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


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


Renal branch arterial sheathing and occlusion.


Baseline treatment.


Eight weeks of treatment.


Initial Lumbosacral MRI showing mild impingement on the left L5 and S1 nerve roots.


Transthoracic echocardiography parasternal short axis view showing elongated chaotic highly mobile echo density attached to normally structured tricuspid valve.


Transesophageal Echocardiography showing rectangular shaped vegetation attached to the entire length of anterior tricuspid leaflet, measuring 1.8 * 1.5 cm.


Repeated Lumbosacral MRI showing L5-S1 spondylodiscitis.


Chest CT scan reveals right lower lobe cavity.


Magnetic resonance imaging of case 1. (A) T1-weighted image (T1WI) showing an ill-defined mass lesion at the pancreatic body.


Magnetic resonance imaging of case 1. (B) T1WI with contrast showing the slight enhancement of the pancreatic lesion with central hyposignal. Arrow (white), pancreatic mass; arrowhead (white), central hyposignal of the lesion.


Abdominal computed tomography of case 2. (A) A huge right suprarenal mass lesion causing mass effect to adjacent liver and kidney.


Abdominal computed tomography of case 2. (B) A closer view of the part with calcification. Arrow (black), calcification in the tumor mass.


(A) Chest X-ray image exhibiting increased bronchoalveolar infiltration over the right lung field.


(B) Chest CT image depicting a large amount of pleural effusion in the right lung.


(C) Multiple low-density nodules in the spleen and adenopathy in the hepatic hilar region.


(D) Multiple new nodules in both lungs and pleurisy.


(E) Mother's chest X-ray image exhibiting a miliary TB pattern.


(F) Mother's chest CT image depicting diffuse interlobular and intralobular septal thickening with ground-glass opacities and multiple nodules.


Lung spiral CT on November 1, 2009, showing incidental finding of an infiltration.


Lung spiral CT on November 29, 2009, showing progression of the infiltration.


Lung spiral CT on December 13, 2009, showing progression of the infiltration after starting treatment for burkholderia.


Lung spiral CT on March 8, 2010 showing partial improvement of the infiltration after starting treatment for cryptococcosis.


The resolution of haemoglobinuria in case 2.


Dental X-ray of the patient's maxillary left region.


Asymmetrical cerebral ventricles. Dilated right ventricle with prominent, irregular choroid plexus.


Time course of symptom onset.


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


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


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


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


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


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


Head CT image with no remarkable findings.


Brain MRI image with no remarkable findings.


Abdominal CT image showing a right cystic adnexal mass with an internal focus of fat and high-attenuation material, suggesting an ovarian teratoma (red circle).


Submandibular mass biopsy revealing florid follicular hyperplasia along with eosinophilic cell infiltration, focal fibrosis and giant cell reaction.


Liver biopsy revealing perisinusoidal deposition of eosinophilic, amorphous material within the extracellular matrix with hepatocyte atrophy, consistent with hepatic amyloidosis.


Bone marrow biopsy revealing diffuse extracellular eosinophilic, amorphous material consistent with amyloidosis.


A. Coin-shaped keratic precipitate on the cornea endothelium (white arrow).


B. The keratic precipitate resolved after starting treatment.


B. The keratic precipitate (white arrow) reduced after starting on treatment.


An ulcerated wound on the sole of right foot, measuring 5x4 cm.


Result of PCR using a 16S rRNA primer. . Notes:
Escherichia coli ATCC 35218 was used as negative control for this amplification assay. A product of 397 bp amplicon was present, which confirmed B. pseudomallei identification.


Photograph shows healing subcutaneous ulcer over thigh.


Medical image.


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


Photograph shows healed subcutaneous ulcer over thigh with scarring.


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


Transesophageal echocardiography. 135.


Mitral valve commissure (60 ). Mobile vegetation, 25 mm in size, is observed in the anterior mitral valve annulus (red arrow). Valve destruction is not observed. This is the portion exposed to reverse flow (green arrow).


Magnetic resonance imaging of the head. Fluid-attenuated inversion-recovery images.


Diffusion-weighted images. Hyperintense areas, mainly in the parietal lobe, are sporadically observed (red arrow) and were considered septic cerebral embolisms.


Representative CT images of the chest. (A) During acute COVID-19 infection, CT chest with intravenous (IV) contrast revealed diffuse ground glass with consolidative changes and no evidence of bullous lung disease (BLD).


Representative CT images of the chest. (B) Three-month post-infection, a repeat CT chest with IV contrast showed right-sided bullous lesions with mediastinal shift.


Representative CT images of the chest. (C) The right lower lobe lung section stained with Elastic Van Gieson (EVG) was used to identify the pleural elastic membrane (arrow) to confirm the presence of the bullae (star) localized within the lung parenchyma.


Pleural effusion and consolidation on chest X-ray of the patient.


Pleural effusion from baseline to the left upper lobe and accompanying total collapse of the left lower lobe.


Abdominal computed tomography 6 month after excision of metastatic adrenal hepatocellular carcinoma.


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


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


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


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


Filling defect RGP retrograde pyelogram.


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


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


CT images on December 2, 2013. Arrows indicate the enlarged paratracheal lymph nodes.


CT images on December 2, 2013. , the right hilar lymph nodes.


CT images on December 2, 2013.the subcarinal lymph nodes.


CT images of May 30, 2014. A; Paratracheal lymph nodes.


CT images of May 30, 2014. B; Right hilar lymph nodes.


CT images of May 30, 2014. C; The subcarinal lymph nodes were subsided in comparison to those in figure 2.


A, b Paraffin section of Anisakis larva in a ventral subcutaneous lesion. M muscle, L lateral chord, R rennet cell, T transverse striation.


Phylogenetic analysis of Anisakis species based on COX2 sequences (532 bp). Nucleotide sequences were aligned and phylogenetic tree analysis was conducted using the Genetyx ver 11 software.


Paraffin section of Dirofilaria species in a dorsal subcutaneous lesion.


Phylogenetic analysis of Dirofilaria species based on 5S rRNA sequences (90 bp). Nucleotide sequences were aligned using the Genetyx ver 11 and CLC Sequence Viewer 6 software. Phylogenetic analyses were conducted using the Mega 6 software. Genetic relationships were inferred by the neighbor-joining (NJ) method. D1 and D2 means Dirofilaria ursi worms collected from Japanese bears in Gifu Prefecture in the middle part of Japan.


