after discontinuation of RA treatment, CECT of the abdomen demonstrated a remarkable regression of the liver masses.


MRI and enhanced MRI: coronary, lateral, sagittal axis. . Notes: MRI shows sheet-like bone destruction area in the left-sided radius, completely or partially discontinuous localized bone cortex, and adjacent soft tissue masses with low-signal intensity on T1-weighted images (A).


MRI and enhanced MRI: coronary, lateral, sagittal axis. T2-weighed images show heterogeneous high signal of. Coronary axis.


MRI and enhanced MRI: coronary, lateral, sagittal axis. Lateral axis.


MRI and enhanced MRI: coronary, lateral, sagittal axis. Enhanced scanning shows heterogeneous enhancement of. Coronary axis.


MRI and enhanced MRI: coronary, lateral, sagittal axis. Sagittal axis. . Abbreviation: MRI, magnetic resonance image.


Pathology and immunophenotyping of primary bone diffuse large B-cell lymphoma, non-GCB (x400). CD20.


Pathology and immunophenotyping of primary bone diffuse large B-cell lymphoma, non-GCB (x400). CD5.


Pathology and immunophenotyping of primary bone diffuse large B-cell lymphoma, non-GCB (x400). PAX-5.


Pathology and immunophenotyping of primary bone diffuse large B-cell lymphoma, non-GCB (x400). MUM-1.


Pathology and immunophenotyping of primary bone diffuse large B-cell lymphoma, non-GCB (x400). Ki67+. . Abbreviation: non-GCB, non-germinal center B-cell-like.


Case 1: 3-month-old male child presenting with symptoms of pallor, abdominal distension, petechial rashes, and recurrent respiratory infections later diagnosed with congenital leukemia. X-ray of dorsolumbar spine shows osteopenia with prominent vertebral end plates (arrows).


Case 1: 3-month-old male child presenting with symptoms of pallor, abdominal distension, petechial rashes, and recurrent respiratory infections later diagnosed with congenital leukemia. Ultrasound abdomen shows enlarged liver of 7.52 cm in craniocaudal span with diffuse and homogeneously increased echogenicity (arrow).


Case 1: 3-month-old male child presenting with symptoms of pallor, abdominal distension, petechial rashes, and recurrent respiratory infections later diagnosed with congenital leukemia. Magnetic resonance imaging (MRI) of the pelvis in coronal plane using short tau inversion recovery (STIR) sequence, shows increased marrow signal intensities in both iliac bones (R x L) (arrows).


Case 1: 3-month-old male child presenting with symptoms of pallor, abdominal distension, petechial rashes, and recurrent respiratory infections later diagnosed with congenital leukemia. Bone marrow aspirate from the iliac bone (Leishman stain, 40 x) shows numerous immature lymphoblasts (black arrows).


Case 2: 3-month-old male child presenting with symptoms of pallor, abdominal distension, and recurrent respiratory infections later diagnosed with osteopetrosis. Frontal radiograph of right femur shows diffuse increase in bone density with flared metaphysis (arrow). A; "Bone within a bone" appearance is also observed (curved arrow).


Case 2: 3-month-old male child presenting with symptoms of pallor, abdominal distension, and recurrent respiratory infections later diagnosed with osteopetrosis. Lateral radiograph of spine reveals sclerosis of vertebral bodies (curved arrow) with relative central lucency (arrows); a characteristic "sandwich vertebra" appearance.


Case 2: 3-month-old male child presenting with symptoms of pallor, abdominal distension, and recurrent respiratory infections later diagnosed with osteopetrosis. Frontal radiograph of skull shows increased bone density with prominent sclerosis of skull base (arrows).


Noncontrast brain CT: acute intraventricular hemorrhage in the right lateral ventricle with small hemorrhage in the atrium of the left ventricle. . Abbreviations: AH, anterior head; CT, computerized tomography; L, left; R, right.


Noncontrast T1-weighted brain MRI: image demonstrates hemorrhage originating from ependyma of right lateral ventricle. . Abbreviation: MRI, magnetic resonance imaging.


A; Hematoxylin and eosin staining of the renal allograft biopsy showing fibrin thrombi in glomerular capillary loops.


B; Jones methenamine silver staining of the renal allograft biopsy showing fibrin thrombi in glomerular capillary loops.


An ulcerative growth present in the alveolus of the right maxilla with the crown of 52 noted within the lesion.


Lesional cells stained positive for CD1a (Immunoperoxidase envision technique, original magnification x400).


Vitiligo with leukotrichia before the surgery.


Repigmentation at the end of 8 weeks following single-hair FUT.


(a). CT scan of the thorax with contrast. Enlarged lymph nodes in station 4R and 4 L.


(b). CT scan of the abdomen with contrast. Enlarged spleen and liver and a dilated portal vein are evident.


(a) An histiocyte containing amastigotes Papanicolaou, medium power.


(b) Cell block preparation: a lot of amastigotes in the cytoplasm of histiocytes and free outside cells. Giemsa, low power.


The masses as seen on an ultrasound of the abdomen.


Ultrasound of abdomen showing a liver mass.


Multiple masses on the wall and mesentery of small bowel.


Masses in the mesentery of the small bowel.


Characteristics of the 5,707 kb and 857 kb deletions of Xq25q26.3 and Xp22.33, respectively. (A). Results of cfDNA screening of the pregnant proband. CfDNA screening study of the maternal plasma, illustrating an uncertain 6 Mb deletion in the long arm of the X-chromosome (128M-133M), Z score = -19.43.


Characteristics of the 5,707 kb and 857 kb deletions of Xq25q26.3 and Xp22.33, respectively. (B and C). SNP array analysis of the fetus (III1) and the couples (II1, II2). (B). The red bar indicates a heterozygous 5,707 kb deletion in Xq25q26.3 (chrX: 127,915,006-133,621,667) in the fetus (III1).


Characteristics of the 5,707 kb and 857 kb deletions of Xq25q26.3 and Xp22.33, respectively. (B and C). SNP array analysis of the fetus (III1) and the couples (II1, II2). (C). The red bar indicates a heterozygous 857 kb deletion in Xp22.33 (chrX: 784,064-1,640,746) in the fetus (III1) and the pregnant proband (II2).


Characteristics of the 5,707 kb and 857 kb deletions of Xq25q26.3 and Xp22.33, respectively. (D). Pseudoautosomal region (PAR1) of the X and Y chromosomes. The 857 kb deletion in Xp22.33 (red bar) was located 164 kb downstream of the SHOX gene (chrX: 585,079-620,146), including the evolutionarily conserved CNE9 (blue bar), which was the SHOX gene enhancer.


