Imaging examination results. (B) CT showed an oval mass with low attenuation in the right lobe of the thyroid and a round nodule with discontinuous peripheral annular calcification. (The yellow arrow indicates the tumor; the green arrow indicates the tumor focally broke into the nodule below and caused the interruption of the annular calcification; the red arrow indicates airway deviation caused by tumor compression).


Imaging examination results. (C) The yellow arrow indicates the left lobe of the thyroid gland; the red arrow indicates airway deviation caused by tumor compression; the green arrow indicates a nodule with interruption of the annular calcification. . Abbreviation: CT, computed tomography.


(A) No postoperative recurrence of the left adrenal lesion was observed, and the right adrenal lesion was unchanged and showed 123I-MIBG accumulation.


(B) 123I-MIBG accumulation showed no change compared to that recorded 7 years ago.


Pedigree chart of the patient's family members (arrow indicates the index patient).


The chest X-ray showed a large dense shadow with an unclear boundary in the left lung field, and the heart was obviously compressed and shifted to the right.


Hematoxylin-eosin staining (a), 40 times magnification: microscopically, there were obviously degenerate fusiform and ovoid tumor cells with loose reticular arrangement, hyperchromatic nuclei, inconsistent cell sizes, and can see the fat composition between the cells.


Immunohistochemical staining showed tumor cells positive for AFP.


Medical image.


Vimentin.


(a) PET/CT examination of the patient with mediastinal MGCT after chemotherapy; whole-body MIP (maximum density projection) images showed large patches of slightly increased radioactivity uptake in the left lung field (black arrow), SUVmax 5.2.


(b) Axial PET/CT fusion images showed varying levels of uptake of radioactive tracers in the lesions, but no uptake in the cystic necrosis area (white arrow).


(c) Coronal PET/CT fusion image.


Serum protein electrophoresis showing the presence of a monoclonal peak migrating in the gamma globulin area amounted at 6.9 g/L.


The immunofixation urine test showing lambda free light chain isotypes.


A; Color fundus at the time of diagnosis. Vitritis and an active toxoplasmic lesion are visible in the papillomacular bundle. B; Optical coherence tomography (OCT) B-scan with the total retina slabs. C; OCT B-scan over the active lesion shows retinal hyperreflectivity (arrow) and a thickened choroid (asterisk) under the lesion. D; A 9 x 9-mm field of view swept-source OCTA (SS-OCTA) image shows inferiorly located no OCTA decorrelation signal, suggestive of reduced blood flow. E; Structural en face image. F; Color fundus image 13 weeks after those in (a-e): inflammatory signs are absent, but an atrophic scar is visible. G; OCT B-scan with the total retina slabs. H; Retinal layers are unrecognizable at the lesion site (arrow) and choroidal thinning is seen (asterisk). I; A 9 x 9-mm field of view on SS-OCTA shows increase in flow signal after treatment. The arrows indicate the vascular loops. J; A structural en face image.


Brain magnetic resonance imaging on first presentation (day 5) showing multiple areas of abnormal signals (white arrowheads): left midbrain high signal on FLAIR sequence.


Left midbrain hypersignal on T2 weighed (T2W) sequence.


Central gadolinium enhancement of left midbrain lesion on T1 sequence.


Scattered supratentorial white matter foci of high FLAIR signal.


Brain magnetic resonance imaging (MRI) (day 30) at the time of the relapse of the neurological manifestations showing left frontoparietal cortical and subcortical areas of isointense T1, high T2 ,. Due to an active hyperacute bleed [arrow. Pointing at spot sign indicating active bleed.


FLAIR.


Restricted diffusion. Signals (arrowhead) increasing in size along the MRI examination.


Area of high T2 and FLAIR signal changes (arrowheads) in the head of the caudate nucleus.


Of abnormal diffusion weighed images (DWI) in the subcortical right cerebellar white matter (arrowheads).


Previous left midbrain lesion has resolved with only a tiny residual of high FLAIR signal corresponding to minimal residual gliosis (arrowhead) (F).


Follow-up brain MRI at D33 showing a necrotico-hemorrhagic lesion in the left hemisphere , interval evolution of cortical/subcortical lesions,. With new lesions in the bilateral thalami.


Cerebellar hemispheres.


Follow-up brain MRI at D33 showing a necrotico-hemorrhagic lesion in the left hemisphere , interval evolution of cortical/subcortical lesions,. Right cerebral hemisphere. (arrowheads indicate abnormal signals).


FLAIR sequences of brain magnetic resonance imaging (MRI) at day 39 showing interval evolution and improvement of thalamic.


Cerebellar.


Right cerebral hemispheric lesions. With no additional lesions as compared to the previous MRI (arrowheads indicate hypersignal abnormalities).


A; Transoperative image of the MH before the ART placement.


B; Preoperative SD-OCT image showing MH dimensions and the presence of an epiretinal membrane and macular schisis changes. MH, macular hole; ART, autologous retinal transplantation.


Bone marrow aspirate at 100 days after the second transplant. May-Grunwald-Giemsa-stained bone marrow smear (x100 magnification) showing normal trilineage haematopoiesis with the presence of erythroid precursors.


The patient's laboratory and treatment diary.


Herpes vegetans facial lesions at initial presentation.


Herpes vegetans facial lesions after 10 days of intravenous foscarnet treatment.


Facial lesions 2 months after presentation.


At the time of bleeding.


Wiped bleeding.


Intact skin underneath the site of bleeding.


May Grunwald - Giemsa (MGG) stained smears from the FNAC of temporal swelling reveal a monomorphous population of cells composed of intermediate-sized cells with pinkish granular cytoplasm and prominent nucleoli (arrows), suggesting overall features to be of a hematolymphoid malignancy in a known case of APML (400x).


X-ray Cervical spine lateral view reveals- osteosclerosis with post op defect of laminectomy with ossification of interspinous ligament, anterior longitudinal ligament.


X-ray Pelvis AP view- reveals Osteosclerosis with ossification of sacrotuberous ligament, sacrospinous ligament, iliolumbar and lumbosacral ligaments and bony overgrowth at ligamentous attachment site.


X-ray Left forearm AP reveals- Osteosclerosis with interosseous membrane calcification.


Preoperative CT scan cervical Spine done 20 years back reveals - spinal canal narrowing due to thickening/ossification of posterior longitudinal ligament at C2 vertebral level.


Recent CT scan cervical spine reveals- Post op defect of laminectomy with recurrence of spinal canal narrowing due to thickening/ossification of ligamentum flavum and thickening/ossification of posterior longitudinal ligament at C2 vertebral level.


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


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


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


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


Multiple pigmented follicular papules.


Widespread ulcers on the right lower leg.


C, d Dense infiltrate of atypical lymphocytes throughout the dermis with Langhans giant cells and epithelioid cells. Original magnification x100.


Paraffin-embedded tissue samples were deparaffinized and stained with anti-CD30 Ab The sections were developed with 3,3'-diaminobenzidine tetrahydrochloride Original magnification x200.


Anti-CD163 Ab. Or liquid permanent red Original magnification x200.


C; Biopsy from the left inguinal lymph node revealed prominent masses of epithelioid cells with giant cells and a dense infiltrate of atypical lymphocytes. And x100.


Absence of IFNgamma or other autoantibodies that may directly hinder/block IFNgamma signaling and normal response to IFNgamma or BCG stimulation. STAT1 phosphorylation (Y701) of HD monocytes after stimulation for 15 min. With 25% (v/v) allogenic HD or patient's serum (from different time points: P1, P2, and ,P3).


Absence of IFNgamma or other autoantibodies that may directly hinder/block IFNgamma signaling and normal response to IFNgamma or BCG stimulation. With IFNgamma previously mixed with 25% (v/v) allogenic HD or patient's serum (from different time points: P1, P2, and P3).


Absence of IFNgamma or other autoantibodies that may directly hinder/block IFNgamma signaling and normal response to IFNgamma or BCG stimulation. (C) STAT1 phosphorylation (Y701) of HD monocytes after IFNgamma stimulation for 15 min. Cells were preincubated 30 min at room temperature in the presence of 25% (v/v) HD or patient's serum (from different time points: P1, P2, and P3) and washed before IFNgamma stimulation.


Absence of IFNgamma or other autoantibodies that may directly hinder/block IFNgamma signaling and normal response to IFNgamma or BCG stimulation. (D) STAT1 phosphorylation (Y701) of monocytes from the patient after IFNgamma stimulation for 15 min.


Absence of IFNgamma or other autoantibodies that may directly hinder/block IFNgamma signaling and normal response to IFNgamma or BCG stimulation. (E) Frequency of IFNgamma+ and/or TNFalpha+ CD4+ T cells from the patient after no stimulation or stimulation with heat inactivated BCG for 48 h.


Absence of IFNgamma or other autoantibodies that may directly hinder/block IFNgamma signaling and normal response to IFNgamma or BCG stimulation. (F) IFNgamma concentration in culture supernatant after no stimulation, IL12, heat-inactivated BCG, or PMA/IONO stimulation of PBMC from the patient and one HD for 48 h. BCG: bacillus Calmette-Guerin; HD, healthy donor; IFNgamma, interferon gamma; NS, non-stimulated; P1, patient's serum before BCGosis diagnosis and IFNgamma therapy (2018-08); P2, patient's serum at the time of BCGosis diagnosis and during IFNgamma therapy (2018-11); P3, patient's serum after BCGosis diagnosis and IFNgamma therapy (2019-02).


Maximum likelihood phylogenetic tree representing the relationship between the clinical M. bovis BCG strain (M. bovis BCG_1811074784) and reference M. bovis BCG strains. Bootstrap values of each branch are indicated.


Frontal view after explantation of the breast implants in our 62-year-old patient.


Silicone residuals after explantation of the breast implants on protocol breast MRI. The diameter of the largest silicone pocket (left) is 2.3 x 1.5 cm.


A) Immunohistochemistry (ALK-staining) of tissue from the lateral and medial lower quadrant of the left breast of our 62-year-old patient.


B) Immunohistochemistry (CD3-staining) of tissue from the lateral and medial lower quadrant of the left breast of our 62-year-old patient.


C) Immunohistochemistry (CD5-staining) of tissue from the lateral and medial lower quadrant of the left breast of our 62-year-old patient.


D) Immunohistochemistry (CD20-staining) of tissue from the lateral and medial lower quadrant of the left breast of our 62-year-old patient.


E) Immunohistochemistry (CD23-staining) of tissue from the lateral and medial lower quadrant of the left breast of our 62-year-old patient.


Macroscopic features of the colon at autopsy. The serosal membrane showed patchy fibrous thickening, and the intestinal wall was edematous.


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


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


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


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


(A) Endoscopic findings of the laryngeal lesion of CD4+T-cell lymphoproliferative disease (LPD) lesion in case 4 prior to cancer chemotherapy.


(B) Fluorodeoxyglucose-positron emission tomography (FDG-PET) at the onset of LPD. White arrows show the increased FDG uptake in the larynx, stomach, and terminal ileum. The maximum standardized uptake value (SUVmax) was 11.8.


(C) Improvement of the laryngeal LPD lesion after bone marrow transplantation (BMT).