Timeline of patient's disease course. (A1) Exemplary axial fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) of the brain demonstrated leukoencephalopathy but no signs of inflammation. Immune-fluorescence microscopy of anti-NMDA receptor staining with high (B1) and low titers (B2) in serum (depicted) and CSF. Bright green cells represent an antibody-antigen-interaction (B1) while dim cells do not reveal such interaction (B2). CSF, cerebrospinal fluid; MRI, magnetic resonance imaging; MP, methylprednisolone; IA, immunoadsorption-therapy; IG, intravenous immunoglobulins; RTX, rituximab; CP, cyclophosphamide; Anti-NMDA receptor, Anti-N-methyl-D-aspartate receptor.


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


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


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


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


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


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


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


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


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


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


Cardiopathological findings. (A) Morphology of the heart showing multifocal inflammatory infiltrates consisting of neutrophilic granulocytes, lymphocytes and histiocytes, capillarostasis, and perifocal single-cell necroses of cardiomyocytes (arrow) (H&E, x400).


Cardiopathological findings. (B,C) Immunohistochemical staining for fibrin demonstrating cross section and longitudinal section of capillaries with prominent microthrombi occluding the lumens (immunohistochemistry for fibrin, x400).


CT of the chest, lung window, demonstrating a mediastinal process invading into the left lung verses a primary pulmonary process invading into the mediastinal border; the appearance was concerning a neoplasm. Further images demonstrate erosion anteriorly into the posterior sternum.


Clinical course of a patient.


White membrane adherent to the pharynx noted on oropharyngeal examination on presentation in a 14-month-old incompletely vaccinated infant with respiratory distress.


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


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


Photograph of completely healed wrist wound taken 2 months later.


A 21-year-old man with Mycobacterium avium infection combined with a bronchogenic cyst. (A) Chest radiography showed a cystic mass in the right upper lobe.


A 21-year-old man with Mycobacterium avium infection combined with a bronchogenic cyst. (B) After anti-tuberculosis medication for 6 months, the mass increased in size and developed multiple cavities.


A 21-year-old man with Mycobacterium avium infection combined with a bronchogenic cyst. (A) Chest computed tomography (CT) revealed a multi-loculated cystic mass with bronchiolitis in the right upper lobe.


A 21-year-old man with Mycobacterium avium infection combined with a bronchogenic cyst. (B) The resected right upper lobe showed an intrapulmonary bronchogenic cyst in the apical segment (arrow) and multiple cavitary necroses in the destroyed apical segment of the right upper lobe (arrowhead).


A 21-year-old man with Mycobacterium avium infection combined with a bronchogenic cyst. (C) Microscopic findings of the multiple cavitary lesions revealed chronic granulomatous inflammation (the lesion is indicated by an arrowhead on the chest CT and gross findings) (H&E, x 100).


A 21-year-old man with Mycobacterium avium infection combined with a bronchogenic cyst. (D) The microscopic findings of the bronchogenic cyst showed that the cyst was walled by ciliated columnar epithelium (the lesion is indicated by an arrow on chest CT and gross findings) (H&E, x 40).


Clinical course. . Abbreviations: ALP, alkaline phosphatase; CRP, C-reactive protein; GM, gentamicin.


The clinical course of the patient. The bar on the bottom indicates the stool quality. mPSL, methylprednisolone; PSL, prednisolone; GCV, ganciclovir; CMV, cytomegalovirus; SF, sigmoidoscopy; CS, colonoscopy; TCS, total colonoscopy; VCE, video capsule endoscopy; DBE, double balloon enteroscopy.


Endoscopic and histologic findings. A; Sigmoidoscopy before methylprednisolone therapy showed easy bleeding and coarse mucosa in the rectum.


Endoscopic and histologic findings. B; Sigmoidoscopy on the 6th hospitalization day demonstrated almost normal rectal mucosa.


Endoscopic and histologic findings. C; Colonoscopy on the 12th day showed multiple punched-out ulcers in the descending colon.


Endoscopic and histologic findings. D; Histologic examination of the ulcers showed crypt abscess and inflammatory cell infiltration (hematoxylin and eosin staining). Original magnification, x4. Scale bar, 200 mum.


Endoscopic and histologic findings. E; Immunohistochemistry for cytomegalovirus was positive. Original magnification, x40. Scale bar, 20 mum.


Endoscopic and histologic findings. F; Double balloon enteroscopy demonstrated multiple ulcers in the small intestine.


Gross necropsy: Heart. External view.


Internal view) of a Malayan tapir with encephalomyocarditis virus infection. Multiple circular to linear white foci (mineralisation) are present in the myocardium.


Histopathology of the heart of a Malayan tapir with encephalomyocarditis virus infection. (A): Areas of basophilia (mineralisation) are surrounded by an intense interstitial inflammatory infiltrate.


Histopathology of the heart of a Malayan tapir with encephalomyocarditis virus infection. (B): Myocardial cells with a diffuse basophilic granulation (mineralisation), surrounded by interstitial infiltration of lymphocytes, plasma cells and a few neutrophils.


CT before therapy.


CT after 8 weeks of therapy.


MRI 4 months after start of therapy Arrows show tumor manifestation.


Erythematous-brown plaque, hardened and rough, with some reddish-honey colored crusts on the dorsum of the fifth right finger, before treatment.


Skin biopsy - Histopathology. (a) Pseudocarcinomatous epithelial hyperplasia with amorphous material in the follicular epithelium, which is surrounded by intense infiltrates of lichenoid pattern (HE, original magnification 40x).


Skin biopsy - Histopathology. (b) Chronic granulomatous inflammatory reaction of tuberculoid pattern with focus of fibrinoid necrosis and absence of acid-fast bacilli (Fite-Faraco, original magnification 200x).


Mycobacterium marinum
culture on Lowenstein-Jensen medium, after 12 days of incubation at 26 C (78.800 F).


Appearance of the exit site on the day of admission. There is a crust around the exit site, and subcutaneous tissue is swollen. Discharged pus is adhering to the gauze.


Ultrasound and computed tomography (CT) evaluation on the day of admission. A; Fluid accumulation, which indicates abscess formation, is observed in the subcutaneous tissue near the exit site on ultrasound.


Ultrasound and computed tomography (CT) evaluation on the day of admission. B; Fluid accumulation is also confirmed on CT images (arrows). No sign of tunnel infection is observed. PD, peritoneal dialysis.