Characteristics of the 5,707 kb and 857 kb deletions of Xq25q26.3 and Xp22.33, respectively. (E). For the proband II2, FISH experiment showed that the Xp22.3 deletion (detected by the probe RP11-1119O18, Spectrum Green) and the Xq25q26 deletion (detected by the probe RP11-313D19, Spectrum Red) located on the different X chromosomes, respectively.


The progression of the pituitary lesion in MRI:. A suspicious low signal in the right-wing of the pituitary (January 15, 2019).


Enlargement of the pituitary lesion involving right cavernous sinus (June 28, 2019).


Involvement of the right cavernous sinus, and ,internal carotid artery (September 24, 2019).


A possible macroadenoma, Knosp IV (October 17, 2019).


The lesion in the sellar region involving bilateral cavernous sinus as shown in MRI. Before chemotherapy.


The lesion in the sellar region involving bilateral cavernous sinus as shown in MRI. After two courses of chemotherapy (R2-MTX).


One year postoperative axial.


Sagittal.


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


Two years postoperative axial.


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


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


The renal biopsy shows edematous interstitium which was infiltrated with lymphocytes and plasma cells. A) Hematoxylin-eosin staining X200.


The renal biopsy shows edematous interstitium which was infiltrated with lymphocytes and plasma cells. B) Periodic acid schiff staining X200.


Mucocutaneous lesions on the face.


Ulcerative lesion on the right hand.


The PCR-RFLP on specimens of lesions.


Significant treatment of lesion by meglumine antimoniate.


Computed tomography images of disseminated coccidioidomycosis lesions. Computed tomography images show: an axial sclerotic bone lesion in December 2020.


Computed tomography images of disseminated coccidioidomycosis lesions. And after 4 months of fluconazole treatment in April 2021.


Computed tomography images of disseminated coccidioidomycosis lesions. , the chest wall mass in December 2020.


Computed tomography images of disseminated coccidioidomycosis lesions. And in April 2021.


Computed tomography images of disseminated coccidioidomycosis lesions. And a right lower lobe lung nodule in December 2020.


Histologic images of chest wall mass biopsy. Hematoxylin & Eosin stained microscopic sections show a diffuse granulomatous inflammation with areas of necrosis (A, 100x, black arrow pointing to necrosis). Rare intact organisms on are consistent with immature spherules of Coccidioides immitis (A, inset, 400x, red arrow pointing to organism).


Histologic images of chest wall mass biopsy. Grocott's methenamine silver stain highlights scattered spherical structures suggestive of yeast forms (B, 400x, red arrow pointing to organism).


Extraoral photograph showing facial asymmetry with a smooth surfaced swelling on the right lower side of the face.


MRI - STIR image showing hypointense areas suggestive of fat.


Hemangiopericytoma-like areas (black arrow) admixed with areas of mature adipocytes (red arrow) (H&E stain, x40).


Typical staghorn pattern with proliferating lesional cells (H&E stain, x200).


Reticulin stain showed distinctive reticulin pattern and each pericyte is surrounded by reticulin fibers (Reticulin stain, x100).


Immunohistochemistry revealing CD99 negativity (IHC stain, x100).


Immunohistochemistry revealing Bcl-2 negativity (IHC stain, x100).


Immunohistochemistry revealing S-100 negativity with positivity in fat containing cells (IHC stain, x100).


Immunohistochemistry revealing Pan cytokeratin negativity (IHC stain, x100).


Immunohistochemistry revealing Desmin negativity (IHC stain, x100).


Immunohistochemistry revealing CD34 negativity in lesional cells, positivity in endothelial cells of vessels (IHC stain, x100).


Immunohistochemistry revealing Smooth muscle actin negativity in lesional cells and positivity in vessel walls (arrow), (IHC stain, x100).


Analytical data: (A) Hyporegenerative microcytic anaemia, abnormality in iron metabolism (Fe), elevation of acute phase reactants and liver enzyme abnormality.


(B) Morphology of peripheral blood with hypochromia, intense rouleaux and thrombocytosis.


(C) Proteinogram with hypoalbuminemia and hypergammaglobulinemia.


Peliosis hepatis. Cystic spaces with no endothelial lining (arrow). HE x 10.


Serial Chest radiographs of the patient. (A) The film showing diffuse alveolar process over bilateral lung field, especially right lower lung field just after extracorporeal membrane oxygenator (ECMO setup).


Serial Chest radiographs of the patient. (B) The film revealing consolidation over both lungs when first time we tried to wean from ECMO. The film on the day before removing ECMO, demonstrating fibrotic change as lung filed in.


Serial Chest radiographs of the patient.


Skull radiograph:multiple lytic areas.


Longitudinal evolution of calcemia.


Clinical progress. Each thin arrow denotes a plasma exchange session (1 volume exchange with 5% albumin and 10 ml/kg virion inactivated plasma). Thick arrows denote eculizumab infusions. Vertical line represents the first eculizumab infusion. Horizontal dotted lines represent normal ranges for haemoglobin.


Clinical progress. Each thin arrow denotes a plasma exchange session (1 volume exchange with 5% albumin and 10 ml/kg virion inactivated plasma). Thick arrows denote eculizumab infusions. Vertical line represents the first eculizumab infusion. Platelets. Respectively. Time on haemodialysis (HD) and peritoneal dialysis (PD) represented by double arrowed lines.


The resolution of haemoglobinuria in case 2.


Serum concentration of total protein before and after each plasmapheresis treatment. First treatment (T:1), second treatment (T:2), third treatment (T:3). Two-way ANOVA showed a significant reduction of total protein in in the post-treatment sample (p=0.007).


Serum concentration of gamma globulins before and after each plasmapheresis treatment. First treatment (T:1), second treatment (T:2), third treatment (T:3). Two-way ANOVA showed a significant reduction of gamma globulins in the post-treatment sample (p=0.008).


Renal computed tomography. . Notes: (A) Enhanced abdominal computed tomography scan shows rupture of the left kidney with perirenal hematoma (green arrow). The point of rupture is clearly seen (red arrow).


Renal computed tomography. (B) Sagittal reconstruction of the computed angiotomography scan showing normal left renal artery with avascular upper pole of left kidney corresponding to the area of rupture (blue arrow).


Fluoroangiography at 1 week a; Segmented arterial occlusions (arrows) on the nasal-inferior branch of the central retinal artery.


6 weeks b; Whitish ischemic retinal edema (star) on the inferior part of the macula due to a new episode of arterial occlusion affecting the temporal-inferior branch of the central retinal artery (arrow).