(D) FDG-PET at the onset of donor-derived CD4+T-LPD after BMT. White arrows show the increased FDG uptake in multiple lymph nodes without laryngeal lesion. The SUVmax was 9.7.


Counts of WBC from day 1 to day 131. . Note: After MSCs infusion, counts of WBC increased and fluctuated around normal level. . Abbreviations: WBC, white blood cell; MSC, mesenchymal stem cell.


Counts of HGB from day 1 to day 131. . Note: After MSCs infusion, counts of HGB increased and fluctuated near normal level. . Abbreviations: HGB, hemoglobin; MSC, mesenchymal stem cell.


Counts of PLT from day 1 to day 131. . Note: After MSCs infusion, counts of PLT increased and fluctuated around normal level. . Abbreviations: PLT, platelet; MSC, mesenchymal stem cell.


A) Erosions and edema in antrum of stomach.


B) Erythema in antrum of stomach.


A) Esophagus 10x mucosal erosions, lymphocytic infiltration of lamina propria.


B) Colon 10x, loss of crypt.


C) Colon 10x, loss of crypts and apoptosis.


D) Colon 20x, apoptosis.


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


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


Clinical images. A; Before therapy with IFNa.


Clinical images. B; During therapy.


Clinical images. C; After 2 months of therapy.


The clinical course of the treatment for relapsed/refractory angioimmunoblastic T cell lymphoma (AITL) with Evans syndrome. The clinical course from the occurrence of Evans syndrome to recovery. The continuous laboratory findings showed that anemia worsened quickly at the first stage, and the lowest number of Hb was 46 g/L. The main treatment was the transfusion of the washed red blood cells. The thrombocytopenia occurred 15 days later, and the lowest number of platelets was 15 x 109/L. Refractory/relapsed AITL combined with secondary Evans syndrome was diagnosed at the second stage. The patient received the first-line treatments for Evans syndrome including prednisone and intravenous immunoglobulin. However, anemia and thrombocytopenia did not improve significantly. The combination of chidamide and cyclosporine were administrated at the third stage, and the anemia and thrombocytopenia gradually improved.


Transfusion-induced iron overload. Axial T2 HASTE TE 90 sequence showing the liver and spleen with low signal absorption caused by iron saturation. Image obtained from the Alberta Netcare Portal.


M-protein levels over time. After initial presentation in 2010, the patient received five rounds of treatment and relapsed each time. The patient received the first dose of daratumumab (16 mg/kg) in October 2013 when he enrolled in the SIRIUS study. M-protein levels were measured at the local laboratory and then centrally after the first dose of daratumumab.


Minimal residual disease. A diagram of the protocol used to assess minimal residual disease shown in a. Bone marrow aspirates subjected to bulk red blood cell lysis and separated into 2 tubes. Each tube was incubated with an 8-marker antibody combination. Tube 1 was stained for surface markers only and tube 2 surface and intracellular markers. Minimal residual disease was then measured by flow cytometry merging data from each tube into one analysis. As shown in b plasma cells (PC) displayed a CD38high CD138int phenotype with low CD19 and CD45 expression indicative of an immature plasmablast (PC) population. By applying a cutoff value of 1 abnormal/clonal plasma cell per million nucleated event for MRD positivity (ie, 10-6 sensitivity threshold of MRD positivity), the bone marrow aspirate tested MRD negative. BM bone marrow, RBCs red blood cells, MRD minimal residual disease.


Posteroanterior chest X-ray showed increase in density in the lower zone of the right hemithorax.


Computed tomography (CT) showing pleural thickening in the right hemithorax and pleural effusion.


Biopsy specimen of the lower right parietal pleura. Megakaryocytes (hematoxylin and eosin staining; original magnification: x 40).


Mixed cellularity type of Hodgkin(HE x400).


Lytic lesion in the skull.


Kinetics of cellular chimerism after the first allo-hematopoietic stem cell transplantation (allo-HSCT) and donor lymphocyte infusion (DLI).


Acute pulmonary oedema following rituximab treatment.


MRI of the brain showing high T2 and FLAIR signal in the occipital and posterior parietal subcortical white matter consistent with PRES following treatment with rituximab.


Single-voxel 1H-magnetic resonance spectroscopy of the tumor area in the left thalamus showing elevated Cho peak in 3.2 ppm and Lip peak in 1.3ppm with decreased NAA in 2.0 ppm, with corresponding short echo time spectra. TE=35ms).


Long echo time spectra. TE=144ms). Cho, choline compounds; Lip, lipid; NAA, N-acetyl-aspartate.


The clinical treatment process of posttransplant lymphoproliferative disorder (PTLD) after transplantation and the changes of serum EBV-DNA titers. HSCT, hematopoietic stem cell transplantation; CsA, cyclosporine; MTX, methotrexate; WBRT, whole-brain radiotherapy.


Photographs 4 months after treatment showed red depigmented fundus in both eyes.


Axial T1-weighted contrast-enhanced magnetic resonance image demonstrating a right temporoparietal, partial ring-enhancing lesion in the white matter.


Axial computed tomographic image obtained at the time of admission, before high-dose steroid therapy was started, showing subfalcine herniation.


Axial computed tomographic image showing aggressive development of edema causing transtentorial herniation.


Clinical photograph of a huge ossifying fibroma of the mandible: Massive size, involvement of the body of the mandible as a whole with expansion of the outer cortex only.


Post-operative results at 6 weeks after surgery: The patient could elevate and depress his lower jaw over amplitude of 3.5 cm. Normal tongue movements were achieved together with adequate competency of lips.


Spinal MRI of the first and third attack. (A-C) Cervical (T2-weighted imaging) and thoracic (fat-saturated T2-weighted imaging) spinal MRI of the initial attack revealed multiple T2-hyperintense lesions throughout the spinal cord. Axial fat-saturated T1-weighted imaging with contrast enhancement showed eccentric lesions with patchy enhancement.


Spinal MRI of the first and third attack. (D-F) Repeat spinal MRI showed new lesions along the cervical and thoracic cord with resolution or attenuation of previous lesions. No enhancement was seen on axial fat-saturated T1-weighted imaging. Lesions were indicated by white arrowheads. MRI, magnetic resonance imaging.


Brain MRI of the second and third attack. (A-C) Brain MRI (fat-saturated T2-weighted fluid attenuated inversion recovery imaging) at the second attack showed ovoid juxtacortical and pontine lesions.


Brain MRI of the second and third attack. (D-F) Repeat MRI (T2-weighted fluid attenuated inversion recovery imaging) at the third attack after steroid cessation showed new lesions adjacent to the left posterior horn of the lateral ventricle and resolution of juxtacortical and pontine lesions. Lesions were indicated by white arrowheads. MRI, magnetic resonance imaging.


The resected specimen revealed three independent type 0-IIc early carcinomas in the forecourt of the pylorus and in the pylorus.


Histological findings of the resected specimen from the type 0-IIc early gastric carcinoma within the submucosa (a).


High-power photomicrography revealed signet ring cell carcinoma (b).


Grossly, the peritoneal lesion showed a tumorous growth measuring 2.0 x 3.0 cm (a).


Microscopically, the lesion was composed of tumorous proliferation of small lymphocytes (b). The lymphoid cells were composed of centrocytic and monocytic lymphoma. Little atypia was seen. A few mitotic figures were present. No lymphoepithelial lesions were seen. Plasmacytic differentiation was noted.


Immunohistochemically, the lymphoid cells were positive for CD20.


Ki67 labeling was 10.


CD30 was negative for staining (f).


Brain magnetic resonance imaging at the time of diagnosis. There is a recognizable, voluminous expansive lesion at the hypothalamic level. FLAIR sequence) with an inhomogeneous structure.


Brain magnetic resonance imaging at the time of diagnosis. First read as calcifications. T1 sequence.


Brain magnetic resonance imaging at the time of diagnosis. . T2 sequence). Optic chiasma, hypothalamic-pineal peduncle and mammillary body are not recognizable.


Brain magnetic resonance imaging at the time of diagnosis. (D, T2W_TSE sequence).


Skin lesions before rituximab treatment.


Clinical picture eight months after initial rituximab treatment.


A: H&E, 40x, Well circumscribed tumor with compressed peripheral adrenal parenchyma (black arrow). 2b: H&E, 100x, Nests of tumor cells with circumscribed margin and adjacent normal adrenal parenchyma (black arrow). 2c: H&E 100x Nests and trabecular pattern of tumor cells, separated by thin fibrovascular septae. 2d: H&E, 400x, Tumor cells having moderate amount of granular eosinophilic cytoplasm, centrally placed round nucleus with fine granular chromatin and inconspicuous nucleoli. Scattered sustentacular cells (black arrow) are also noted.


Time-course change in this case. According to the decrease of inflammation represented by CRP, the number of atypical lymphocytes decreased. The copy number of EBV began to decline in the convalescent phase. In the acute phase, EBV VCA-IgM was higher than EBV VCA-IgG, but in the convalescent phase, EBV VCA-IgG was higher. BZLF1 mRNA (70.09 copies/mugDNA) and TRAbs (0.24 IU/l) were detected in the acute phase. *Index stands for sample absorbance/absorbance of cut-off serum. EBV Epstein-Barr virus, VCA viral capsid antigen, BZLF1 one of the EBV-immediate-early lytic genes, TRAb thyrotropin receptor antibody.


Platelet and WBC counts following immunotherapy with durvalumab. WBCs are multiplied by 102.


Electroencephalogram recorded on day 8. Encephalopathy is suspected because of the diffuse slowing of the background activity.


Right lower extremity shin ulcerations.


Photograph showing bilateral ocular proptosis with lid erythema, edema, and severe chemosis, worse in the right eye. This led to lagophthalmos and corneal exposure.


(A, B) Computed tomography showing marked bilateral orbital soft tissue swelling and proptosis, right greater than left, with right retro-bulbar hematoma and/or collection exerting mass effect on the right globe. Bone is intact across both slides cuts.


(C) Magnetic resonance imaging demonstrating enhancing intraorbital masses, bilateral proptosis, mass effect, and involvement of extraocular muscles. The left lateral rectus muscle is enlarged (arrow).


Preoperative . A hypointense mass (white arrows) from the left orbit apex to the anterior cranial fossa is shown on T1-weighted axial (A) MRI scan.


Preoperative . It is hyperintense on T2-weighted axial.


Preoperative . And sagittal.


Preoperative . MRI scans, with a significant enhancement on contrast images.


Preoperative . Obvious hyperintensity is identified on the ADC map.


Preoperative . But not on DWI.


Postoperative. MRI. The mass is absent on both T1WI.


Postoperative. MRI. T2WI. While edema (red arrows) recedes incompletely.


Postoperative. MRI. The contrast scan (I) shows no enhancement indicating the mass was excised completely.


Hematoxylin-eosin staining of the excised mass (x20) (A) shows numerous capillary vessels containing red blood cells (black arrows) distributed in the vacuolated stromal cells (red arrows).


Immunohistochemistry staining of the mass shows that the endothelial cells of capillary vessels (red arrows) were positive (brown=positive) for CD31.


Some interspersed monocytes (red arrows) and macrophages (black arrow) were positive for CD68 (E).


Vacuolated stromal cells are positive for GFAP.


Medical image.


Syn. Is negative among the whole sample tissue.