Gram staining and acid-fast staining of the pus collected on the day of admission (magnification, x1,000). A; Weakly stained gram-positive rods are observed with Gram staining (arrow). B Acid-fast bacilli are observed with acid-fast staining.


Serum protein electrophoresis revealing monoclonal gamma/lambda gammopathy (IgG1) of unknown significance with lambda light chains, confirmed by an immunofixation study.


Fourteen hours after initiation of terlipressin treatment skin purpuric lesions developed on the. Left arm.


Lower abdomen.


Breasts.


The evolution of skin lesions on the patient's left arm:. 24 h following initiation of terlipressin treatment.


36 h following treatment initiation.


Right vestibular schwannoma with maximum diameter of 28 x 25 x 26 mm. MRI T2 image of Gamma Knife Radiosurgery (GKR) treatment planning (a).


Right vestibular schwannoma with maximum diameter of 28 x 25 x 26 mm. MRI T2 image 21 months after GKR (b). Extensive peritumoral brain edema with fourth ventricle compression is evident.


Right vestibular schwannoma with maximum diameter of 41 x 35 x 35mm. MRI T1 contrast-enhanced image before first surgery (a).


Right vestibular schwannoma with maximum diameter of 41 x 35 x 35mm. MRI T1 contrast-enhanced image of Gamma Knife Radiosurgery (GKR) treatment planning (b).


Right vestibular schwannoma with maximum diameter of 41 x 35 x 35mm. MRI T2 image at 18 months after GKR (c); peritumoral brain edema (PTBE) in the right cerebellar hemisphere and brain stem is clearly visible.


Right vestibular schwannoma with maximum diameter of 41 x 35 x 35mm. MRI T2 at image 3 months after surgical removal showing complete PTBE resolution (d).


Right clinoid meningioma. MRI T1 contrast-enhanced images before.


Right clinoid meningioma. After. Surgery showing complete removal of the meningioma.


Right clinoid meningioma. MRI flair images highlight peritumoral brain edema before surgery.


Right clinoid meningioma. At 2 months after surgery ; an almost complete resolution is clear.


MRI imaging showing the patchy T2 and diffusion hyperintensity in the occipital loves and adjacent cerebellar hemisphere.


MRI showing area of ischemia in right occipital lobe possibly due to right vertebral artery dissection.


MRI showing extension stable white matter disease without evidence of acute infarct.


CT Scan of the head showing small linear areas of hyperintensity in the posterior occipito-parietal junction as well as enlarged ventricles suggesting the recurrence of hydrocephalus.


Images of case 1. Fetal magnetic resonance imaging shows massive ascites and compressed lungs (A).


Images of case 1. Chest X-ray.


Images of case 1. Postmortem chest CT. Show pulmonary hypoplasia.


Images of case 2. Fetal magnetic resonance imaging shows massive ascites, hepatomegaly, and compressed lungs (A).


Images of case 2. Postmortem chest.


Images of case 2. Abdominal CT. Show pulmonary hypoplasia and massive ascites with hepatomegaly.


Scheimpflug-based corneal topography of the right eye (OD). (A) Preoperatively, demonstrating PMD pattern with inferior steepening associated with thinning and irregular astigmatism on the anterior sagittal map.


Scheimpflug-based corneal topography of the right eye (OD). (B) Four days following combined corneal wedge resection and corneal cross-linking, showing regularization of the topographic pattern.


Scheimpflug-based corneal topography of the right eye (OD). (C) Eight months postoperatively, depicting a stable regularized anterior pattern with mild inferior steepening and a thinnest pachymetry of 452mum.


Lung, intranuclear cytomegalovirus inclusion body (Hematoxylin & Eosin x400).


Lymph node, acid fast positive bacilli (Hematoxylin &Eosin x400).


Lymph node, intranuclear cytomegalovirus inclusion body and plump histiocytes replacing the nodal architecture (Hematoxylin & Eosin x400).


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


Cutaneous melanoma lesion with surrounding vitiligo.


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


High-resolution computed tomography of the chest at diagnosis showing a large right upper lobe cavity. And extensive random nodules in bilateral lower lobes.


High-resolution computed tomography of the chest after 1-month of treatment showing increase in cavitation and new-onset consolidation and ground glass appearance bilaterally in the upper lobes; bilateral pneumothoraces and intercostal drains are also seen.


Wound status after debridement, vancomycin-loaded bone cement implant, and negative pressure wound therapy installment. After sharp debridement.


Wound status after debridement, vancomycin-loaded bone cement implant, and negative pressure wound therapy installment. After resection of non-viable bone, and ,application of the vancomycin-loaded bone cement implant.


Wound status after debridement, vancomycin-loaded bone cement implant, and negative pressure wound therapy installment. After negative pressure wound therapy installment.


Autologous platelet-rich gel (APG) preparation and the topical administration over the wound bed. APG was prepared after evaluation, and ,informed consent obtained.


Autologous platelet-rich gel (APG) preparation and the topical administration over the wound bed. The gel was administered onto the surface of the wound.


Ulcer healing and follow-up. Wound status after the second autologous platelet-rich gel treatment.


Ulcer healing and follow-up. Complete wound closure was observed after a treatment period of nearly 5 months.


Ulcer healing and follow-up. Foot condition at the 1 month follow-up.


Ulcer healing and follow-up. After the intervention, and 1 year after she left the hospital, the patient was without ulcer recurrence.


Biomechanical parameter improvement following treatment with offloading therapeutic footwear. Biomechanical parameters including ankle angle, hip angle, center of mass, gait, and ,balance before wearing the custom-made footwear.


Biomechanical parameter improvement following treatment with offloading therapeutic footwear. Changes in biomechanical parameters after wearing the custom-made footwear.


Bronchoscopy confirms membranous defect 1 cm above the carina.


Axial.


Sagittal. Computed tomography images demonstrating 3-4 cm defect in posterior membranous trachea (arrow).


Examination results of case 4. (A) Face photograph of case 4 showing an indurated mass lesion with an overlying non-healing ulcer with discharge in the lacrimal sac area of the right eye (arrow).


Examination results of case 4. (B) CT scan showing soft tissue lesion in the anterior part of right medial orbit (arrow).


Examination results of case 4. (C) Photomicrograph showing chronic granulomatous inflammation with giant cells (arrow).