The MRI findings of case 2. (A) The swelling (it can be seen in the blue coil) in the left nasopharyngeal wall and rear of the tongue before receiving the PCET regimen.


The MRI findings of case 2. (B) The neoplasm (it can be seen in the blue coil) shrank obviously after 2 cycles completed.


Peripheral smear H&E stain. Pseudo Pelger-Huet neutrophil: a finding seen in MDS, can also be seen in B12 deficiency. This finding is characterized by a bilobed nucleus, and markedly reduced granulation.


Peripheral smear H&E stain. (a) Dyserythropoiesis Giemsa stain 1000x. Nuclear budding is evident in image.


Bone marrow aspirate one day after admission. (a) Erythroid and megakaryocyte hyperplasia: The bone marrow is hypercellular with ineffective erythropoiesis.


Bone marrow aspirate one day after admission. (b) Megakaryocyte dysplasia. The megakaryocytes are abnormal with multiple small lobes seemingly disconnected from one another.


The final PET-CT and enhanced CT evaluation of the patient. (A) The final PET-CT evaluation showed complete metabolism remission after eight cycles of tislelizumab and lenalidomide.


The final PET-CT and enhanced CT evaluation of the patient. (B) The enhanced CT evaluation showed complete remission 4 months after PET scan.


Lemierre syndrome patient with neck stiffness, cervical lymphadenopathy and tenderness along the course of external jugular vein.


X-ray AP and lateral view of the neck showing increase in prevertebral shadow at 4th cervical vertebral region. Cervical lordosis is lost. Diffuse pulmonary infiltrates present.


CECT neck showing peripheral enhancing hypodense area in the prevertebral space compressing trachea and oesophagus.


Axial CECT lung window showing well-defined subpleural nodules with central cavity and feeding vessel. Minimal bilateral pleural effusion noted.


Right atrial thrombus (center) surrounded by pulmonary thromboendarterectomy specimens.


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


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


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


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


Case 1 preoperative physical appearance. Anterior view showing imbalance of shoulder and waist line. Other characteristic findings such as short stature, a small chest, and variable limb abnormalities were not found. The scar seen at the center of his abdomen was made when he received a renal transplant. Lateral view showing thoracic rib humps and thoracolumbar kyphosis.


Case 2 preoperative physical appearance. Lateral view showing prominent right scapula and rib hump. However, there were no apparent abnormalities such as a small chest, obvious short stature, and short limbs. Clinical photos during forward bending showed an obvious right rib hump and mild left lumbar hump.


Clinical picture of the lesion.


Surgically excised lesion.


Surgical site after removal of granuloma.


Vestibuloplasty of shallow sulcus.


Histopathological picture showing numerous plasma cells in cytoma.


Magnified view of connective tissue stroma.


Immunohistochemical examination with kappa chain immunoglobulin markers.


Immunohistochemical examination revealing lambda chain immunoglobulin markers.


Follow-up examination revealing no reoccurrence of lesion.


Time course of symptom onset.


Show sagittal contrast-enhanced T1-weighted MRI-sequences. No evidence of thrombosis in the sagittal superior sinus at day 12 following vaccination.


Show sagittal contrast-enhanced T1-weighted MRI-sequences. Thrombosis of the sagittal superior sinus (circle) at day 14 following vaccination.


Laboratory findings of platelet count (solid line)/. Dimer (dashed line), and imaging studies. The x-axis represents the number of days after vaccination. Show sagittal contrast-enhanced T1-weighted MRI-sequences. Regression of thrombosis at day 20 following vaccination.


Show axial contrast-enhanced T1-weighted MRI-sequences:. No evidence of thrombosis in the left-sided lateral transverse sinus at day 8 following vaccination.


Thrombosis in the left-sided lateral transverse (circle) sinus at day 18 following vaccination.


Laboratory findings of platelet count (solid line)/. Dimer (dashed line), and imaging studies. The x-axis represents the number of days after vaccination. Axial cranial CT showing a left-sided, space-occupying atypical intracranial hemorrhage (ICH) with subarachnoidal hemorrhage at day 21 following vaccination.


Endoscopic view of a sessile 0.3 cm LCH polyp in the sigmoid colon.


Endoscopic view of an ulcerated, and ,infiltrated 0.5 cm LCH polyp in the cecum.


Photomicrography of a submucosal LCH nodule with central necrosis, and ,ulceration (H&E, 100x).


Photomicrography of LCH destructive infiltration of colonic crypt (H&E, 400x). CD1a immunostaining of infiltrative lesion showed in. (400x). CD207 immunostaining of the same lesion in. (400x).


Medical image.


Preoperative MRI. T1 axial without contrast.


T1 axial with contrast.


T2 sagittal.


T2 coronal - heterogeneous expansive formation involving the skull base, mainly the sphenoid sinus and clivus with neoplastic aspect and dissemination to cavernous sinus, determining compression of the brainstem, surrounding vascular structures, right optical nerve, and optical chiasm.


Postoperative MRI,. T1 axial without contrast.


T1 sagittal with contrast.


T2 coronal - control image showing excellent local control of lesion, normalization of the brainstem anatomy, and absence of compression of the optic pathways.


(A) Severe bladder wall thickness with distinct layering, perivesicular stranding, and reduced intravesical volume.


Remarkable improvement in bladder wall thickness and bladder space.


Biopsy. The mass presented as a well-described, encapsulated lesion.


Lymph node biopsy, showing a follicular lymphoma with brisk TFH response and BCL2-rearrangement. (A) low power view showing a disturbed lymph node architecture, with numerous small follicles arranged in a back-to-back fashion.


Lymph node biopsy, showing a follicular lymphoma with brisk TFH response and BCL2-rearrangement. (B). The follicle centers are composed predominantly of small centrocytes and scattered centroblasts (less than 15/high power field), in the absence of tangible body macrophages.


Lymph node biopsy, showing a follicular lymphoma with brisk TFH response and BCL2-rearrangement. The B-cells in de follicles express CD10.


Lymph node biopsy, showing a follicular lymphoma with brisk TFH response and BCL2-rearrangement. , BCL6.


Lymph node biopsy, showing a follicular lymphoma with brisk TFH response and BCL2-rearrangement. , overexpress BCL2. As illustrated in the anti-BCL2 immunostain. (scale bar: 100 microm).


Lymph node biopsy, showing a follicular lymphoma with brisk TFH response and BCL2-rearrangement. And are intermingled with numerous follicular T-helper cells, as illustrated by a immunostaining against PD1.