Results of bone marrow biopsy showing obviously hypocellular bone marrow spaces with increased fat spaces, in line with the aplastic anemia typical appearance (H&Ex100).


CT Abdomen showed 3.5 x 2.5 cm primary tumour in pancreatic head/uncinate process mass with complete encasement of superior mesenteric artery (SMA)/superior mesenteric vein (SMV). No evidence of any regional lymphadenopathy or liver metastasis. The figure illustrates the approximate extent of pancreatic mass (circled), pancreatic duct dilatation (yellow arrow) and the narrow superior mesenteric artery (red arrow).


CT Abdomen showing severe anasarca and retroperitoneal haemorrhage. The figure shows the bilateral retroperitoneal haemorrhages both right sided (thick arrow) and left sided (thin arrow). It illustrates the asymmetry with right side retroperitoneal haemorrhage being larger in size.


Increasing factor VIII level as chemotherapy was given, also shows timeline of other used immunosuppressive therapies.


Noncontrast computed tomography scan of the chest showing a 2 cm round soft tissue mass with smooth regular margin in the left lower lobe.


Fibrotic stromal fragment with papillary features in a background of abundant blood (Papanicolaou stain, x100).


Fibrovascular fragment associated with round cells (Diff-Quik stain, x200).


Cohesive sheets of surface cells arranged in pavement-like fashion (Diff-Quik stain, x400).


Dense collagenous stromal tissue associated with bland appearing round cells (x200).


Both surface and round cells are positive for thyroid transcription factor-1 immunostain (x200).


AE1/AE3 immunoreactivity is present in the surface cells but not the round cells (x200).


Progesterone receptor immunoreactivity is present in the round cells but not the surface cells (x200).


MRI- Well circumscribed intravesical mass.


Gross: Encapsulated mass weighing 600 gms and measuring 13 x 10 x 9 cms.


TTE: a small, mobile 4-5 mm echodensity at the tip of the non-coronary leaflet.


Macroscopic appearance of the resected tumor. The tumor was solid and grayish with smooth margins.


a Low-power magnification of the biopsy showing capsule (red arrowhead), adrenal tissue (black arrowhead) and an admixture of adipose and hematopoietic cells. b High-power magnification of the biopsy showing adipocytes (black arrowhead), erythroid precursors (cyan arrowhead), lymphoid precursors (blue arrowhead) and megakaryocytes (green arrowhead). Bony spicules and sinusoids are conspicuously absent from the specimen confirming it is a myelolipoma.


A; Resected specimen showing a well-encapsulated tumor.


B; Resected specimen cut surface revealing adipose tissue with interspersed areas of hemorrhage.


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


Palmar erythema with slight edema. Toes are involved as well.


X-rays of the hip showing an osteolytic tumor at the site of the fracture (left side).


Mononuclear cells stained strongly positive for CD1a, whereas giant cells with emperipolesis stained negative (black arrows) (a).


Some CD1a + cells are round-shaped with oval nuclei, reminiscent to RDD-cells ("Blanks cells" or transitional cells) (b).


S-100 protein is strongly expressed by histiocytes of both RDD and LCH components.


A - Surgical biopsy demonstrates: fusiform cells proliferation, arranged in curved bundles, sometimes in a whirl pattern, between which there was founded an important number of foamy histiocytes, plasmocytes, and multinucleate cells.


B - Second biopsy, it is observed, in the sample, atypical big lymphocytes.


C - Second biopsy, it is observed, in the sample, positive CD30.


A - Firth contrasted chest magnetic resonance evidenced an expansive lesion of infiltrative pattern in the retrosternal region, reaching the soft parts and the intercostal muscles between the first and the fourth right costal cartilages. There wasn't a cleavage plane between the lesion and the pectorals major muscle.


B - Computerised tomography with protons emission - PET/CT-scan - revealed retrosternal expansive lesion, poorly defined and with an heterogeneous metabolism increasing, that extends from the first to the fourth right costal arches and involves the region of the right internal mammary and the right cardiophrenic region, presenting an increased metabolism (SUV = 3, 8) and mediastinal lymphadenomegaly, presenting an increased metabolism in the upper and lower paratracheal region (SUV = 19, 9).


C - Control computerised tomography with protons emission - PET/CT-scan that resulted with the complete resolution of the expansive lesion in the thorax and a mediastinal lymphadenomegaly.


Preoperative orbit MRI. Coronal T1 weighted image.


Preoperative orbit MRI. Coronal T1 weighted image post gadolinium enhancement.


Preoperative orbit MRI. Coronal T2 weighted image.


Preoperative orbit MRI. Sagittal T1 weighted image post gadolinium enhancement. Showing a well-circumscribed lesion isointensity on T1-weighted images and hypointensity on T2-weighted image with good enhancement and has small cystic/necrotic change noted in the left frontal base, orbital roof, and upper-medial orbital region. The black arrows point out the dural tail sign.


Post-operative orbit MRI. Coronal T1 weighted image.


Post-operative orbit MRI. Coronal T1 weighted image post gadolinium enhancement.


Post-operative orbit MRI. Coronal T2 weighted image. Showing gross total removal of the tumor.


The images of CT and cystoscopy in a patient with ALK-positive ALCL involving the urinary bladder. . Notes:. Enhanced CT scan showing an exophytic broad-based nodular lesion (white arrow) on the left bladder wall.


The images of CT and cystoscopy in a patient with ALK-positive ALCL involving the urinary bladder. Cystoscopy revealing an irregularly shaped nodule with congestive and hemorrhagic appearance (black arrow). . Abbreviations: CT, computed tomography; ALK, anaplastic lymphoma kinase; ALCL, anaplastic large-cell lymphoma.


H&E and IHC staining in the urinary bladder sample of ALK-positive ALCL. . Notes:. Diffuse infiltration of tumor cells in the lamina propria of bladder (200x, H&E).


H&E and IHC staining in the urinary bladder sample of ALK-positive ALCL. Tumor cells with pleomorphic nuclei, prominent nucleoli, and ,brisk mitotic activity (400x, H&E).


H&E and IHC staining in the urinary bladder sample of ALK-positive ALCL. Strong immunoreactivity of CD30 with membrane staining pattern in neoplastic cells (400x, IHC).


H&E and IHC staining in the urinary bladder sample of ALK-positive ALCL. A diffuse cytoplasmic, and ,nuclear staining for ALK protein (400x, IHC).


H&E and IHC staining in the urinary bladder sample of ALK-positive ALCL. Negative expression of AE1/AE3 in tumor cells (200x, IHC).


H&E and IHC staining in the urinary bladder sample of ALK-positive ALCL. Tumor cells exhibiting negative expression for synaptophysin (200x, IHC). . Abbreviations: H&E, hematoxylin-eosin; IHC, immunohistochemical; ALK, anaplastic lymphoma kinase; ALCL, anaplastic large-cell lymphoma.


High-resolution computer tomography imaging showing a large lung lesion in the left parahilar side.


Surgical sample of lingula inflammatory myofibroblastic tumor in 3-year-old child.


Cytogenetic study shows 47, XXY karyotype with Philadelphia chromosome abnormality.


Right anterior skull base exposure (a) Right anterior skull base exposure showing reddish optic nerve tumor.


(b) Dura propria incised over optic nerve tumor.


(c) Optic nerve sectioned distal to the chiasm (Blue arrow). Black arrow denotes right internal carotid artery. Green arrow denotes the chiasm.


T1-weighted, gadolium-enhanced MR images; a sagittal image shows a homogenously enhanced mass at the ventral foramen magnum, whose size is around 20 mm in diameter (a). On axial image, the tumor seemed to be attached to dura mater around C2. The tumor severely compressed the ventral medulla oblongata.


Medical image.


The axial, T2-weighted MR image showed no medullary edema.


No residual tumor in the images.


Trends of. Activated partial thromboplastin time (aPTT).


Factor VIII level, and ,inhibitor titer.


Platelet and absolute neutrophil count (ANC) and therapeutic interventions.


FDG PET imaging patient 1. (A) Relapse 6 months after the therapy with CAR T-cells (prior to Pola-BR).


FDG PET imaging patient 1. (B) Complete metabolic remission after three courses of Pola-BR.


FDG PET imaging patient 1. (C) Confirmed complete metabolic remission 12 weeks after alloHSCT.


FDG PET imaging patient 2. (A) Relapse seven months after the therapy with CAR T-cells (prior to Pola-BR).


FDG PET imaging patient 2. (B) Complete metabolic remission after three courses of Pola-BR.


FDG PET imaging patient 2. (C) Confirmed complete metabolic remission 52 days after alloHSCT.


Symmetrical hyperkeratosis with scaling over both hands extending medially up to the elbows.


Symmetrical hyperkeratosis with fine scales over both feet, up to the ankle, in the 'socks' area.


Lamellated hyperkeratosis, intact granular layer, acanthosis, and mild spongiosis, with mild perivascular lymphocytic infiltrate.


Bone marrow . A; In situ hybridization for kappa light chain, with a positive signal indicated by blue staining (arrow).


Bone marrow . B; Immunohistochemistry for plasma cells (CD138).


Kidney. Biopsies, light microscopy. C; Lobulated glomerulus with extracapillary proliferation (crescent; star; HE).


Kidney. Biopsies, light microscopy. D; Hypercellular glomerulus with segmental fibrinoid necrosis (arrow; HE).


Clinical fundus photo of a 44-year-old male presenting with diminution of vision following dengue fever. (A) Right eye. (A) Right eye showing additional retinal whitening exclusively inferior to the right macula.


Clinical fundus photo of a 44-year-old male presenting with diminution of vision following dengue fever. (B) Left eye. Both eyes depicting perivascular exudates, intraretinal hemorrhages, cotton wool spots and macular edema.


Fundus fluorescein angiography of a 44-year-old male presenting with diminution of vision following dengue fever. (A) Right eye.


Fundus fluorescein angiography of a 44-year-old male presenting with diminution of vision following dengue fever. (B) Left eye. Both eye showing disc and perivascular leakage limited to posterior pole indicative of vasculitis. In addition, there is capillary nonperfusion due to occlusion of multiple small arterioles supplying the macula of right eye confirming macular ischemia.


Chest X-ray . A; Chest X-ray revealed thickened lung marking in both lower lung fields.


CT scan. On admission. B; Chest CT scan showed honeycombing, reticular and ground glass opacities in the lower lung fields (arrows).


Chest CT scan showing anterosuperior mediastinal mass before. Arrow), and . A; The size of the anterosuperior mediastinal mass was 3.5 x 1.9 cm with CT 5 HU.


After. Arrow) treatment. B; The same mass was diminished to 1.2 x 1.0 cm with CT 16 HU.


Intraoral examination revealed a healthy oral mucosa.


Intraosseous medullar biopsy of the mandible.


Immunohistochemical profile, revealed positivity for BCL-6, CD-10, CD-20, C-MYC, PAX-5 and strong positivity for Ki-67.


MRI findings at onset of neurological disturbances. . Notes: Brain MRI images from June 2015 showed. T2 hyperintense lesions in left temporal lobe, and ,brainstem (circles).


MRI findings at onset of neurological disturbances. T1 hyperintense lesions in basal ganglia (thin arrows), known as calcifications.