Examination results of case 5. (A) Face photograph of case 5 showing a preseptal swelling below the left superior orbital rim (arrow).


Examination results of case 5. (B) CT scan of the orbits showing soft tissue swelling in front of the superior orbital rim with no evidence of bony erosion (arrow).


Examination results of case 5. (C) Photomicrograph showing chronic granulomatous inflammation with giant cells and caseation necrosis (arrow).


Examination results of case 6. (A) Face photograph of case 6 showing large ulceration on the right cheek below the right lower eyelid.


Examination results of case 6. Microphotograph showing. Chronic granulomatous inflammation with giant cells, and ,caseation necrosis.


Examination results of case 6. Positive acid fast bacilli indicated by an arrow.


Hands revealing postaxial polydactyly.


Outward bending of knees (genu valgum).


Intraoral photograph revealing multiple missing and malformed teeth in both maxillary and mandibular arches.


Orthopantomogram showing missing teeth i. r. t 12,22, 31,32,41,42 and retained deciduous tooth i. r. t 81.


Burst suppression pattern upon presentation to the Emergency department.


Axial CT scan showing hyperdense fourth ventricle mass lesion with contrast enhancement and obstructive hydrocephalus.


Postoperative axial CT scan showing tension pneumoventricle.


Axial CT scan performed after placement of the external ventricular drain showing partial resolution of the intraventricular pneumocephalus.


Biopsy specimen with a portion of renal cortical and medulla containing 12 glomeruli, 2 of which were sclerotic. Three glomeruli presented slight segmental mesangial sclerosis, 2 others presented mesangial sclerosis and irregular thickening of blood vessel walls (due to ischemia). Diffuse edema, interstitial fibrosis, focal atrophy, and tubular deterioration were present among with diffuse lymphomonocytic infiltration with infiltration of the tubular tissue. Arteriosclerosis was present. Immunofluorescence tests were negative. Electronic microscopy was not performed. The specimen was compatible with FSGS and interstitial nephritis.


Serial serum creatinine and total bilirubin levels are reported with regard to immunosuppressive and anti-HCV treatment.


Microscope images obtained during resection of the intrathecal catheter-associated granuloma. (a) Prior to resection, the granuloma (chevron) surrounded the distal end catheter (arrowhead).


Microscope images obtained during resection of the intrathecal catheter-associated granuloma. (b) The granuloma (at left) was separated from the distal end of the catheter (right) and spinal cord. Image orientation, cephalad at left.


Histologic examination of the catheter mass demonstrated dense fibrous tissue with necrotic debris and chronic inflammation composed of histiocytes and small mature lymphocytes, consistent with granuloma (hematoxylin and eosin preparation; x20 magnification).


Histopathology of the excised conjunctival lesion. Low power.


High power.


Cerebral computed tomography scan on day 1 after occurrence of aphasia and right hemiplegia revealing a left rolandic intraparenchymal hematoma.


Cerebral angiography on day 1. Issue by left arterial carotid showing segmental narrowing and dilatation (string of beads) in all vascular territories without aneurysm (red arrows).


An 85-year-old male with history of prostate cancer status post radiation treatment presented with rising prostate- specific antigen level of 6.1 ng/mL. (a) Axumin positron emission tomography-computed tomography axial image showing increased radiotracer uptake (standardized uptake value maximum of 5.3) in the left internal iliac lymph node (yellow arrow).


An 85-year-old male with history of prostate cancer status post radiation treatment presented with rising prostate- specific antigen level of 6.1 ng/mL. (b) Magnetic resonance imaging pelvis T1 weighted axial image depicting a few enlarged bilateral internal iliac lymph nodes (red arrow) which were otherwise inconclusive for recurrence.


A 76-year-old male with history of prostate cancer status post brachytherapy with rising prostate-specific antigen level of 6.4 ng/mL. (a) Axumin positron emission tomography-computed tomography (CT) axial image showing focal asymmetric tracer activity in the prostate with standardized uptake value maximum (SUVmax) 2.1 (yellow arrow) in contrast to marrow activity (SUVmax 1.4).


A 76-year-old male with history of prostate cancer status post brachytherapy with rising prostate-specific antigen level of 6.4 ng/mL. (b) Non-contrast CT of pelvis for radiation planning axial image showing brachytherapy seeds but no visible mass (red arrow).


An 88-year-old male with history of prostate cancer status post prostatectomy presented with progressive back pain and prostate- specific antigen level of 6.9 ng/mL concerning for recurrence. (a) Bone scan was negative.


An 88-year-old male with history of prostate cancer status post prostatectomy presented with progressive back pain and prostate- specific antigen level of 6.9 ng/mL concerning for recurrence. (b) Axumin positron emission tomography- computed tomography axial image demonstrating intense tracer uptake (standardized uptake value maximum 6.4) in the left posterolateral aspect of the T8 vertebral body (red arrow).


An 88-year-old male with history of prostate cancer status post prostatectomy presented with progressive back pain and prostate- specific antigen level of 6.9 ng/mL concerning for recurrence. (c) Pre-biopsy magnetic resonance imaging performed showing T2 hypointense lesion (yellow arrow) measuring 2.2 cm which was consistent with osteoblastic metastasis on biopsy.


BCR-ABL1 expression level, leukocyte number and the percentage of blast cells in bone marrow before and after anti-CD19 CAR-T treatment since April 24, 2017.


Patient responses after infusion. (A) After infusion, the number of CAR copies in the peripheral blood continued to increase and reached the highest value on day 10. The number of CAR copies remained high even after administration 320 mg tocilizumab. No CAR copies were detected 120 days after infusion.


Patient responses after infusion. (B) Serum cytokine levels increased after anti-CD19 CAR-T cell infusion.


Cerebral MRI presenting the temporal evolution within 3 days (from left to right) and EEG excerpt. First row: axial T2-weighted FLAIR images showing increasing bilateral confluent widespread hyperintensities of the supratentorial white matter predominantly on the left. Second row: axial T2-weighted FLAIR images revealing new hyperintensities of the left cerebellar peduncle. Third row: axial SWI demonstrating subtle and small susceptibility artifacts in the splenium of the corpus callosum. Fourth row: axial pre- and post-contrast T1-weighted MPRAGE showing enhancement of the left parieto-occipital region. FLAIR, Fluid-Attenuated Inversion Recovery; SWI, Susceptibility Weighted Imaging; MPRAGE, Magnetization-Prepared Rapid Acquisition with Gradient Echo.