Lymph node biopsy, showing a follicular lymphoma with brisk TFH response and BCL2-rearrangement. FISH highlights the presence of a BCL2-rearrangement, corresponding to the BCL2 overexpression in the follicles.


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


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


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


Conjunctival chemosis and proptosis of the right eye.


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


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


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


(A) Gadolinium enhanced sagittal and coronal T1 MRI showing diffuse involvement of cauda equina with encasement of conus medullaris (arrows).


(B) Staging whole-body 18F-FDG PET-CT coronal and sagittal views showing hypermetabolic mass in the cauda equina and lumbar nerve root sleeves (arrows).


Follow up MRI.


PET-CT. After chemotherapy showing complete resolution of the hypermetabolic cauda equina lesion. Linear FDG uptake in the posterior lumbar dura (arrows) is postoperative in nature.


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


A 6-year-old female child showing bilateral proptosis and bitemporal swelling.


Axial CECT showing enhancing infiltrates occupying the lateral orbital wall and causing proptosis. The infiltrate extended toward the bilateral temporal fossae beneath the temporalis muscle. There were extradural infiltrates extending bilaterally extradurally beneath the temporal bones.


Axial CECT showing extradural infiltrates extending bilaterally beneath the frontal and temporal bones. On both sides, small lobules were extending into the cortex of the frontal lobes and causing perifocal edema.


Coronal CT showed the left maxilla also infiltrated by the lesion.


Bone marrow biopsy showing hypercellular marrow with sheets of blast cells (H & E, 40x).


FNAC from temporal swelling with hemorrhagic background showing blast cells (May Grunwald Geimsa stain, 20x).


FNAC from temporal swelling showing clumped blast cells with an occasional signal blast cell (May Grunwald Geimsa stain, 20x).


Peripheral blood smear showing blast cells (Giemsa stain, 40x).


Multiple skin lesions on the neck, trunk and upper arms, consisting of infiltrated deep red violaceus nodules measuring 1-1,5 cm.


(a) Diffuse infiltrate sparing the epidermis mainly composed of small lymphocytes.


(b) The same Figure:higher magnification.


Small CD20+ B cells.


CD10 antigen stain.


The skin lesions disappeared leaving a slight hyperpigmentation.


Massive fungating parotid tumor.


Right transverse sinus thrombosis (arrow showing the absence of contrast).


Postoperative photograph taken 8 months later.


Preoperative abdominal contrast-enhanced CT scan showed a well-circumscribed heterogeneously mass in the right suprarenal areal (arrow). Axial sections.


Preoperative abdominal contrast-enhanced CT scan showed a well-circumscribed heterogeneously mass in the right suprarenal areal (arrow). Coronal sections.


Macroscopic features of the tumor showed a well-circumscribed and partially encapsulated solid tumor measuring 5.5x5x3.2 cm in maximum dimension. The normal adrenal gland was displaced by the tumor and presented at the edge of the tumor.


Microscopic details of the tumor. (A) The interlacing bundle and fascicles of the tumor (arrowhead) and compressed adrenal tissue (arrow). (H&E, x 100).


Microscopic details of the tumor. (B) Leiomyosarcoma with nuclear pleomorphism and giant cell formation with mitotic activity in the range of 8-10 mitoses/10 high power fields (H&E, x 400).


Microscopic details of the tumor. (C) Immunohistochemical staining for desmin is positive (x 100).


Microscopic details of the tumor. (D) Immunohistochemical examinations showed strong immunoreactivity for H-caldesmon (x 100).


Sagittal T2-weighted image flair sequence L-spine.


Sagittal T2-weighted image.


Chest CT scan of patient.


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


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


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


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


Multiple pink papules and sun-damaged skin of the right cheek.


Immunohistochemical profile of the mantle cell lymphoma, Case 2. x100.


PET scan demonstrated no abnormal FDG processes throughout the body. Large right-sided pleural effusion was present, but without any hypermetabolic activity (arrows).


shows the heart rate in beats per minute prior (gray bars) and immediately after eyeball pressure testing (black bars, annotation "cardiac arrest," respectively), at the 11 investigated points in time. On day 40, cardiac arrest occurred independently of EP during tracheal suctioning.


Renal biopsy specimen showing mild focal segmental extracapillary proliferation (arrow); hematoxylin and eosin stain. . Note: Original magnification x200.


Case 1: color Doppler sonographic evaluation. Complete inversion of the portal venous flow.


Case 1: center lobular hemorrhagic confluent liver cells necrosis around a central vein showing few inflammatory infiltrates within lumen, suggesting diagnosis of venoocclusive disease (H&E, 100x).


Case 1: liver with normal architecture; inflammatory infiltrate is completely absent. Diffuse swelling of liver cells cytoplasm suggesting toxic-related damage (H&E, 40x).


Case 2: widespread structural anomalies of the portal venous vessels with dilated lumen, sometimes herniated in the perivascular parenchyma (CD34 immunoreaction, 40x).


Magnetic resonance imaging brain. Sagittal.


Coronal demonstrating a sellar lesion with suprasellar extension exhibiting homogenous enhancement. Red arrows demonstrate a sellar lesion with suprasellar extension with homogenous enhancement.


On 3-month follow-up, magnetic resonance imaging. Sagittal.


Coronal sequences demonstrated progressive and enlarging lesion. Red arrows demonstrate the progressively enlarging lesion.


Magnetic resonance imaging brain imaging. Sagittal.


Postoperative imaging, as visualized in demonstrating gross total resection of the mass. Red arrows demonstrate removal of the previously enlarging lesion.


Changes of hemogram during BRD (Bortezomib 2mg weeklyx4, DXM 20mg weeklyx4 and Rituximab 375mg/m2 monthly) chemotherapy. The proposal of BRD chemotherapy was present in (A).


Changes of hemogram during BRD (Bortezomib 2mg weeklyx4, DXM 20mg weeklyx4 and Rituximab 375mg/m2 monthly) chemotherapy. The platelet counts increased to normal after first two rounds of BD, but decreased to 12x109/L after the third round, and became refractory to platelet transfusion (B).


Changes of hemogram during BRD (Bortezomib 2mg weeklyx4, DXM 20mg weeklyx4 and Rituximab 375mg/m2 monthly) chemotherapy. Additional, the hemoglobin also decreased 8 days after third round of BD (C).


Changes of platelet count after multiple managements on thrombocytopenia. The response of platelet was not sufficient after second round DXM (20mg qd for 3 days). With the consequence treatment including methylprednisolone, intravenous immunoglobulin (IVIG), recombinant human thrombopoietin (TPO) and TPO receptor agonist, no response was observed as well, and patient suffered from with platelet transfusion refractoriness.