MRI findings at onset of neurological disturbances. Leptomeningeal contrast enhancement at midbrain-pons junction (arrow). . Abbreviation: MRI, magnetic resonance imaging.


T2-weighted magnetic resonance images show.


Axial and
 sagittal views of a 92-year-old patient (Case #1). A tumor mass
(arrows) affected the (left panel) cervix uteri, corpus uteri, and
(right panel) parametrium, and (left panel) a
swollen lymph node (arrowhead) was present in the pelvic cavity.


Optical coherence tomography angiography was used to analyze the vascular flow of the superficial plexuses.


Deep plexuses.


Outer retina.


Choriocapillaris Vascular networks appeared at the superficial and deep plexuses. No blood flow was detected in the tumor at the outer retina or choriocapillaris.


Sclerosing cholangitis in the index patient. (A) Upper abdomen magnetic resonance showing diffuse and marked enlargement of intra- and extrahepatic bile ducts.


Sclerosing cholangitis in the index patient. (B) Liver biopsy showing one dilated duct with "onion-skin" type of periductal fibrosis.


The infant at initial presentation with extensive hemangioma involving most of the right cheek and right eyelids. There were five ulcerated, hemorrhagic spots which had been covered with dressings by the parents.


Three hemangiomatous lesions on the right side of palate and adjacent buccogingival surfaces could be also be visualized as the child cried.


Small hemangioma was also present on the right third toe.


Three days after initiation of the propranolol therapy, there was visible alteration in the color of the lesion, softening in texture and the infant could slightly open the right eye.


There was considerable improvement after completing four weeks therapy.


Magnetic resonance imaging images (a,b) Pre-treatment T1-weighted gadolinium-enhanced MRI (axial and coronal images).


(a) Preoperative three-dimensional computed tomography.


(b) Postoperative three-dimensional computed tomography. The occipital bone has been removed, and the foramen magnum has been opened.


Magnetic resonance imaging images (a,b) T1-weighted gadolinium-enhanced MRI (axial and coronal images) after 2 weeks. Diffuse enhancement of the meninges has improved markedly.


(c,d) T1-weighted gadolinium-enhanced MRI (axial and sagittal images) after 2 months. Diffuse enhancement of the meninges has almost disappeared.


T1-weighted sagittal magnetic resonance imaging images with contrast enhancement. (a) The image was obtained at the time of diagnosis of panhypopituitarism, showing the pituitary stalk thickening (white arrowhead).


T1-weighted sagittal magnetic resonance imaging images with contrast enhancement. (b) Image after 6 months showed that the lesion at the hypothalamus was enlarged (white arrowhead).


T1-weighted magnetic resonance imaging images with contrast enhancement. (a) Axial image showed that new multiple enhanced lesions were present at the basal ganglia (white arrowhead) and deep white matter in the frontal lobe (white arrow).


T1-weighted magnetic resonance imaging images with contrast enhancement. (b) Coronal image showed that the lesion at the hypothalamus had progressed (black arrowhead), and there were some enhanced lesions surrounding the hypothalamus (white arrowhead).


T1-weighted coronal magnetic resonance imaging images with contrast enhancement. (a) Before steroid administration, there were enhanced lesions at the hypothalamus (white arrow) and the cerebral parenchyma (white arrowheads).


T1-weighted coronal magnetic resonance imaging images with contrast enhancement. (b) Eighteen months after administration of steroid, the enhanced lesion at the hypothalamus was reduced (white arrow), and the lesions at the brain parenchyma were completely diminished.


Chest X-ray.


Thoracic ultrasound. Images showing a large left-sided pleural effusion.


Thoracic ultrasound. Images showing near-complete resolution of the left-sided pleural effusion post intrapleural fibrinolytic therapy and drainage.


Representative MRI studies of patients. (A) A T2-weighted image of the brain from Case 1, demonstrating a hyperintense mass in the right parietal cortex.


Representative MRI studies of patients. (B) A T2-weighted image of the brain from Case 2, demonstrating a lesion in the right superior parietal lobe.


Representative MRI studies of patients. (C) A T2-weighted image of the brain from Case 3, demonstrating a large mass of the right posterior fossa.


Representative MRI studies of patients. (D) A T2-weighted image of the brain from Case 4, demonstrating mass involving the right posterior parietal lobe.


Representative MRI studies of patients. (E) A T2-weighted image of the brain from Case 5, demonstrating a large right fronto-parietal mass with midline shift.


Miller class 1 recession 15, 16.


Full thickness mucoperiosteal flap reflected followed by a partial thickness one, to create a recipient bed.


PrF placed as the membrane.


Flap advanced and sutured.


Seven months follow up.


Miller class 1 recession 25, 26.


Horizontal followed by vertical releasing incision made.


Amniotic membrane placement.


Hematoxylin and eosin staining of a tumor section (x200).


Chest CT images showing metastases before.


After treatment with apatinib. Respectively). . Note: The arrows and arrowheads indicate the pulmonary metastases. . Abbreviation: CT, computed tomography.


Main toxicities during apatinib treatment. . Notes: (A) Elevated alanine transaminase.


Main toxicities during apatinib treatment. (B) Elevated aspartate amino transferase.


(A) Anterior segment photo taken using mobile camera and 20 dioptre condensing lens during indirect examination. The child was not co-operative for slit-lamp photography at the time of presentation.


(B) Slit lamp picture showing dull glow due to vitreous exudates taken after corneal tear repair with iris abscission showing. Cornea shows folds on the descemet membrane due to tight sutures owing to the tissue loss.


(C) Slit lamp picture showing quiet eye without any infection after core vitrectomy.


(A) Gram stain of the vitreous aspirate showing gram positive cocci in chains suggestive of streptococci.


(B) Blood agar plate showing multiple colonies with complete hemolysis suggestive of beta-hemolytic streptococci.


Pathology and immunohistochemistry. . Notes: (A) The arrow points to Hodgkin lymphoma cells expressing CD30. The image was obtained by staining CD30 when the disease was diagnosed in May 2012. Magnification. Is 40x10.


Pathology and immunohistochemistry. (B) The arrow points to Hodgkin Reed-Sternberg cells surrounded by a large number of inflammatory and immune cells in an involved lymph node. The image was obtained from the initial involved lymph node. Magnification. Is 40x10.


Pathology and immunohistochemistry. (C) The arrow points to the large cells expressing CD30 admixed with lymphocyte cells. These larger cells also expressed CD15, but we could not exclude the possibility of lung involvement. However, the patient exhibited classical B symptoms and experienced recurrence with incomplete remission. According to the PET/CT examination, the disease was classified as stage IV B lymphoma in September 2013. Is 100x10. . Abbreviations: ASCT, autologous stem cell transplantation; CT, computed tomography; PET, positron emission tomography.


Pathology and immunohistochemistry. (D) After ASCT failure, the patient received six cycles of brentuximab vedotin treatment. However, the disease progressed after these therapies in April 2014. Then, through fiberoptic bronchoscopy lesion biopsy, the patient's multiple bilateral pulmonary lesions were diagnosed with involved classical Hodgkin lymphoma cells. Is 100x10. . Abbreviations: ASCT, autologous stem cell transplantation; CT, computed tomography; PET, positron emission tomography.


Response to therapy as shown on the PET/CT. . Notes: (A) The patient was diagnosed with classical Hodgkin lymphoma (HL) involving the neck, mediastinal and left hilus pulmonis lymph nodes in stage II B (fever) disease in May 2012.


Response to therapy as shown on the PET/CT. (B) After four cycles of ABVD, the neck and right hilus pulmonis lymph nodes faded. The mediastinal lymph nodes diminished but still appeared metabolically active in October 2012. Furthermore, the disease involved a new lesion.


Response to therapy as shown on the PET/CT. (C) After ASCT in May 2013, a partial response was achieved, and the mediastinal lymph nodes remained as residual lesions.


Response to therapy as shown on the PET/CT. (D) After the patient received ASCT and radiotherapy, the patient suffered again from fever and cough. The PET/CT demonstrated multifocal progressive disease involving primary and additional involved lymph nodes with increased metabolism of different levels compared with the previous PET/CT scan. The arrows indicate mediastinal and hilus pulmonis lymph nodes involved with Hodgkin lymphoma cells. . Abbreviations: ABVD, doxorubicin, bleomycin, vincristine, and dacarbazine; ASCT, autologous stem cell transplantation; CT, computed tomography; PET, positron emission tomography.


Photomicrograph of a characteristic erythrocyte cast found upon microscopy of the urinary sediment derived from the presented case (40x magnification).


Panel of photomicrographs derived from the presented renal biopsy case. Overview in periodic acid-Schiff (PAS) stain (100x magnification).


Panel of photomicrographs derived from the presented renal biopsy case. Detail of a glomerulus, PAS stain, (400x).


Panel of photomicrographs derived from the presented renal biopsy case. Detail of a glomerular Congo red stain (400x), note birefringence indicating presence of amyloid deposits.


Panel of photomicrographs derived from the presented renal biopsy case. Electron microscopic preparation showing amyloid fibrils (31,500x). D. , Dept. Of Renal Pathology, University of Erlangen, Germany).


Panel of photomicrographs derived from the presented renal biopsy case. Immunohistochemistry demonstrating presence of lambda.


Panel of photomicrographs derived from the presented renal biopsy case. But not kappa. Light chain deposits (400x); (images provided by Maike Buettner-Herold, M.


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


Fundus photography of the right and left eyes. Extensive choroidal coloboma is seen in the right eye.


Fundus photography of the right and left eyes. , markedly different from the left eye.


Fluorescein fundus angiography of the right and left eyes. A; The right eye shows no changes of DR.


Fluorescein fundus angiography of the right and left eyes. B; The left eye displays a wide area of retinal nonperfusion.


Bronchoscopy revealing mucopurulent tracheobronchitis and a well-demarcated area of increased friability with white-colored pseudomembrane involving the carina and right upper bronchus.


Brushing from the pseudomembrane showing clusters of septate fungal hyphae with a positive potassium hydroxide (KOH) preparation.


Holter ECG: atrial fibrillation with fast ventricular rate.


ECG: arrows show: sinus beats (SR), supraventricular beats (SB), episodes of non-sustained VT (nsVT).


Histopathological examination: specimens from the wall of the left ventricle and interventricular septum - image of giant cell (GC) myocarditis with areas of fresh and degradable organization with the formation of fibrous scar (FS) tissue.


(A-C) Ultra-wide-angle fundus photographs of the right eye from 1, 2, and 5 months post-treatment. White sheathing of the vessels alleviated first, and supratemporal hemorrhage resolved at 5 months later.


(D) Optical coherence tomography of the right eye 1 month after treatment showing disappearance of subretinal exudation and much less vitreous cells.


Nonenhanced CT performed at first admission, 5 hours after headache onset. Subtle signs of subarachnoid hemorrhage are evident (arrow), and there is also slight dilatation of the temporal horns of the lateral ventricles, suggesting hydrocephalus.


Digital-subtraction angiography performed during the endovascular treatment procedure, 10 hours after the onset of subarachnoid hemorrhage. A: Injection of the left internal carotid artery showing a small aneurysm at the junction of segments 1 and 2 of the anterior cerebral artery.