(A,B) Histologic workup of the biopsy of the left frontal lobe and the cerebral autopsy. (A) Histology of the biopsy of the left frontal lobe showing perivascular infiltrates (arrow) of neutrophils, eosinophils, and macrophages (Hemalaun Eosin [HE] stain).


(A,B) Histologic workup of the biopsy of the left frontal lobe and the cerebral autopsy. (B) Histology of the cerebral autopsy revealing diffuse generalized inflammation and acute hemorrhages (arrow) (Hemalaun Eosin [HE] stain).


Photographs of the right eye before and after treatment. A; At the first visit, a whitish infiltration with a feathery edge, satellite (red arrow), and a brownish pigmented lesion (green arrow) on the epithelial surface and anterior stroma were presented at cornea.


Photographs of the right eye before and after treatment. B; One week after medical treatment, dense infiltrates and corneal plaques were found.


Photographs of the right eye before and after treatment. C; Five weeks after medical treatment, the lesion was replaced by a corneal scar without an overlying superficial corneal plaque and epithelial defect.


Photographs of the right eye before and after treatment. D; The lesion became a corneal scar after 2 months of treatment.


Scorpion sting site on the middle of the thumb 56 hours after the accident.


Map of the Para state, in the northern Brazil. Inset emphasizes the hydrographic basin of the Tapajos river. The black star indicates Tapari, where the envenomation provoked by R. amazonicus occurred. Distance is shown on a relative scale bar. The map was created using the free software QGis 2.2.


MRI showing bone marrow edema (white arrow) in the right shoulder in the. Sagittal view.


Coronal view.


Axial view.


(A) Timeline of tropinin and BNP levels and therapy with IVIG and steroids in case 1.


(B) Timeline of troponin, BNP levels, PR interval and therapy with IVIG and steroids in case 2. The number of days refers to the onset of the fever. BNP, brain natriuretic peptide; IVIG, intravenous immunoglobulins; IV, intravenous; NV, normal values.


12-lead ECG of the first patient 5 days after fever onset showed a mild ST-segment depression, and ,a deeper T-wave inversion compared with previous ECG in the anterior precordial leads.


12-lead ECG of the second patient 8 days after fever onset showed a sinus bradycardia (HR 48 beats per minute) with a first-degree atrioventricular block (PR = 216ms).


Case 1: Transverse unenhanced computed tomography (CT) images (A and B) demonstrate dense peribronchial consolidation (thin arrows) with air bronchograms (curved arrows); note the rim of consolidation (wide arrow) peripheral to a focus of ground-glass opacity, reminiscent of the "reverse halo" sign seen in organising pneumonia, and small bilateral effusions are present (arrowheads).


Case 2: Transverse section (C) shows several foci of peribronchial and perilobular consolidations (arrows) and ground-glass opacity (arrowheads), and small pleural effusions are present.


Case 3: Transverse high-resolution computed tomography (HRCT) image (D) demonstrates patchy peribronchial ground-glass opacity with superimposed reticulation and mild traction bronchiectasis (arrows).


Case 4: Transverse HRCT images.


Case 4: Transverse HRCT images. Show extensive, patchy ground-glass opacity, traction bronchiectasis (arrows in E), superimposed reticulation with peripheral and peribronchial consolation interlobular septal thickening.


A; Nodules on the dorsum of the foot (blue arrows) before treatment with intralesional doxorubicin.


B; The same lesions (red arrows) 2 weeks after the first injection with intralesional doxorubicin.


C; After over a year from the beginning of treatment, only some minimal scarring (yellow arrow) was identifiable.


A; Lasik Xtra: after flap lifting and excimer laser treatment, the corneal stroma is soaked by riboflavin 0.25% saline solution (VibeX Xtra) for 90 s.


B; After 90 s of riboflavin soaking, the corneal surface is washed with balanced salt solution and the flap repositioned. Then, accelerated high-fluence corneal collagen cross-linking was performed at 30 mW/cm2 for 90 s of UV-A exposure.


C; The final aspect of the cornea at the end of the treatment is shown.


Corneal endothelium at 1.


Medical image.


6. Months after Lasik Xtra showing cell pleomorphism. No significant endothelial cell loss was established after treatment.


The clinical, dermoscopic, and histopathological manifestations of BCC. A; A black macule of 2 mm in diameter is observed on the left auricle (arrowhead).


The clinical, dermoscopic, and histopathological manifestations of BCC. B; Dermoscopic findings: multiple blue-gray ovoid nests and a whitish veil are observed, without arborizing vessels.


The clinical, dermoscopic, and histopathological manifestations of BCC. C, d The tumor cells proliferate in a palisading pattern at the periphery, with basal melanosis. There are deposits of mucin and clefts in the surrounding area. The upper dermis shows the infiltration of inflammatory cells, mainly lymphocytes [HE; original magnification: x40.


The clinical, dermoscopic, and histopathological manifestations of BCC. X100.


Progressive erythema of the left periorbital area. 1, 2, and 3 March 2018.


Progression after initiation of oral penicillin. Initially the forehead swelled, accompanied by generalized oedema of the face and the appearance of a red protrusion in the same area.


An ultrasound image of the motile nematode.


Trans-esophageal echocardiography mid-esophageal view, 0 , with color doppler showing inlet type of ventricular septal defect (VSD; red arrow). LA: Left atrium; LV: Left ventricle; RA: Right atrium; RV: Right ventricle.


Trans-esophageal echocardiography mid-esophageal for chamber view, PTFE patch after closure of ventricular septal defect (VSD; red arrow) and severe LV dysfunction. PTFE: Polytetrafluoroethylene, LA: Left atrium; LV: Left ventricle; RA: Right atrium; RV: Right ventricle.


Modified apical four chamber view on transthoracic echocardiography examination showing a vegetation of size 6 x 7 mm vegetation (red arrow) was seen on the PTFE patch on the right ventricular side in. PTFE: Polytetrafluoroethylene, CS: coronary sinus; LV: Left ventricle; RA: Right atrium; RV: Right ventricle.


Apical four chamber view on transthoracic echocardiography examination showing no vegetation after 8 weeks of antifungal therapy on the PTFE patch (red arrow) in apical four chamber view on transthoracic echocardiography examination. PTFE: Polytetrafluoroethylene, LA: Left atrium; LV: Left ventricle; RA: Right atrium; RV: Right ventricle.