PCR and Sanger test for polymorphism of FcgammaR. Results showed that this patient is FcgammaRIIalpha 131H/R.


PCR and Sanger test for polymorphism of FcgammaR. And FcgammaRIIIalpha 158F/V.


Changes of hemoglobin, platelet, and hemolysis indexes after Eltrombopag withdraw. The hemoglobin recovered in 50 days.


Changes of hemoglobin, platelet, and hemolysis indexes after Eltrombopag withdraw. Results shows that LDH.


Changes of hemoglobin, platelet, and hemolysis indexes after Eltrombopag withdraw. And platelet count recovered to normal in 20 days later.


Changes of hemoglobin, platelet, and hemolysis indexes after Eltrombopag withdraw. IBIL.


Changes of hemoglobin, platelet, and hemolysis indexes after Eltrombopag withdraw. Ret. Improved immediately within 3 days after eltrombopag withdrawal, and decreased to almost normal within 10 days.


Bone marrow aspiration results: Wright-Giemsa staining (magnification, x 1,000).


Preoperative facial photograph. Frontal view of the patient before operation, showing fullness of left inferolateral orbital and periorbital region with slightly upward displacement of the lateral canthus.


Postoperative facial photograph. Frontal view of the patient 5 years after the surgery, showing complete resolution of inferolateral orbital fullness.


It shows the appearance of generalized proliferative gingival lesion in patient.


It shows the palatal right side swelling with intact overlying mucosa.


It shows histological specimen showing a dense cellular infiltration in the stroma just beneath the epithelium. HE stains. Original object lens magnification 4x.


It shows larger magnification demonstrates cells and nuclei characteristics: mononuclear cells with moderately amount of cytoplasm and round to oval nucleus with prominent nucleoli. Original object lens magnification 40 x.


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


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


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


Meropenem was used from the third day onwards. The red arrow represents the start time of the final treatment plan. The patient was discharged on the 13th day and was hospitalized again on the 20th day. Platelet count.


Meropenem was used from the third day onwards. The red arrow represents the start time of the final treatment plan. The patient was discharged on the 13th day and was hospitalized again on the 20th day. White blood cell count.


Meropenem was used from the third day onwards. The red arrow represents the start time of the final treatment plan. The patient was discharged on the 13th day and was hospitalized again on the 20th day. Daily maximum temperature.


Meropenem was used from the third day onwards. The red arrow represents the start time of the final treatment plan. The patient was discharged on the 13th day and was hospitalized again on the 20th day. Liver function tests, aspartate transaminase, and ,alkaline phosphatase.


Meropenem was used from the third day onwards. The red arrow represents the start time of the final treatment plan. The patient was discharged on the 13th day and was hospitalized again on the 20th day. Total bilirubin level.


Meropenem was used from the third day onwards. The red arrow represents the start time of the final treatment plan. The patient was discharged on the 13th day and was hospitalized again on the 20th day. Creatinine levels.


MRI results of lumbar plain scan. The result of TIWI.


MRI results of lumbar plain scan. The result of T2FS.


MRI results of lumbar plain scan. The result of T2WI. The right lumbar vertebrae 4 and 5 showed high signal, and the signal intensity of L4-5 and L5-S1 increased. Abnormal signal was seen around lumbar 4-5 vertebral body, T1WI was equal signal, T2WI was slightly high signal, and lipid pressure image was high signal. The right psoas major, iliopsoas major, and left psoas major were swollen. Irregular abnormal signal shadow was seen in the course area, with uneven internal signal. The lesions on the right side were large, and the maximum axial plane was about 8.1 x 6.0cm.


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


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


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


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


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


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


CT scan showing MZL subcutaneous soft nodular lesion in the left lumbar region of patient n. 2.


Endoscopic views in the surgery.


Patients was a 27 year old female. Dyserythropoiesis, Dysgranolopoiesis (pseudo pelger huet raw).


A 49 year old man with dysmegakaryopoiesis. Unilobule megakaryocytic.


49 year old man who was referred to clinic because of Macrocytic Anemia. Dyserythropoiesis, Dysgranolopoiesis.


The third patient was a 40 year old female. Dyserythropoiesis.


CT scan of the neck showing a normal thyroid gland.


Histopathology image of the thyroid tissue suspicious for PTC.


Histopathology image of the thyroid tissue showing florid Hashimoto's thyroiditis.


Karyotype 46,Y,t(X,3)(p11.2;p14)mat of male patient.


Pedigree of the male's patient family.


Timeline organizing main events of the case.


Plain radiograph of a 9-year-old boy with a painful left thigh swelling of 5-month duration. There is a reduction in the corticomedullary differentiation of the distal diametaphysis of the femur with soft-tissue swelling, preserved fat plane, spiculated periosteal reaction, and cortical erosion.


The fungal bodies are highlighted in this periodic acid-Schiff-stained section (x600).


Six months after treatment with antifungal drugs.


(A) In case 1, the normal breast structure was destroyed. At the edge of tumor, tumor cells were compressed by massive fibrous tissue into a streamline alignment.


(B) Immunohistochemistry stain showing that MPO was markedly positive in the cell plasmid. (Hematoxylin and eosin staining; magnification, x200).


(A) In case 2, mesenchymal tissues were packed into the tumor cells, arranged into a line and the fatty tissue was infiltrated at the edge of the tumor.


Trend of patient's platelet count (blue line) and hemoglobin (red line) over the hospital stay with respect to timing of splenectomy. Follow-up platelet count and hemoglobin on May 1 (not depicted on the graph) was 1,204,000/mm3 and 10.6 g/dl, respectively.


Slit-lamp findings for the left eye. Dense vitreous hemorrhage was detected (arrow).


Postoperative findings. A; Fundus photography for the left eye 2 months after surgery. The optic disc and the macula exhibited a normal color. Numerous fine retinal folds were also observed.


Postoperative findings. B; Optical coherence tomography findings for the left eye. While the shape of the central fovea was normal, the external limiting membrane was absent, and the inner segment ellipsoid line was extremely thin and not continuous under the fovea.


Fundus examination is not clear, and small patches of yellow-white lesions could be seen. OD.


Fundus examination is not clear, and small patches of yellow-white lesions could be seen. OS. Fundus fluorescein angiography shows retinal venous engorgement with fluorescein leakage and high fluorescence of the optic disc.


Fundus examination is not clear, and small patches of yellow-white lesions could be seen. OS.