Digital-subtraction angiography performed during the endovascular treatment procedure, 10 hours after the onset of subarachnoid hemorrhage. B: Simultaneous injection of both internal carotid arteries shows complete occlusion by coiling of the aneurysm.


MRI was performed at re-admission, 25 days after endovascular treatment of anterior cerebral artery aneurysm. A: T2-weighted MRI images showing subcortical areas with abnormal signal intensities and swelling in the left hemisphere.


MRI was performed at re-admission, 25 days after endovascular treatment of anterior cerebral artery aneurysm. Diffusion-weighted (B1000).


MRI was performed at re-admission, 25 days after endovascular treatment of anterior cerebral artery aneurysm. Apparent-diffusion-coefficient (ADC) maps show no diffusion restriction and elevated ADC values in the abnormal areas, suggesting vasogenic edema.


MRI was performed at re-admission, 25 days after endovascular treatment of anterior cerebral artery aneurysm. D: T1-weighted MRI images after gadolinium administration show patchy enhancement of the abnormalities.


MRI was performed 7 months after endovascular treatment of the anterior cerebral artery aneurysm. A: T2-weighted MRI images show considerably diminished reversible posterior leukoencephalopathy syndrome lesions, with only minimal residual enhanced-signal regions in the left hemisphere.


MRI was performed 7 months after endovascular treatment of the anterior cerebral artery aneurysm. B: T1-weighted MRI images after gadolinium administration show no enhancement of the abnormalities.


A; Marked nipple enlargement with multiple bluish areas and myxoid appearance.


B; Alcian blue stain highlighting the myxoid nature of the proliferation.


Multifocal areas of myxoid proliferation with ill-defined boundaries intermixed with sclerotic tissue.


Fibrocollagenous septa containing preexisting ducts between two foci of myxoid proliferation with stellate cells surrounded by clear halos.


Loosely arranged fascicle of spindle cells with slender cytoplasms in a myxoid background.


At the base, the lesion boundaries tended to be well demarcated.


The immunoprofile was characterized by a diffuse expression of CD34.


Weak-to-moderate expression of actin.


Weak but noticeable expression of S100 protein.


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


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


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


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


Predominantly mononuclear cells showing prominent nucleoli (x40).


Immunohistochemical staining shows CD30 positive for the large cells.


Immunohistochemistry positive for Pax 5.


Abdominal CT scan with contrast. Findings of bilateral enhancing lesions in the kidneys. Multiple rounded hyperdense lesions throughout the renal parenchyma bilaterally, more pronounced in the left kidney. Left perinephric hematoma 8.8 x 5.2 cm. Axial view (left). Diffuse thickening of the stomach wall. No evidence of liver lesions.


Abdominal CT scan with contrast. Findings of bilateral enhancing lesions in the kidneys. Multiple rounded hyperdense lesions throughout the renal parenchyma bilaterally, more pronounced in the left kidney. Left perinephric hematoma 8.8 x 5.2 cm. Axial view (right).


Abdominal MRI. Multiple rounded hypo enhancing lesions noted throughout the renal parenchyma bilaterally. Axial view (left).


Abdominal MRI. Multiple rounded hypo enhancing lesions noted throughout the renal parenchyma bilaterally. Coronal view (right).


Microscopic appearance of the high-grade Burkitt's lymphoma. Stomach. Gastric mucosa with a dense lymphoid infiltrate in the lamina propria consisting of intermediate size monotonous lymphoma cells with round nuclei, fine chromatin, and multiple nucleoli. Mitoses are conspicuous. Multiple apoptotic bodies impart a starry sky pattern to the lesion (A, B: hematoxylin & eosin).


Microscopic appearance of the high-grade Burkitt's lymphoma. Stomach. Gastric mucosa with a dense lymphoid infiltrate in the lamina propria consisting of intermediate size monotonous lymphoma cells with round nuclei, fine chromatin, and multiple nucleoli. Mitoses are conspicuous. Immunohistochemistry was positive for CD20, CD10, BCL6.


Microscopic appearance of the high-grade Burkitt's lymphoma. Stomach. Gastric mucosa with a dense lymphoid infiltrate in the lamina propria consisting of intermediate size monotonous lymphoma cells with round nuclei, fine chromatin, and multiple nucleoli. Mitoses are conspicuous. C-MYC MUM1, and are negative for CD5, BCL2, CD30, and terminal deoxynucleotidyl transferase (TdT). Fluorescence in situ hybridization (FISH) was 73% positive for MYC-IGH fusion and negative for IGH-BCL2 and BCL6 rearrangements.


Photograph of the patient showing skin hyperpigmentation in the face.


Abdominal CT findings. A; CT scan showing diffuse hypodense enlargement of the pancreatic head (arrow). . Notes:. Unenhanced.


Abdominal CT findings. . Notes:. Unenhanced.


Abdominal CT findings. Arterial phase. . Abbreviation: CT, computed tomography.


A gross pathological examination revealed a 3.0 x 4.0 cm multiseptated mass in the pancreatic head (arrow). The cut surface of the tumor was yellowish (arrow).


Histopathology showed small tumor cells without cell adhesion or tissue structure proliferation,HE immunochemical staining was positive for B-cell markers CD20, and . (A-C x400; D x200). . Abbreviation: HE, hematoxylin and eosin.


CD79a , compatible with the diagnosis of diffuse large B-cell non-Hodgkin lymphoma.


HE immunochemical staining confirmed a proliferative index of over 50-60% (D).


A; PET-CT did not detect any signs of disease recurrence after 16 months.


Abbreviations: R, right; L, left; PET-CT, positron emission tomography-computed tomography.


(A, B) A CT scan showing diffuse hypodense enlargement of the pancreatic tail (arrow).


Pathological findings. (A) HE shows irregularly-shaped, atypical lymphocyte infiltration (x40).


Pathological findings. (B) CD20 positive atypical lymphocytic cells (x400).


Pathological findings. (C) A high Ki-67 proliferation index (80%; x200). . Abbreviation: HE, hematoxylin and eosin.


Lesions were significantly reduced after 2 cycles of CHOP chemotherapy regimen (A, B).


After 4 cycles of CHOP chemotherapy regimen (C, D).


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


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


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


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


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


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


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


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


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


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


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


Pedigree presenting VHL gene mutation status and malignancy. Both brothers were diagnosed with renal cell carcinoma (RCC) with VHL gene mutation and one of his sons was confirmed VHL mutation without clinical manifestation.


(A) Spine magnetic resonance imaging showed multiple enhancing nodular lesions of the spinal canal suspected leptomeningeal metastasis of unknown primary malignancy.


Positron emission tomography computed tomography whole body scan showed a 3-cm enhancing heterogenous mass in the right kidney (arrow).


Focal mural thickening with intense fludeoxyglucose uptake in the sigmoid colon.


Polymerase chain reaction sequencing analysis of von Hippel-Lindau (VHL) gene showed a p. Glu70Lys (c.208G > A)
mutation in exon 1, confirming the diagnosis of VHL disease.


Brain magnetic resonance imaging showed three enhancing lesions (arrows) in bilateral cerebellar hemispheres.


Left cerebellar tonsil , suggesting hemangioblastomas. N.


Abdomen-pelvic computed tomography scan showed newly developed hepatic metastasis in S6.


An enlarged aortocaval lymph node (arrow) n.


Response to eculizumab treatment in mitomycin-C-induced TMA. Laboratory parameters over the course of treatment. Treatment periods are indicated by coloured bars: yellow, PE; green, rituximab; red, haemodialysis; blue, eculizumab. Day 0 represents TMA manifestation.


Fine-needle aspirate from a renal mass in a cat. Poorly cellular and hemodiluted sample, with large three-dimensional clusters of moderately pleomorphic epithelial cells with variable nucleus/cytoplasmic ratio, moderate anisokariosis and prominent nucleoli (May-Grunwald-Giemsa stain; Bar=50 mum).


Gross appearance and histopathology of a feline renal mass. (A): Surgically resected kidney. The tumor mass has completely invaded cortex and medulla of the cranial pole; on section, the tumor tissue is non-capsulated and composed of multiple red lobules embedded in a dark red gelatinous tissue (Bar=2.5 cm).


Gross appearance and histopathology of a feline renal mass. (B): Moderately pleomorphic epithelial cells arranged in irregular tubules and papillae, consistent with tubulo-papillary renal cell carcinoma (Hematoxylin and eosin stain; Bar=50 mum).


Treatment process and the changes of plasma EBV-DNA titers.


(a) Noncontrast computed tomography head showing large hyperdense extra-axial lesion over midline frontoparietal region.


(b) Noncontrast computed tomography head (bone window) showing erosion of the skull.


(a) Magnetic resonance imaging showing an isointense tumor on T1-weighted sequence.


(b) Magnetic resonance imaging axial view showing a hyperintense tumor on T2-weighted sequence.


(c) Contrast-enhanced magnetic resonance imaging (coronal) showing heterogeneously enhancing tumor (with appearance suggestive of sulci and gyri: mini-brain appearance; see inset for illustration).


(d) Contrast-enhanced magnetic resonance imaging (sagittal) showing heterogeneously enhancing tumor (with appearance suggestive of sulci and gyri: mini-brain appearance; see inset for illustration).


On magnetic resonance venogram, middle part of superior sagittal sinus was not visualized.


(a) Low-power microscopy (H and E, x20) showing a cellular tumor lying in sheets. Tumor is seen breaching the bone (arrow). (b) High-power microscopy (H and E, x40) showing plasmacytoid cells with atypical and binucleate forms. (c) Immunohistochemistry showing diffuse positivity for lambda light chain and absence of kappa chain (light chain restriction).


A bladder mass with.


Heterogeneous high-mid signal intensity on T1-weighted imaging as well as. Mid signal intensity on T2-weighted imaging.


Cystoscopic findings show a bulging mass with marked vascularity over the left lateral wall of the bladder.


Axial computerized tomography sections reveal a 1.7 cm x 2.4 cm mass (arrow) over the left lateral wall of the bladder with no extravesical invasion.


(a) The tumor is composed of cell balls of neoplastic cells with small oval granular nuclei and abundant granular cytoplasm (H and E, x200). (b) The tumor cells are positive for chromogranin (immunohistochemical, x200).


Bone marrow smear preparation showing a macrophage filled with Leishmania amastigotes (central black arrow).


Photomicrograph of the bone marrow using Giemsa special stain, highlighting the macrophage-filled L. amastigotes (black arrows).


Photomicrograph of bone marrow showing numerous macrophages containing L. amastigotes (black arrows).


Photomicrograph of the gastric mucosa showing scattered macrophages (white arrow) containing L. amastigotes.


Bone marrow aspirate showing erythroid and myeloid precursors with vacuolization and megaloblastoid changes a: low power field, b: high power field.


Diagram of TP53 c.401T>G (p. F134C) alteration in Case 2.


Diagram of TP53 c.401T>G (p. F134C) alteration in Case 2. (B) The 3-dimentional model structure of TP53 wild-type analyzed by SWISSMODEL.


Diagram of TP53 c.401T>G (p. F134C) alteration in Case 2. (C) The Phe134 of TP53.


Diagram of TP53 c.401T>G (p. F134C) alteration in Case 2. (D) The Cys134 of mutated TP53.