Ultrasonographic findings in the patient. Dotted circle indicates a mass with a heteroechoic pattern and 4-cm diameter.


Computed tomography findings in the patient. A partially enhanced localized tumor was detected in his left testis, with no distant metastasis or lymph node swelling.


Macroscopic appearance of the resected testis. The white arrow indicates the macroscopically recognized normal testicular tissue that was subsequently cryopreserved. The black arrow indicates the testicular tumor.


Histopathological findings of the resected testicular tumor. Hematoxylin-eosin stain of the embryonal carcinoma and yolk sac tumor (100x).


Histopathological findings of the resected testicular tumor. And immature teratoma (100x).


Histopathological findings of resected normal testicular tissue. Numerous seminiferous tubules, including Sertoli cells, spermatogonia, spermatocytes, and several early round spermatids but no late spermatid were identified, indicating late maturation arrest (Johnsen score, 6) (400x).


Ureteral catheter was inserted through an opening in utriculus.


Both testes, epididymis, spermatic cords, vessels, and rudimentary structures were seen in right side inguinal exploration.


Ultrasonography of the pelvis showing ureteric jets bilaterally (arrows), ruling out obstruction (calculus) in the ureter.


Disease course and patient management over time in three patients (A-C). ED, Emergency Department; LMWH, low-molecular weight heparin; i. V. , intravenous; VM, Venturi mask; FiO2, fractional inspired oxygen; NIV, non-invasive ventilation; CPAP, continuous positive airway pressure; HFNC, high-flow nasal cannulae; FKT, physiokinesitherapy; NC, nasal cannulae; CT, computed tomography; ECMO, extra-corporeal membrane-oxygenation.


The ratio of partial pressure arterial oxygen to fractional inspired oxygen (PaO2/FiO2) and C reactive protein (CRP) levels over time in three patients (A-C). Despite daily variations in minimum and maximum PaO2/FiO2 values, the trend shows progressive respiratory function improvements since the start of nintedanib in all patients.


Timeline of the presented case report. BP, blood pressure; SCr, serum creatinine; BUN, blood urea nitrogen; CsA, cyclosporine.


(a-b) Postoperative axial MRI on the 10th POD showing extensive cytotoxic edema with restricted diffusion in the right fronto-orbital, insular, and posterior frontal cortex.


(c-d) Serial postoperative axial MRI showed extensive cytotoxic edema involving the right fronto-parietal-temporal and insular cortex, right thalamus, and left fronto-insular cortex.


(a-d) Axial MRI performed 4 weeks after surgery revealing extensive gray and white matter disease with patchy enhancement in both cerebral hemispheres, worse in the right side, extending into the right basal ganglia, thalamus and pons.


Pathology revealing encephalomalacia of cortex characterized by cystic degeneration/cavitation.


Astrocytic gliosis with microglial nodules.


Perivascular lymphocytic monocyte cuffing.


Reactive gliosis There are no viral inclusion bodies. There is pyramidal neuronal loss in hippocampus.


Fundus photograph showing active juxtamacular retinitis before treatment.


Inactive lesion after treatment with intravitreal clindamycin.


Spectral-domain optical coherence tomography showing hyperreflective spots in the vitreous, macular edema with intra-, and ,sub-retinal fluid before treatment, hyperreflectivity of the neurosensory retina can be noted in the temporal aspect precluding the individualization of the different layers.


Normal retinal thickness and foveal contour after treatment.


Fundus photograph showing active juxtamacular toxoplasmic retinochoroiditis before treatment.


Sharpening of lesion borders after treatment with intravitreal clindamycin.


Spectral-domain optical coherence tomography showing elevation of the neurosensory retina, and ,retinal pigment epithelium with the presence of intra-, and ,sub-retinal fluid before treatment, hyperreflectivity of the neurosensory retina can be noted in the inferior nasal aspect precluding the individualization of the different layers.


Normal foveal contour with evidence of retinal pigment epithelial and outer retinal atrophy after treatment.


Fundus photograph showing active juxtamacular focal retinitis before treatment.


Spectral-domain optical coherence tomography showing increased retinal thickness, subretinal fluid.


Vitreous hyperreflectivity before treatment. Normal retinal thickness and foveal contour after treatment.


Fundus photograph showing active juxtapapillary retinitis before treatment.


Quiescent lesion after treatment with intravitreal clindamycin.


NSR with dynamic changes in T-waves in V1 and V2 when comparing two ECGs.


Repeat ECG after second emergency department visit.


Pulmonary artery clot.


Right ventricle clot. Of case 2 extracted via thrombectomy.


Photographs of the progression of a refractory fungal stromal abscess of the right eye in an 11-year-old female alpaca on day 1 (A)-Day 1, on presentation, there is approximately a 5 mm paraxial stromal abscess with a yellow creamy appearance and fluffy borders, pinpoint satellite lesions in the adjacent stroma (unable to appreciate in photo), marked geographical corneal edema, and dense stromal corneal vascularization. Photo obtained prior to application of fluorescein stain.


Day 2 (B)-By day 2, a satellite lesion adjacent to the stromal abscess had substantially increased in size by roughly 3 mm and the multiple small corneal bullae had worsened/coalesced to become a large corneal bulla overlying the medial aspect of the lesion with fluorescein stain uptake.


Day 3 (C)-By day 3, despite aggressive medical management the two stromal abscesses had coalesced, the corneal bullae had progressed, and the overlying cornea appeared moderately malacic. Photo obtained prior to use of fluorescein stain; after application it was noted the ulcer had increased in size to cover the whole lesion. Corneal cross linking with the accelerated protocol was performed the following day.


Day 7 (D)-On day 7, the stromal abscess had continued to increase by ~2 mm with improvement in corneal bullae, malacia, and progression of stromal vascularization. Fluorescein staining is evident overlying a portion of the abscess.


Photographs of the right eye of an 11-year-old female alpaca post-operatively after penetrating keratoplasty for a fungal stromal abscess immediately after surgery (A)-A 3 mm 4 ply porcine small intestinal submucosa graft (Vetrix Plus) was placed within the penetrating keratoplasty site with an 11 x 9 mm island conjunctival graft overlying the lamellar keratectomy site of 50% stromal depth, sutured in place with 8-0 polyglactin 910 suture.