Histological and immunohistochemical staining of the tumor cells. Monomorphic medium-sized lymphoid cells with angiocentric pattern (hematoxylin, and ,eosin stain, original magnification x100 [A], and ,x200 [B.


Histological and immunohistochemical staining of the tumor cells. Immunostaining for CD3.


Histological and immunohistochemical staining of the tumor cells. CD56.


Histological and immunohistochemical staining of the tumor cells. Granzyme B.


Histological and immunohistochemical staining of the tumor cells. EBER by in situ hybridization. (original magnifications x100).


Positron emission tomography/computed tomography shows significant 18F-FDG uptake in multiple sites of the body.


Including the nasopharynx.


Skin and subcutaneous tissue of the right chest.


Small intestine, and kidneys.


Bone marrow examination at diagnosis.


Chromosome karyotype analysis at first diagnosis: 45, X, -X [16].


Filling defect RGP retrograde pyelogram.


Histopathologic examination revealed a MALT lymphoma of the rectum. (a) Hematoxylin-eosin (HE) staining x20.


Histopathologic examination revealed a MALT lymphoma of the rectum. (b) HE staining x200.


Histopathologic examination revealed a MALT lymphoma of the rectum. (c) Immunohistochemistry (IHC) was negative for CD3.


Histopathologic examination revealed a MALT lymphoma of the rectum. (d) IHC was positive for CD20.


Histopathologic examination revealed a MALT lymphoma of the rectum. (e) IHC was positive for CD21.


Histopathologic examination revealed a MALT lymphoma of the rectum. (f) IHC was positive for Bcl-2.


A; H&E staining of the bone marrow showing marked interstitial involvement by medium sized cells with small but conspicuous nucleoli.


B; CD20 immunohistochemistry highlights marked involvement of the bone marrow by abnormal B-cells.


A; Representative karyotype of the second clone. The second clone, a composite of two cells, was a doubling of the stemline clone (the first clone) with two copies of a translocation between 14q and 18q (IGH;BCL2, red arrows), in addition to a 14q and 19q translocation (IGH;BCL3, white arrows). Six copies of chromosome 12 are underlined.


B; FISH analysis of the second clone using dual fusion IGH;BCL2 probe (green/red). Black and white image for IGH signal shows 8 loci indicating that all IGH sequences are rearranged and present on derivative chromosomes 14, 18, and 19. Black and white image for BCL2 signal shows 6 loci which represent two intact and two derivative chromosomes 18, and two derivative chromosomes 14. Merged image shows green IGH signals and red BCL2 signals which overlap in four loci, arrows (two copies of derivative chromosome 14 and two copies of derivative chromosome 18). Right panel, IGH break-apart probe (green/red) signal showing four green and four red foci indicative of the presence of four rearranged IGH loci.


Patient with a large abnormal swelling on the right side of face.


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


Histopathology of bone marrow biopsy showing scattered infiltration of atypical large lymphocytes. (A) Low-power view of the bone marrow biopsy (H&E stain, x50).


Histopathology of bone marrow biopsy showing scattered infiltration of atypical large lymphocytes. (B) High-power view of the atypical lymphocytes (H&E stain, x200).


Histopathology of bone marrow biopsy showing scattered infiltration of atypical large lymphocytes. (C) Immunohistochemical staining of CD20-positive lymphoproliferative cells (x400).


Histopathology of bone marrow biopsy showing scattered infiltration of atypical large lymphocytes. (D) EBER in situ hybridization indicating positive signals in the nuclei of background cells (x200).


Photomicrography of the nodal biopsy. (A) Low-power view reveals effaced structure by marked infiltrate of small-to-medium-sized atypical lymphocytes with clear cytoplasm (H&E stain, x100).


Photomicrography of the nodal biopsy. (B) High-power view showing polymorphous lymphoid infiltrate with high endothelial venules (H&E stain, x400).


Photomicrography of the nodal biopsy. (C) Immunohistochemically, large immunoblastic lymphocytes were positive for CD20 (x400).


Photomicrography of the nodal biopsy. (D) Podoplanin immunostain revealed expanded follicular dendritic cell meshwork (x400).


Photomicrography of the nodal biopsy. (E) EBER in situ hybridization followed by PD-1 immunostaining showed that lymphoma cells were negative for EBER.


Photomicrography of the nodal biopsy. (F) EBER in situ hybridization followed by the immunostaining of CD20 indicated positive-signal lymphocytes infiltrate indicating positive signals in the nuclei of background cells (x600).


Pathology and CT images of the tumor : Patient 1.


Patient 2.


Patient 3.


Patient 4. Red arrow indicate tumor mass.


Curves of systolic and diastolic blood pressure and heart rate during chlorpromazine application : Patient 1.


Patient 4. Colored bars represent continuous intravascular infusion (i. V. Pump). Purple arrows indicate time of bolus intramuscular injection of chlropromazine. Black arrows indicate 3 h after chlorpromazine application. Blue arrows indicate time of operation. BP, blood pressure; CPZ, chlorpromazine; i. V. , intravenous; i. M. , intramuscular.


Multiparametric flow cytometry shows two distinct clones (CD19pos and CD19neg) of cells both of which are positive for CD45, CD22, CD10, CD25, CD103, CD11c, CD123 and surface Igkappa in similar intensities. The plasma cells do not show clonal restriction.


MRI images (a) Axial T1WI shows heterogeneous signal intensity tumor in the right side of the posterior fossa, mainly iso-to slightly low signal intensity, with multiple round-like low signal intensity regions. The masses have well-defined margins, the right cerebellar hemisphere and vermis are involved, the fourth ventricle and brain stem are compressed and deformed.


(b) Axial T2WI shows that the tumor appears as iso-to slightly high signal intensity, with multiple round-like high signal intensity regions. Contrast enhanced MRI.


(c) Axial contrast enhanced MRI shows that the mass had obvious heterogeneous enhancement with peritumoral edema and non-enhancement regions of multiple small round cystic lesions and necrosis.


(d) Sagittal enhanced image shows that the fourth ventricle was not clear and the contours of enhanced cauliflower-like masses.


(e) Axial enhanced image of enhanced FLAIR sequence shows multiple non-enhanced cystic lesions and necrosis more clearly.


Microscopic examinations of the tumor show many primitive neural tube, choroidea, squamous epithelium, appendix organ of skin, cartilage, bone, columnar epithelium, and muscle tissues.


Flexible nasopharyngolaryngoscopy view of the right BOT mass before treatment.


After 3 cycles of R-CHOP chemotherapy.


After the completion of 6 cycles of R-CHOP chemotherapy.