Schematic representation of the BCL6-LPP fusion in Case 2. An 838 kb-sized deletion of chromosome 3q27.3-3q28 (base 187461439 on chromosome 3q27 to base 188299507 on chromosome 3q28), resulting in a fusion of the BCL6 with the LPP gene.


Pituitary MRI at two months from the beginning of chemotherapy demonstrated the tumor (size of about 2 x 1.5 x 3.2 cm) was larger than before without cavernous sinus involving in Case 2.


GTG-banding revealed a complex karyotype multiple numerical and or structural rearrangements.


PET-CT of the case 3 demonstrates bilateral thalamus and basal ganglion lesion and splenic lesions with high fluorodeoxyglucose (FDG) uptake (1a/b) while biopsy samples of the same patient demonstrate centroblastic lymphoid cells on hematoxylin & eosin staining (40x magnification) (1c) and tumor infiltration on CD20 staining (200x magnification) (1d).


Viral load before and after treatment. Viral load in copies/MI for Cytomegalovirus (CMV) measured at admission, post treatment with valgancyclovir and during follow-up.


A 57-year-old woman who presented with a new breast lump. Current mediolateral oblique screening mammography images of the right.


A 57-year-old woman who presented with a new breast lump. Left. Breast demonstrating fatty replaced breast parenchyma and a global asymmetry involving the right superior lateral breast.


A 57-year-old woman who presented with a new breast lump. Current craniocaudal screening mammography of the right.


A 57-year-old woman who presented with a new breast lump. The right breast ultrasound of the global asymmetry at 10 o'clock demonstrating diffuse hyperechoic changes in the breast parenchyma without a focal mass or posterior acoustic shadowing.


A 57-year-old woman who presented with a new breast lump. The right breast ultrasound guided biopsy at 10 o'clock with tissue sampling of the hyperechoic breast parenchyma. Posterior shadowing seen in this image is an artifact due to the biopsy needle (as indicated by arrow).


A 57-year-old woman who presented with a new breast lump. Current mediolateral oblique screening mammography images of right.


A 57-year-old woman who presented with a new breast lump. Compared to previous right breast mammography from 21 months prior. Showing new fatty replaced breast parenchyma and a global asymmetry involving the right superior lateral breast.


Tilt test registration. The figure shows the recording of systolic blood pressure, diastolic blood pressure, and heart rate in clinostatic and sitting position (passive orthostatic position not performable because of severe presyncopal symptoms) during a tilt test. In sitting position, an immediate reduction in systolic blood pressure to 55 mmHg and diastolic blood pressure to 28 mmHg is evident, without any change in the heart rate, which remains stable at 76 beats/min.


Electrocardiogram ,cardiac ultrasound.


The figure shows the 12-lead electrocardiogram pointing out the first-degree atrioventricular blockage (panel A). In panel B, cardiac ultrasound (parasternal long-axis view) depicts left ventricle wall thickness, diffuse myocardial hyperechogenicity, and mild pericardial effusion.


Pedigree of the family carrying the MUTYH mutation c.1187G>A (p. Gly396Asp). CAMA, breast cancer; CRC, colorectal cancer; EC, endometrial cancer (Department of Clinical Genetics, St. Elizabeth Cancer Institute, Bratislava, Slovakia).


Pedigree of the family carrying the MUTYH mutations c.1187G>A (p. Gly396Asp) and c.536A>G (p. Tyr179Cys). CRC, colorectal cancer; RCC, renal cell cancer (Department of Clinical Genetics, St. Elizabeth Cancer Institute, Bratislava, Slovakia).


Contrast-enhanced CT of chest showing pericardial effusion (white arrow), bilateral pleural effusions and left-sided lung consolidation (red arrow).


Cranial magnetic resonance imaging (MRI) of a patient with anti-CV2 autoimmune encephalitis. (A-C) T2WI axial images.


Cranial magnetic resonance imaging (MRI) of a patient with anti-CV2 autoimmune encephalitis. (D-F) FLAIR axial images.


Cranial magnetic resonance imaging (MRI) of a patient with anti-CV2 autoimmune encephalitis. (G) FLAIR coronal scan.


Cranial magnetic resonance imaging (MRI) of a patient with anti-CV2 autoimmune encephalitis. (H) Enhanced MRI.


Cranial magnetic resonance imaging (MRI) of a patient with anti-CV2 autoimmune encephalitis. (I) Diffusion-weighted MRI. The arrows indicate abnormal signals in the white matter area of the bilateral lateral ventricles and bilateral internal capsules. No significant enhancement was observed.


Swelling seen in the left anterior maxillary region.


Intraoral view showing left buccal and palatal swelling.


Orthopantomogram showing a poorly circumscribed lesion showing radiolucency with 23 missing.


Photomicrograph showing staghorn pattern and blood vessels are lined by flat endothelial cells (H&E stain, x100). H&E: hematoxylin and eosin.


Photomicrograph showing typical staghorn pattern of vascular channels, the blood vessels are lined by flat endothelial cells(H& E stain, x400).


Photomicrograph shows network of capillary vessels with a staghorn pattern, where lumen is lined by flat endothelial cells. The tumor cells present a pale cytoplasm with round or ovoid nuclei(H&E stain, x400).


Tumor showing positive reactivity with CD34 typically around vasculature (IHC stain, x40).


Tumor showing positive reactivity with CD 99 staining (IHC stain, x100).


Showing the abdominal end of the VP shunt tube (black arrow) entering the jejunum.


Initial clinical presentation:clinical composite photograph of the patient's left eye reveals an extensive fleshy salmon solid tumor of the conjunctiva extending into the orbit inferonasally.


Histopathology from biopsied conjunctival lesion:photomicrograph reveals sheets of large neoplastic lymphoid cells with moderate nuclear pleomorphism, vesicular chromatin, and large nucleoli underlying normal epithelium. (H&E, 30X).


Immunohistochemical stains of conjunctival lesion:photomicrographs of multiple immunohistochemical assays showed that the large lymphoid cells stained strongly positive for CD20 and MUM-1; it was also positive for Pax-5 and weakly positive for Bcl-6. The large lymphoid cells were negative for CD10. The small background lymphocytes stained positive with CD3.


(a) Solitary, exophytic, sessile, soft tissue mass, pinkish red in color present on mandibular anterior edentulous alveolar ridge.


(b) Solitary, exophytic sessile soft tissue mass pinkish red in color with indentation of right maxillary central incisor.


Reconstructed orthopantomography from cone beam computed tomography showing irregular radiolucent lesion in mandibular anterior region.


(a) Cone beam computed tomography showing expansion of both cortical plates in mandibular anterior region with lingual perforation.


(b) Three-dimensional Cone beam computed tomography of mandible showing destructive lesion.


Photomicrograph showing surface epithelium and fibrocellular stroma with isolated odontogenic epithelial islands and eosinophilic dentinoid material (H&E stain, x100).


Positive Van Gieson stain showing ghost cells (yellow color) and dentinoid material (reddish pink) (Van Gieson stain, x100).


Pathological findings of the testis. A; Histopathological examination detected diffuse infiltration of the right testis by large atypical lymphocytes (HE, x400).


Pathological findings of the testis. B; These cells were positive for CD20 (x400).


Patient's front view.


Parotid swelling on right side.


Parotid swelling on left side.


CT showing enlarged parotid and submandibular glands with multiple cystic locules and thinned out parenchyma. CT = Computed tomography.


FNAC showing salivary gland acinar and ductal cells with sheets of lymphocytes (H&E stain, x100). FNAC = Fine-needle aspiration cytology.


FNAC showing salivary gland acinar and ductal cells with sheets of lymphocytes (H&E stain, x400). FNAC = Fine-needle aspiration cytology.


Minor salivary gland biopsy did not show lymphocytic infiltration (H&E stain, x40).


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


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


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


(B) Family tree, with electropherogram results of affected patient and carriers.


CT scan - coronal view. Large mass lesion (arrow) within right kidney measuring up to 7.4 x 7.5 x 9.2 cm.


CT scan - coronal view showing right kidney mass with subcapsular haematoma (arrows).


Right kidney specimen - cream and pink colour tumour with mixture of solid and cystic components with haematoma in the lumen of the cyst and possible necrosis.


Microscopic features of adult Wilms' tumour showing blastemal elements.


Microscopic features of adult Wilms' tumour showing stromal elements and focal anaplastic elements.


(a) Tumor cells showing CD34 positivity (IHC x100).


(b) Tumor cells showing smooth muscle actin positivity (IHC x100).


Bone marrow aspiration revealed morphological findings compatible with ALL-L2 (May-Giemsa staining, 1000x).


B) FISH analysis with PML/RARalpha-specific probes showing two orange (PML) and two green (RARalpha) signals. No PML/RARalpha fusion signal (which should appear yellow) was detected.


On MRI, a lesion measuring 5 x 3 cm in left temporal region eroding the underlying bone.


FNAC revealing small, blue, round cells forming rosettes at places (Leishman, 40x).


Peripheral blood film demonstrating myeloid blasts with abundant cytoplasm.


A; Bone marrow aspirate at diagnosis depicting red cell anisopoikilocytosis, hypogranular platelets, myeloblasts and monoblasts/promonocytes.


B; Bone marrow aspirate after induction chemotherapy depicting red cell dysplasia with intercytoplasmic bridging and occasional myeloblasts.


C; Bone marrow aspirate after stem cell transplant depicting a normal haematopoietic maturation and no myeloblasts or monoblasts seen.


Capillary electropherogram obtained from the ABI PRISM 3700 genetic analyzer. Double peaks are observed from the nucleotide at marker position 42 (indicated above), revealing 2 different sequences: Sequence #1: AA GTC GCC ACC TAC CAC AGA GCC AT (wild-type). Sequence #2: -- --- --C ACC TAC CAC AGA GCC ATC AAA ATC (7-bp deletion).


Mutations detected in pre-treatment, post-treatment and post-transplant PB or BM samples.


(A) Plasma glucose trend in case 1.


(B) Plasma glucose trend in case 2.


The appearance of the lesions at admission to our center. Hemorrhagic bullous lesions in the oral cavity.


The appearance of the lesions at admission to our center. , ecchymotic and purpuric lesions scattered over the lower extremity.


The appearance of the lesions at admission to our center.dorsum of the hand.


Chest computed tomography shows widespread scattered ground-glass opacities in both lungs, findings compatible with severe Covid-19 pneumonia.


Hematoxylin and eosin stained histologic section of the nodular lesion demonstrate diffuse infiltrate of anaplastic appearing cells with large nuclei, prominent nucleoli, and with moderate amounts of pink cytoplasm consistent with anaplastic large cell lymphoma (ALCL). Notice abundant background neutrophils.


High power view of hematoxylin and eosin-stained section highlights the anaplastic large lymphoma cells with large oval nuclei and prominent nucleoli.


Immunohistochemical stain using CD30 antibody demonstrates uniform and strong expression of CD30 antigen in anaplastic large cells with membrane and Golgi patterns of staining.


Light microscopy. Early stage of thrombotic microangiopathy: this artery shows oedematous intima and few myointimal cells corresponding to "mucoid intimal hyperplasia" (FAOG, 400x).


Light microscopy. Later changes of thrombotic microangiopathy: the artery contains fibro-oedema with few collagen fibers within intima revealed in blue with trichome FAOG (FAOG, 400x).