4 weeks after surgery (B)-The eye was visual and comfortable 4 weeks after surgery with a healthy island conjunctival graft, sutures intact but dissolving, and a dilated pupil.


Timeline of the alpaca's clinical course and treatments. Black stars indicate specific treatments and results. Day 4: Corneal cross-linking performed and subconjunctival injection of 0.5 ml voriconazole 1%. Day 9: Culture growth of Scopulariopsis brevicaulis. Day 10: Surgical lamellar keratectomy, penetrating keratoplasty, and island conjunctival graft. Day 11: Parenteral ceftiofur crystalline-free acid once. Day 20: Culture growth of Fusarium verticillioides. Day 37: Recheck at ISU-considered healed. Day 51: Recheck with rDVM-no relapse off medication. Day 375: Telephone and photo updates with owners and rDVM-small scar, no concerns. Details about the products and dosages can be found in the main text. = pantoprazole (yellow bar).


A; Color fundus photograph on the day of the patient's fourth foscarnet injection (white arrow indicates pigmented scar).


B; Color fundus photograph 12 h later demonstrating large tear and focal detachment of the retina in the area of temporal necrosis (blue arrow) with superior pigmented lesion (white arrow).


(Case 1) Chest X-ray on admission.


(Case 1) Leg ultrasound showing thrombus in Left saphenofemoral vein.


(Case 2) Chest X-ray on admission.


(Case 2) USG Doppler showing thrombus in Rt. Popliteal vein.


(Case 3) Chest X-ray on admission.


(Case 3) Ultrasound right lower limb showing thrombus with sluggish flow.


A - Note the capsular thickening and ill-formed vascular channels (H & E x
100).


B - Immunohistochemistry with anti-HHV8-LANA1 showing nuclear positivity in
spindle cells and in the endothelial cells lining the vascular channels.


Beaded Gram-positive bacilli (arrow) in Gram-stained smear from positive blood culture bottle (magnification: x1000).


Colonies of
Mycobacterium chelonae
 on MacConkey agar after 48 h of aerobic incubation at 28. C.


Whole-body bone scan reveals increase uptake in T8-T9, left femur, left knee, and left ankle.


The thyroid scintigraphy with technetium-99m showed a large cold nodule in the left lobe of the thyroid gland.


Follicular thyroid carcinoma invasion to the tumor capsule vessels.


Whole-body scan after 150 micg of iodine 131, intake was indicative of extensive bone metastases.


Hands radiogram - osteoarthritic changes with geodes.


Legs ulcerations - healing progress. 13.07.2016.


Legs ulcerations - healing progress. 13.10.2016.


Legs ulcerations - healing progress. 27.01.2017.


Legs ulcerations - healing progress. 19.10.2017.


Chest CT image on initial presentation (10 years before the onset of Budd-Chiari syndrome) showing an anterior mediastinal tumor mass with a low-density area. The pathological diagnosis was invasive thymoma (type B2). She underwent systemic chemotherapy (CAMP therapy) followed by total thymectomy at that time. CT, computed tomography.


Abdominal CT image on the first visit to our hospital showing a large right hepatic mass of irregular density with indistinct borders. Abundant ascites was also detected.


CT scan with bilateral pneumonic infiltrates.


Abdominal pelvis CT scan. A; Initial CT scan showing dilated appendix with hypoenhancing wall (arrow) and minimal surrounding fat stranding. There were no drainable fluid collections.


Abdominal pelvis CT scan. B; Repeat CT scan 3 days later showing dilated appendix with hypoenhancing wall (arrow), now with an adjacent loop of small bowel with thickened wall (arrowhead). There remained no drainable fluid collections, no free fluid, and no free air.


Ileocecectomy specimen. The appendix was completely necrotic (arrowhead) as was a segment of ileum that was in direct contact with the appendix (arrows).


MRI or CT scan images of the patient. Indicated partial enhancement of pia mater in brain enhanced MRI.


MRI or CT scan images of the patient. Revealed an area of abnormal attenuation measuring 67 mm x 62 mm in the right lobe of the liver, indicative of a single large multi-loculated abscess in abdominal enhanced CT.


MRI or CT scan images of the patient. Displayed the abscess reduced to 51 mm x 37 mm 3 days after emergency CT-guided percutaneous drainage of the liver abscess in abdominal plain CT.


MRI or CT scan images of the patient. Showed no lesions in liver in the reexamination of abdominal CT after full recovery.


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.


Multiple smooth, round, and pinkish papules on the skin of the face near the angle of the mouth.


Gross picture of the excised specimens.


Herpes vegetans facial lesions at initial presentation.


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


Facial lesions 2 months after presentation.


Chest radiograph showing milliary mottling.


Computed tomography-scan showing pulmonary interstitial emphysema.


Left eye showing an inferonasal opalescent limbal lesion extending into cornea with fimbriated edges.


Fundus image of the left eye showing healing necrotising retinitis after initiation of treatment.


Right eye showing an inferonasal gelatinous mass at the limbus extending into cornea with feeder vessels.


Fundus image of the left eye showing retinitis and retinal vasculitis with multiple yellowish granular lesions and perivascular sheathing.


Histopathology image showing multilayered conjunctival epithelium with dyskeratotic cells and stromal fibrosis, suggestive of conjunctival epithelial dysplasia.


(a) Initial magnetic resonance angiography (MRA) showed stenosis in the terminal portion of the bilateral internal carotid artery.


(b) MRA performed after 1 year revealed progression of stenosis in the right middle cerebral artery.


(c and d) Single-photon emission computed tomography with iodine-123 iodoamphetamine revealed preserved cerebral blood flow and a significant decrease in vascular reserve in the right hemisphere.


(a) Magnetic resonance angiography revealed good angiogenesis from the external carotid system to the right cerebral hemisphere and progression of stenosis in the left middle cerebral artery.


(b and c) Single-photon emission computed tomography with iodine-123 iodoamphetamine showed preserved cerebral blood flow and a significant decrease in vascular reserve in the left hemisphere.


(a and b) Six months after the initial surgery, susceptibility-weighted imaging (SWI) revealed the absence of cerebral microbleeds (CMBs) in the left hemisphere.


(c and d) Nine months after the initial surgery, SWI showed three de novo CMBs in the left hemisphere (white arrows).


Erythematous lesions in both the lower extremities.