A; Baseline whole-body MIP image demonstrating intense FDG uptake in a large retroperitoneal mass (red arrow) compatible with patient's follicular lymphoma. Showing the large, FDG-avid mass (red arrow). Note the common bile duct stent (red arrowhead) that is markedly anteriorly displaced by the lymphomatous mass and explains the patient's presentation with obstructive jaundice. C Whole-body MIP image following three cycles of R-CHOP shows no residual metabolically active lymphoma.


Representative axial PET/CT image from the same time point as in.


Is notable for the presence of minimal residual abnormal soft tissue in the retroperitoneum (red arrow, Lugano 2), with uptake equal to blood pool, compatible with a complete metabolic response. The common bile duct stent is in near-orthotopic location now that the retroperitoneal mass has dramatically reduced in size (red arrowhead). E Whole-body MIP image at the end of therapy, again demonstrating no metabolically active tumor.


Again depicts the complete metabolic response (Lugano 1) and also the removal of the common bile duct stent.


Coronal PD MRI of left and right hips without contrast showing serpentine low signal irregularity along the weightbearing portion of the femoral head with associated rim of edema compatible with avascular necrosis. There are extensive regions of bonny infarctions involving the entire visualized bony pelvis (including the pubic body, ischial tuberosity, iliac wing and sacrum) and proximal femur/intertrochanteric region. Both studies are indicatvie of stage 3 and suspected early stage 4 FICAT femoral head avascular necrosis.


MRI left shoulder demonstrating serpiginous PD hyperintense and T1 hypointense signal along the peripheral margin of the humeral head. These fingidngs are consistent with avascular necrosis of the left humeral head.


CT of thoracic vertebrae axial view showing "polkadot" appearance.


MRI dorsal spine Sagittal view.


T1W image.


T2W image. STIR image showing altered bone marrow signal intensity involving D1-D7 vertebrae appearing hypointense on both T1W and T2W images with contiguous involvement of posterior element. Patchy residual normal bone marrow signal noted in D1-D7 vertebrae. Extra dural/epidural lesion arising from C7 to D8 vertebrae appearing hypointense on T1W and hyperintense on T2W/STIR causing significant mass effect on cervicodorsal spinal cord. Intracord T2W/STIR hyperintense signal at D2-D3 level.


MRI dorsal spine coronal view/STIR image showing contiguous involvement of costovertebral joints at multiple levels noted on left side.


MRI dorsal spine axial view T2W image showing contiguous infiltration into left costovertebral joint and adjacent rib with evident altered bone marrow signal. Infiltrative extradural/ epidural lesion causing significant mass effect on spinal cord and shift of cord to right side depicted.


Intraoperative pictures.


Hemangiomatous lesion in para spinal soft tissue above dorsal vertebra.


Post laminectomy exposing epidural lesion encasing posterior aspect of cord. Decompression of cord and instrumentation using pedicle screws and interconnecting rods.


Post op X-ray Dorsal spine. AP.


Lateral view.


Nivolumab and Bilirubin.


Nivolumab and Liver Function Tests.


Full blood count parameters are shown; white blood cell count (WBC, reference range 0.49-5.51 xx109/. , neutrophils (0.02-3.88 x 109/. And platelets (54-487 x 109/. Venetoclax + Azacitidine administration, starting from day 20 onwards, is indicated by the blue bar.


The grey-white and typical multicystic appearance of the lesion was shown during laparoscopic operation (arrow).


Histological findings of the resected lesion tumor (Hematoxylin and eosin staining). The lesion consisted of dilated cystic ducts surrounded by the connective tissue of smooth muscle, and ,capillaries (x20).


Histological findings of the resected lesion tumor (Hematoxylin and eosin staining). Ducts are lined by columnar epithelium (x100).


Terson syndrome: color retinography. (A, B) Posterior pole in the right and left eye.


Terson syndrome: color retinography. (C) Inferior retinal periphery in the left eye.


Pedigree of the family transmitting Rob translocation chromosome t(14; 15)(q10;q10) Open hexagon designates a presumed carrier of t(14; 15)(q10;q10). Filled hexagon designates a known carrier of t(14;15)(q10;q10). The proband, IV-1 (arrow), has disomy t(14;15)(q10;q10). The proband's wife, IV-2, had a normal karyotype. Their deceased son, V-1, was a carrier of karyotype 45,XY,der(14;15)(q10;q10).


Sperm cells after hybridization with TelVysion 14q32.33 (Spectrum Red) and TelVysion 15q26.3 (Spectrum Green). The sperm with red arrow may be a diploid sperm.


(A) Progressive ischemia was developed leading to necrosis of fingers.


(B) The necrosis of fingers except the thumb of the left hand.


(C) The necrosis of fingers in feet.


Comparative study of brain MRI before.


Six months after starting treatment with deferasirox. Shows no change in the signal of basal ganglia structures.


Cloudy cornea (red arrow), arcus junvenilis (black arrow).


(a) Renal histology with foam cells in mesangium on light microscopy (arrow) (H and E, x40), (b) renal histology with electron dense mesangial deposits (arrow).


WBC gradually increased postoperatively. . Notes: "A" represents the day the patient took hydroxyurea 0.5 g tid po; "B" represents the day the patient took hydroxyurea 1.0 g tid po; "C" represents the day the patient took hydroxyurea 2.0 g bid po; "D" represents the day the patient took hydroxyurea 1.0 g tid po; "E" represents the day the patient did not take the hydroxyurea; "F" represents the day the patient took hydroxyurea 1.0 g tid po. The patient was discharged on March 30, 2015. . Abbreviations: bid, twice daily; po, per os; tid, three times a day; WBC, white blood cell.


Bone marrow biopsy (hematoxylin and eosin 10x40).


Immunohistochemistry (MPO 10x40). . Abbreviation: MPO, myeloperoxidase.


Aspiration of intracapsular seroma fluid after explantation of the intact capsule containing the implant.


Intracapsular seroma fluid.


Histological image of the fibrinous implant capsule and the fibrinous exudate containing anaplastic tumour cells on the inner surface of the capsule. Black arrows = anaplastic tumour cells.


Cytological image of the neoplastic seroma fluid containing numerous highly atypical large anaplastic tumour cells characteristic for anaplastic large-cell lymphoma (ALCL) as well as scant inflammatory cells, predominantly lymphocytes (Hematoxylin and eosin stain; black arrows = anaplastic tumour cells; grey arrows = lymphocytes).


Cytological image of the neoplastic seroma fluid containing numerous highly atypical large anaplastic tumour cells characteristic for anaplastic large-cell lymphoma (ALCL) as well as scant inflammatory cells, predominantly lymphocytes (CD30 stain; black arrows = anaplastic tumour cells; grey arrows = lymphocytes).