Immunofluorescence microscopy. IgA deposits are observed within mesangium and glomerular membranes (400x).


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


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


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


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


Peripheral smear showing 'flower cells' (magnification 100X).


Bone marrow studded with malignant lymphocytes (magnification 10X).


Antigram showing antibody screen positive with 3 cell panel.


Showing antibody screen positive with 3 cell panel.


Showing antibody identification using 11 cell panel.


Antigram showing antibody identification using 11 cell panel.


Showing use of select cell for antibody identification.


Showing Rh/K phenotyping of the patient.


Showing Rh/K phenotyping of patient's husband.


Lesions in the left nostril, in the left nasogenian sulcus and on the tongue.


Imaging, bone marrow biopsy findings and characterization and location of the novel FAS heterozygous variant in a patient with CD4 lymphopenia and ALPS. (A) Computed tomography of abdomen and pelvis. (1) Coronal section: Splenomegaly. (2) Splenic volume estimation by 3D reconstruction: 1,034 milliliter (mL) (normal 200 +- 50 mL). (3) Axial section: Paraortic and mesenteric lymphadenopathy.


Imaging, bone marrow biopsy findings and characterization and location of the novel FAS heterozygous variant in a patient with CD4 lymphopenia and ALPS. (C) Diagram of the FAS gene identifying intron/exon structure and protein domains. Mutations are indicated at their approximate location and identified by symbols corresponding to mutation type. The new mutation identified in the index patient indicated by the red arrow. Figure adapted by Hsu et al.


Imaging, bone marrow biopsy findings and characterization and location of the novel FAS heterozygous variant in a patient with CD4 lymphopenia and ALPS. . (D) FAS-induced apoptosis was evaluated in terminal effector memory cells (TEM) and TCRalphabeta+ DN T cells of index patient and healthy subjects using an ex vivo flow cytometric assay based on FAS crosslinking. (1) Average fold increase +- standard error of mean (SEM) of Annexin-V expression in TEM (CD45RA-CCR7-CD27-) from 4 independent experiments with index patient (red) and 8 different healthy controls (blue) with different concentrations of anti-FAS crosslinking antibody. (2) Average fold increase +- SEM of Annexin-V expression in DNT cells (TCRalphabeta+CD4-CD8-) from 4 independent experiments with index patient (green) and 8 different healthy controls (purple) with different concentrations of anti-FAS crosslinking antibody.


Lateral x-ray of the left wrist shows a mass with internal calcifications at volar aspect of left distal forearm. The low density of the lesion on radiograph likely signifies a lesion that is fat-predominant.


Ultrasound reveals a spheroid hyperechoic lesion with internal heterogeneity. A continuous hyperechoic rim with posterior shadowing is present, suggestive of calcifications, and is in keeping with x-ray findings.


MRI T2-weighted fat suppressed sequence.


T1-weighted sequence A well-demarcated T1 hyperintense lesion is noted compressing on the flexor digitorum superficialis and flexor carpi radialis muscles. The lesion shows fat suppression.


MRI examination with T1-weighted post-gadolinium sequence in sagittal view. The fat-contaning lesion shows no significant contrast enhancement. No invasion into adjacent muscles detected.


Intraoperative photograph showing a well-demarcated oval tumour.


Histological views of the osteolipoma. The tumour consists of adipose tissues with a few foci of ossification. Lipoblasts are not present and there is no feature of malignancy.


MRI of the thoracic spine in sagittal and axial views at the levels of T6-T7. . A = sagittal view; B = axial view; I = initial presentation; II = day 14th after diagnosis; III = week 11th after diagnosis. The regression of the canal stenosis over time from initial presentation to following up can be appreciated on the sagittal view (red arrow) as well as on axial images (red arrow). The reduction of the lesion size can be appreciated on the axial images (blue arrow).


MRI of the lumbar spine in sagittal and axial views at the levels ofL5-S1. . A = sagittal view; B = axial view; I = initial presentation; II = day 14th after diagnosis; III = week 11th after diagnosis. The images show regression of the central spinal canal stenosis: from near-complete-obliteration on the initial image (B. II.1 red arrow) to the subsequent re-emergence of the spinal canal (B. II.2 and B. II.3 green arrow) with medical treatment. Also noted is the decrease in size of the bony masses and is the most prominent in the sacral region (II. A images blue arrow).


Clinical appearance of lesion.


Immunohistochemical staining with S100 marker.


Immunohistochemical staining with CD1a marker.


(a and b) Photomicrographs of direct immunofluorescence showing kappa restriction (FITC, x400).


Intraoral photograph showing lesion in-situ.


Midline split incision given.


Segmental mandibulectomy done.


Reconstruction using fibula flap.


Histopathology of the patient showing high cellular mesenchymal component that consists of numerous monomorphic spindle-shaped fibroblast and histiocyte like cells in varying proportions, multinucleated giant cells seen interspersed in the connective tissue stroma, and the tumour cells are invading the osseous tissue at the periphery (x40).


Postoperative orthopantomogram.


Platelet trend throughout hospital stay.


(A) Leukemic phenotype at baseline. The histograms report both the leukemic clone (in red) and the normal B cell compartment (in green) to underscore the expression of aberrant markers.


(B) minimal residual disease (MRD) evaluation performed at 4 different timepoints (the number on the top of each panel represents the number of months from diagnosis) and compared with baseline phenotype.


Eosinophils; ALL, leukemic clone).


Dotplots are represented with a dimensionality reduction approach (principal component analysis or automatic population separator (APS) in infinicyt software, Cytognos) which allow the identification of the different immune population within the bone marrow. Lymphocytes, ER, erythroblasts, N, granulocytes, M, monocytes.


A; Coronal section of the CT chest showing right lower lobe mass abutting adjacent lung, mediastinum and diaphragm below.


B; Gross appearance of the mass (>15 cm) post resection.


(a-c) Multiple nodulo-papular, ulcerated lesions in gingiva involving the entire mandibular arch, gingiva of left posterior maxillary arch in relation to the premolars and molars along with similar lesions in the posterosuperior aspect of the left buccal mucosa (yellow arrows).


Orthopantomogram showing severe generalized irregular alveolar bone destruction in the entire mandibular and in the left posterior maxillary alveolar ridge region.


(a) The presence of sheet-like proliferation of Langerhans cells, having coffee bean-shaped appearance, eosinophils, and plasma cells (H and E, x100). (b) Langerhans cells exhibiting positivity for anti-CD1a (x40).


Light micrographs of kidney transplant biopsy. (A) Glomerulus with intracapillary fibrin, red cell fragments, and karryorhectic debris (hematoxylin and eosin x 40).


Light micrographs of kidney transplant biopsy. (B) Segmentally sclerosed glomerulus with double contouring and fibrin (silver x 40).


Light micrographs of kidney transplant biopsy. Arterioles with fibrin, and ,focal onion skinning with myxoid intima, red cell fragments, and . Karyorrhexis. Hematoxylin, and ,eosin x 40.


Light micrographs of kidney transplant biopsy. Arterioles with fibrin, and ,focal onion skinning with myxoid intima, red cell fragments, and . . Silver x 40).


Electron micrographs of kidney transplant biopsy. (A) Mesangial expansion by increased mesangiocytic processes and electron dense deposits.


Electron micrographs of kidney transplant biopsy. (B and C) Subendothelial lucent widening with loss of endothelial fenestrations, mesangial interpositioning, and intramembranous electron-dense deposits.


Electron micrographs of kidney transplant biopsy. (D) Higher power view of deposits showing vaguely fibrillary substructure.


Serum creatinine and trough ciclosporin levels compared against time from admission, and commencement of both pazopanib and cabozantinib.


Extraoral photograph showing diffuse swelling over the right corner of mouth.


Intraoral photograph showing a 4 cm x 3.5 cm well-circumscribed growth on broad base stalk.


Wide excision of the lesion done with sufficient margins all around.


Postexcision specimen.


Microscopic findings indicate diffuse proliferation of oval and spindle-shaped tumor cells with abundant eosinophilic cytoplasm, a multinodular growth pattern, and a "staghorn" configuration.


A, B: Brain CT scan shows an expansile bone lesion in the right frontal bone, invading the surrounding soft tissues.


C: Chest CT scan shows a heterogeneous mass in the manubrium of the sternum composed of soft tissue and bone components.


A low-magnification (10x) pathology of the sternal mass showing fibromuscular tissue infiltrated with round tumour cells.


A high-magnification (40x) pathology shows round cells with small to moderate amounts of cytoplasm and high mitotic activity accompanied by vascular invasion.


Primary tumor and follow-up magnetic resonance imaging. (a) Gross-total removal of the medulloblastoma.


Primary tumor and follow-up magnetic resonance imaging. (b) Radiotherapy at 32.4 Gy for the posterior fossa and 23.4 Gy for the whole brain and spine; consequently, 55.8 Gy was irradiated around the tumor cavity.


Primary tumor and follow-up magnetic resonance imaging. (c) Image obtained 7 years later showing no evident aneurysmal formation.


Primary tumor and follow-up magnetic resonance imaging. (d) The 5-mm hyperintense nodule (arrow) on the continuous wall of the resected cavity discovered 9 years later.


Intraoperative findings. (a) The aneurysmal dome buried in the medulla oblongata (asterisk).


Intraoperative findings. (b, c) The aneurysm neck was clipped to keep the parent artery flow.


Diffuse enlargement and ulceration of labial gingiva.


Enlargement and ulceration of palatal mucosa.


Intra oral peri apical radiograph.


Histopathological evidence of peripheral CD8+ T-cell lymphoma.


History of inflammation, hemoglobin, and recombinant human erythropoietin doses.


Lateral abdominal X-ray: Aneurysm of the abdominal aorta.


3D reconstruction of multislice computed tomography angiography: Extensive calcification of the abdominal aorta extending to the primitive iliac arteries.


Contrast enhanced multislice computed tomography angiography cross section: Partial thrombosis of the abdominal aorta wall.


Histological and immunophenotypic results of excisional biopsy of left cervical lymph node. Hematoxylin and eosin (H&E)-stained sections is seen (A).


Histological and immunophenotypic results of excisional biopsy of left cervical lymph node. Immunohistochemical staining of these specimens shows that the infiltrated lymphocytes are positive for CD20.


Histological and immunophenotypic results of excisional biopsy of left cervical lymph node. , CD21.


Histological and immunophenotypic results of excisional biopsy of left cervical lymph node. Of follicular dendritic cells, and EBER (magnification x20).


Histological and immunophenotypic results of excisional biopsy of the axillary lymph node and peripheral blood smear. H&E-stained sections is seen.


Histological and immunophenotypic results of excisional biopsy of the axillary lymph node and peripheral blood smear. Immunohistochemical staining of the specimens shows that the diffuse infiltrated lymphocytes are positive for CD20.


Histological and immunophenotypic results of excisional biopsy of the axillary lymph node and peripheral blood smear. EBER. (magnification x20).


Histological and immunophenotypic results of excisional biopsy of the axillary lymph node and peripheral blood smear. Wright's staining of peripheral blood smear showed typical atypical lymphocytes (D) (magnification x400).


Chest X-ray of case 1 showing pulmonary hemorrhage.