Ten months evolution of renal function after eculizumab initiation.


Picture taken during flare of cryoglobulinemia-induced leukocytoclastic vasculitis, ulcerations, and gangrene affecting the lower extremities. This was 6 months prior to the current presentation.


(A) At low magnification, the tumor tissue is rich in cells showing a rounded oval to spindle-like shape, and the intercellular stroma is rich in "antler-like" parenchyma branching vessels (HE x 100).


(B) Mitotic image is not easy to be seen in high magnification (HE x 400 mm).


Both CD34.


Vimentin. Were positive by immunohistochemical staining.


The Ki-67 index was ~20% (C).


A; Coronal maximum intensity projection (MIP) of 18F-FDG PET imaging before admission. Accumulation was found in the stomach, in the right hepatic lobe, in the extensive lymph node metastases, and in the whole thyroid gland.


B; Transverse section of the thyroid on 18F-FDG PET/CT imaging before admission. Diffuse uptake in bilateral thyroid lobes was observed.


C; Transverse section of the thyroid on CT imaging after admission. The thyroid gland was diffusely swollen. Its size enlarged and its CT value decreased after hospitalization. In addition, the adipose tissue concentration in the surrounding area increased.


Cytology specimen that was obtained by fine-needle aspiration from the right lobe of the thyroid gland (Papanicolaou stain; original magnification x400). Discohesive atypical cells with irregular hyperchromatic nuclei containing prominent nucleoli were present. Round-shaped cells with cytoplasmic mucin vacuoles and eccentrically placed nuclei were signet-ring-cell carcinoma cells (arrow). Cells with a high nuclear-to-cytoplasmic ratio were thought to be poorly differentiated adenocarcinoma cells (arrowhead). There were numerous mitotic figures (big arrowhead). Based on these findings, the thyroid lesion was defined as "malignant" (metastatic carcinoma) by TBSRTC.


Glomerulus with intraglomerular lipoprotein thrombi. (A) Glomerulus with dilated glomerular capillaries containing characteristic acellular, lamellated, intracapillary lipoprotein thrombi. PAS staining.


Glomerulus with intraglomerular lipoprotein thrombi. (B) Dilated peripheral glomerular capillary containing a lipoprotein thrombus with its characteristic electron microscopic appearance. While the endothelial cells on the left-hand side are visible and slightly enlarged, they are not detectable in the upper right side. Transmission electron microscopy.


A; Distention of the gallbladder with gallstones and mild thickening of the wall.


B; Cholangiogram during ERCP showing distal bile duct stricture requiring sphincterotomy, balloon sweep, and stent placement.


C; H&E stained tissue section showing metastatic high grade breast ductal adenocarcinoma in the submucosa of the gallbladder (200 magnification; 20x).


D; GATA3 immunohistochemically-stained tissue section positive in the metastatic adenocarcinoma, helping to confirm a breast primary (200 magnification; 20x).


Testicle without fixation, extensively infiltrated by cream-colored neoplasia (*) and with areas of necrosis.


Immunohistochemical analysis showing a positive reaction for myeloperoxidase, labeling the neoplastic cells (brown) with preservation of the seminiferous duct (negative) on the right side of the image (magnification 400X).


Cellular thyroid aspirate comprising intermediate to large sized atypical lymphoid cells with scant cytoplasm and fine chromatin (Giemsa stain A, 20x B, 40x).


E 200x). CD 20 C, Tdtimmunopositivity (200x) Flow cytometry showing leukemic cells positive for D, CD 34 E, CD79a F, cMPO.


200x). CD 34 C, CD 20 D, CD 43 immunopositivity (200x).


Thyroid Biopsy showing A, infiltration of thyroid parenchyma by leukemic cells.


Electron microscopic findings at the first renal biopsy. Several microspheres are shown in the GBM of a capillary loop (arrowheads).


T1-weighted head and neck magnetic resonance image (MRI) with fat saturation revealed a 2.6 centimeter enhancing soft tissue lesion occupying the right carotid space and the right parapharyngeal space at the level of carotid bifurcation with right internal and external carotid artery encasement (Open arrow).


Post-treatment T1-weighted head and neck MRI showed decreased size of the right carotid body tumor with slightly anterior displacement of the right parapharyngeal fat (Arrow head).


Proliferation suppression of circulating sarcoma cells, more than 80% of growth inhibition, was observed for doxorubicin, eribulin, gemcitabine, olaratumab/doxorubicin combination, and pazopanib.


Chest computed tomographic scan before treatment.


After 3 months' treatment.


Paronychia in left ring finger.


Papulopustular rash in right leg.


The thicker eyebrows.


The darker beard. Were found, respectively.


Photomicrography of the lymph node. Effacement of the original architecture due to sinusoidal infiltration by large atypical multinucleated cells (HE, 100X).


Photomicrography of the lymph node. Immunohistochemistry positivity for CD30 (HE, 400X).


Photomicrography of the liver showing microscopic, and ,multifocal infiltration of the portal tract by large atypical multinucleated cells (HE, 400X).


Photomicrography of the lung showing focal infiltration of large atypical multinucleated cells in the parenchyma and perivascular. Note hemorrhagic foci and organizing pneumonia (HE, 100X).


The diagram illustrates modifications in hemoglobin (Hb) and IgAk monoclonal spike (left Y axis), platelets (PLT) and symptoms (right Y axis) by treatment in our patient. Symptom Scale: 0-100-point scale, based on patient's reported symptoms. Higher scores indicate more severe symptoms. RCD: Rituximab-Cyclophosphamide-Dexamethasone; CHOP: Cyclophosphamide-Doxorubicin-Vincristine-Prednisone. Red arrow: initiation of ibrutinib.


Magnetic resonance image demonstrates a 3.0x2.5 cm size solid mass with mildly enhancement on left kidney lower pole with a central necrotic portion.


Left kidney coronal opening specimen shows a well-circumscribed encapsulated mass measuring 2.7x2.8 cm size, involving the lower pole. The mass revealed areas of myxoid change necrosis, and cystic change.


Microscopic findings. (A) The low power appearance demonstrating a capsule of dense collagenous fibrous tissue and myxoid zone and inflammation with cellular zone consisting of spindle cells arranged in fascicles.


Microscopic findings. (B) The area of myofibroblastic proliferation showing densely cellular fascicles.


Microscopic findings. The tumor cells were potive for smooth muscle actin.


Microscopic findings. And vimentin.


Imaging Results: Normal Chest X-Ray.