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


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


Blood culture on Petri plate of
C. violaceum. Image courtesy of Bryan Mangroe, Department of Microbiology, Academic Hospital Paramaribo, Suriname.


A) Sheets of cells with reticular growth pattern and a more compact adenoid cystic morphology (Hematoxylin & Eosin stain, Zeiss Axioshop 40, magnificationx100).


B) Sickled erythrocytes (Hematoxylin & Eosin stain, Zeiss Axioshop 40, magnificationx400).


A) Lung metastasis, patient case #3.


B) Response after platin-based chemotherapy.


C) Mediastinal lymphadenopathy, patient case #3.


D) Response after platin-based chemotherapy.


Timeline of main pharmacologic interventions.


Concentration of direct and indirect bilirubin (mumol/L) in the infant's serum from the time of admission to day 6.


Copies of CD19-specific CAR-T cells in the peripheral blood/bone marrow of the patient after CAR-T cells infusions. Abbreviation: PB, peripheral blood; BM, bone marrow. A. CD19-CAR T cell copies from peripheral blood mononuclear cells after the first infusion.


Copies of CD19-specific CAR-T cells in the peripheral blood/bone marrow of the patient after CAR-T cells infusions. Abbreviation: PB, peripheral blood; BM, bone marrow. B. CD19-CAR-T cell copies from bone marrow mononuclear cells after the first infusion.


Copies of CD19-specific CAR-T cells in the peripheral blood/bone marrow of the patient after CAR-T cells infusions. Abbreviation: PB, peripheral blood; BM, bone marrow. C. CD19-CAR-T cell copies from peripheral blood mononuclear cells after the second infusion.


Patient at presentation.


Intraoperative appearance of the frontal bone.


Complete resolution of the periorbital swelling.


Magnetic resonance imaging (mri) scan of the neurocranium, gadolinium-enhanced T1-weighted sequences. (A-C) Sibling 1. Mri axial.


Magnetic resonance imaging (mri) scan of the neurocranium, gadolinium-enhanced T1-weighted sequences. (A-C) Sibling 1. Coronal.


Magnetic resonance imaging (mri) scan of the neurocranium, gadolinium-enhanced T1-weighted sequences. (A-C) Sibling 1. Sagittal view. Large mass located in the parieto-temporal lobe, multifocal localization, extension into the corpus callosum and infiltration to the right hemisphere.


Magnetic resonance imaging (mri) scan of the neurocranium, gadolinium-enhanced T1-weighted sequences. (D-F) Sibling 2. Mri axial.


Magnetic resonance imaging (mri) scan of the neurocranium, gadolinium-enhanced T1-weighted sequences. (D-F) Sibling 2. , coronal.


Magnetic resonance imaging (mri) scan of the neurocranium, gadolinium-enhanced T1-weighted sequences. (D-F) Sibling 2. And sagittal view Tumor mass located in the parieto-temporal lobe with periventricular, ependymal spread. Multifocal localization, up to the right frontal and temporal regions.


Clinical presentation of the patient during the first course of high-dose methotrexate (HD-MTX). MTX concentrations were monitored closely at 44, 68, 72, and 96 h after MTX infusion until the target level was reached. The patient developed vomiting, diarrhea, and cholecystitis at day 4 after infusion. The highest level of serum alanine aminotransferase (ALT) occurred at day 7. Dasatinib was withdrawn at the onset of vomiting and diarrhea.


Clinical presentation of the patient during the second course of HD-MTX. MTX concentrations were monitored closely at 44, 68, 72, and 96 h after MTX infusion until the target level was reached. Skin toxicity appeared at day 8, with the highest level of serum ALT appearing day 10 after HD-MTX infusion. Dasatinib was withdrawn at the onset of rashes.


Brain computed tomography (CT) of the patient after oral low-dose MTX. Multiple hematomas were shown involving the left frontal.


Brain computed tomography (CT) of the patient after oral low-dose MTX. , parietal.


Brain computed tomography (CT) of the patient after oral low-dose MTX.temporal lobes.


Brain computed tomography (CT) of the patient after oral low-dose MTX. And the centrum semiovale.


CT scan of the abdomen showing diffuse asymmetric wall thickening of the pylorus and antrum (arrow).


Upper endoscopic view of a large friable ulcer occupying most of the gastric antrum.


Repeat CT scan of the abdomen post treatment. No visible thickening of the stomach wall (arrow).


Repeat endoscopic view post treatment. Normal appearance of the antrum and pylorus.


Low-magnification view of the previous ulcer site post treatment (H&E stain, x100). No histopathologic evidence of residual tumor.


The chest radiograph showed a grossly enlarged cardiac shadow, an enlarged pulmonary trunk and a small-calibre ascending aorta. No rib notching was noted.


Computed tomography images showing.


A small-calibre ascending aorta with the aortic arch interrupted after the origin of the left common carotid artery (arrow in A) and separated from the left subclavian artery (arrowhead in B) and descending aorta (curved arrow in B). The pulmonary trunk (* in A) was markedly dilated.


(C) A ventricular septal defect could also be visualized (arrow).


MR imaging.


MR venogram in the sagittal view An abnormal signal in the right transverse-sigmoid sinus (white arrowhead), associated with inflammatory changes in the right mastoid is noted in a. Absence of flow signal of a sigmoid sinus and a tight narrowing of the contralateral transverse sinus (white arrowhead) are depicted in b. Bilateral enlargement of the optic nerve sheaths (white waved arrowheads) and bulging of the optic discs (black arrowheads) are depicted in c. Appearances are consistent with an otogenic, right transverse-sigmoid sinus thrombotic occlusion with contralateral transverse sinus tight stenosis and indirect signs of an increased intracranial pressure.


DSA Internal jugular vein retrograde injection in the LL view.


DSA unsubtracted mask in the lateral oblique view The following day, mechanical thrombectomy with a double stent-retriever technique.


DSA, right CCA injection, late venous phase in the lateral oblique. White arrowheads) resulted in a satisfactory, although partial, reopening of the transverse and sigmoid sinuses.


AP views Unsatisfactory, partial recanalization of the lateral transverse and sigmoid sinus at the end of the first endovascular procedure is depicted in a. White arrowheads) resulted in a satisfactory, although partial, reopening of the transverse and sigmoid sinuses Note severe stenosis of the left lateral transverse sinus (white arrowheads in c and d).


Serum free light chain ratio and proteinuria over 4 years.


(A,B) Gastroscopy revealed multiple erosion and ulcer in gastric body and gastric angle.


(C) EUS revealed hypoechoic thickening of the mucosa layer.


(D) ME-NBI showed irregular marginal crypt epithelium and subepithelial capillary network.


(E) Abdominal computed tomography showed thickening of the wall of gastric body and gastric fundus and mild enhancement, and the surrounding lymph nodes were enlarged.


(F-H) The procedure of ESD.


(A) Hematoxylin-eosin staining x 200.


(B) Immunohistochemistry showed positive reactivity for CD20.


(C) Immunohistochemistry showed positive reactivity for CD79a.


(D) Immunohistochemistry showed partially positive reactivity for Mum-1.


(E) Hematoxylin-eosin staining x 200.


(F) Immunohistochemistry showed positive reactivity for CD20.


(G) Immunohistochemistry showed positive reactivity for CD79a.


(H) Immunohistochemistry showed positive reactivity for Bcl-2.


(A) Gastroscopy revealed erosion and ulcer in greater curvature of gastric antrum.


(B) EUS revealed a hypoechoic lesion from mucosa layer, muscularis mucosa layer, and submucosa layer.


(C-F) ME-NBI showed irregular marginal crypt epithelium and subepithelial capillary network.


(G,H) The procedure of ESD.


(a) Bilateral scrotal hematoma.


(b) Normal macroscopic appearance of right testis and spermatic cord.


(c) Normal macroscopic appearance of left testis and spermatic cord.


(a) moderate swelling and bluish discoloration of the right scrotum.


(b) Scrotal hematoma at the ultrasonography of the right scrotum.


(c) Right adrenal hemorrhage.


Extraoral examination revealing facial asymmetry on the right side of the face.


Intraoral examination revealing a well-defined solitary erythematous growth in the right retromolar region.


Orthopantamograph revealing ill-defined radiolucency encompassing the entire right side of the mandible.


Reconstructed computed tomography scan revealing large expansile lytic on the right posterior mandible region.


Completely resorbed Medial aspect of the ramus with alveolar erosion.


Waxy papular lesions over the trunk and back.


Leonine facies and exaggeration of facial ridges.


Doughnut sign on the metacarpophalangeal joints.


Alcian blue stain highlights markedly increased dermal mucin (Alcian blue, x20).


A large, unilocular radiolucency involving the right side of the mandible. Well-demarcated lesion involving 41-47 region. Destruction of buccal plate and lingual plate is seen. Extensive root resorption of 46 and 47 is seen. Lower border of mandible is intact.


Blasts with cytoplasmic blebs and a basophil.


Abnormal, large platelets.


Abnormal megakaryocytes and marrow fibrosis.


Megakaryocytes with pleomorphic nuclei.


Strong CD 61 positivity in megakaryocytes.


A; Fine needle aspirate showing small lymphocytes, scattered pigmented and nonpigmented cells, and proteinaceous material (cell block HE; magnification x1,000).


B; Immunohistochemical stain showing CD20 B lymphocytes (magnification x1,000).


C; Immunohistochemical stain showing few CD3 T lymphocytes (magnification x1,000).


Immunohistochemical staining of tumor cells for PD-LI (22C3) in our patient. PD-L1 expression was 90%.


PET/CT did not show focal hypermetabolism of those lesions corresponding to the nodules in CT.


Timeline scheme of major clinical event of the patient since diagnosis.


Preoperative magnetic resonance imaging images. T2-weighted axial.


Preoperative magnetic resonance imaging images. T1-weighted axial.


Preoperative magnetic resonance imaging images. Gd-enhanced T1-weighted axial. Images show contrast-enhancing lesion surrounded by a vasogenic edema with a little compress to fourth ventricular.


Histopathologic findings. A hematoxylin, and ,eosin section shows a tumor tissue within cerebellar tissue.


Histopathologic findings. A hematoxylin, and ,eosin section shows Reed-Sternberg cells (arrows), eosinophils, plasma cells, histiocytes, and ,small lymphocytes.


Histopathologic findings. Immunostain shows immunoreactivity for CD30 marker.


Follow-up magnetic resonance imaging 36 months after operation. T2-weighted axial.


Follow-up magnetic resonance imaging 36 months after operation. T1-weighted axial.


Follow-up magnetic resonance imaging 36 months after operation. Gd-enhanced T1-weighted axial. Images show preoperative-enhanced mass is removed totally. There is no evidence of local recurrence, edema, or abnormal enhancement.


MRI on admission (5 months before death). MRI on admission. Transversal, and ,sagittal Flair sequence.


MRI on admission (5 months before death). Sagittal T2-weighted sequence. Demonstration of a hyperintense lesion extending on both side of the pons (arrow), predominantly on the left side beneath the red nuclei up to the right sided mesencephalon along the third ventricle.


Microscopical findings within the biopsy specimen. (a) hematoxylin and eosin staining: Enlarged dark nuclei of oligodendroglial cells.