Contrast enhanced computed tomography image of the abdomen: 5.5 cm x 4.4 cm sized well encapsulated inhomogeneous mass (arrow heads) with central areas of necrosis in the upper pole of right kidney.


Microscopic examination of right nephrectomy specimen follicular cells suggesting metastatic deposits from thyroid malignancy or a rare primary renal tumor (thyroid like follicular carcinoma of the kidney) inset: Immunohistochemistry performed showed that the cells were strongly positive for pan-cytokeratin, thyroid transcription factor-1, thyroglobulin (as shown in figure), suggesting metastatic deposits from thyroid malignancy.


Ultrasound of neck revealed bilateral hypoechoic nodules with peripheral rim of egg-shell calcifications (left lobe nodule is shown).


Fluorodeoxyglucose positron emission tomography-computed tomography maximum intensity projection image shows a hypermetabolic lesion in the thyroid and left acetabular region. Transaxial fused 18F-fluorodeoxyglucose positron emission tomography-computed tomography image shows hypermetabolic calcified nodule (black arrow) in the left lobe of thyroid gland with maximum standardized uptake value of 12.6 (arrow) and hypermetabolic lytic lesion in left acetabulum with maximum standardized uptake value of 9.5 (arrow).


Histopathology image of thyroidectomy specimen revealed features consistent with follicular variant of papillary thyroid carcinoma with vascular invasion.


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.


MRI findings were: Multiple hyper signal lesions in periventricular and subcortical with involvement of subcortical Mfibers in parietal lobe, preserving basal gangelia, thalamus and corpus callosum, the possibility of demyelinating disease should be considered.


Chest computed tomography showed right side pleural effusion.


Abdominopelvic computed tomography showed hypo dense areas suggestive for kidney infarction.


Brain MRI showed a hyper signal lesion in left hemisphere of cerebellum.


TTE shows heavy calcification and thickening of aortic valve with two mobile masses attached to the aortic valve. . Abbreviation: TTE, transthoracic echo.


Clinical presentation of anterior abdominal wall cold abscess.


CT scan of the abdomen showed two cystic collections in the anterior abdominal wall with peripheral enhancement.


Tracing the month long course of life-threatening vasculitis after aneurysm clipping in a 33-year-old woman. Initial clipping. (a) After coil embolization for rupture of a right internal carotid artery (ICA) aneurysm, an unruptured left posterior communicating artery (PComA) aneurysm was incidentally detected and then treated by clipping; this intraoperative angiogram demonstrated flow in PComA and fetal posterior cerebral artery (PCA) after clipping and no residual aneurysm filling.


Tracing the month long course of life-threatening vasculitis after aneurysm clipping in a 33-year-old woman. Initial clipping. (b) Postoperative CT confirms clipping was successful. Readmission and reclipping.


Tracing the month long course of life-threatening vasculitis after aneurysm clipping in a 33-year-old woman. Initial clipping. Eleven days later (day 1), patient returns to the emergency department where head CT.


Tracing the month long course of life-threatening vasculitis after aneurysm clipping in a 33-year-old woman. Initial clipping. MRI. Showed acute infarction in the orbitofrontal and left frontal opercular cortical regions. CTs during hospital days 11-22.


Tracing the month long course of life-threatening vasculitis after aneurysm clipping in a 33-year-old woman. Initial clipping. Day 11 , progressive mass effect, and ,infarction.


Tracing the month long course of life-threatening vasculitis after aneurysm clipping in a 33-year-old woman. Initial clipping. Day 12 , after surgical decompression, evolution of new bifrontal infarctions.


Tracing the month long course of life-threatening vasculitis after aneurysm clipping in a 33-year-old woman. Initial clipping. Day 16. Demonstrating new left PCA infarct with worsening of bilateral frontal infarctions.


Tracing the month long course of life-threatening vasculitis after aneurysm clipping in a 33-year-old woman. Initial clipping. Day 17 (h), repeat angiogram shows high-grade stenosis and near-complete occlusion of the left PCA at the P1-2 junction; mild short segment stenosis involves several cortical branch vessels of left MCA.


Tracing the month long course of life-threatening vasculitis after aneurysm clipping in a 33-year-old woman. Initial clipping. Day 22 (i), intraoperative angiogram after nickel-containing clip removal was replaced with titanium clip.


Timeline: Clinical, epidemiological and laboratory assays of SARS-CoV-2 and CHOV coinfection case. Schematic timeline with events described from top to bottom: molecular and serological laboratory assays for SARS-CoV-2 (light blue) and CHOV (green), type of mechanical ventilation applied to the patient, timeline with the date (year, month, day) and the days of symptoms onset (*) with color coding representing the health institution and clinical management, epidemiological and clinical case description. Abbreviations used in the figure: SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; CHOV, Choclo orthohantavirus; RT-PCR, real time reverse transcription polymerase chain reaction; PCR, polymerase chain reaction; CLIA, chemiluminescent immunoassay; SIA, strip immunoblot assay; PRNT80, 80% plaque reduction neutralization test; Ig, immunoglobulin (A, M and G for this case); ICU, intensive care unit; AMV, advance in mechanical ventilation; COVID-19, coronavirus disease 2019.


Clinical course of the patient. (A) Stage 1: from pathogeny to intubation.


Clinical course of the patient. (B) Stage 2: ECMO stage.


Clinical course of the patient. (C) Stage 3: transplant and post-transplant stages.


Microscopic examination of the explanted lung (hematoxylin-eosin stain, x50) shows extensive consolidation of lung tissue and pulmonary interstitial fibrosis (arrowheads). Ring fibrosis connecting alveolar orifice rings and inflammatory cell infiltration into the alveolar walls with pneumocyte hyperplasia and squamous metaplasia.


Follow-up single photon emission computed tomography/computed tomography imaging with indium-111-labeled octreotide demonstrates progression of metastatic disease, with two octreotide avid metastatic tumor deposits in the (contralateral) right kidney, which developed 2 years subsequently. An octreotide avid pulmonary metastasis is noted in the left lung.


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.


MRI of the brain revealed subtle increased signal intensity in bilateral hippocampal on FLAIR sequences (A).


CT scan of the abdomen indicated a space-occupying lesion in right-side ovarian, later pathologically identified as mature ovarian cystic teratoma (B).


Immunohistochemical findings . GFAP.


Immunohistochemical findings . S-100. Immunohistochemical staining were positive.


Inflammatory response. In this patient's ovarian teratoma. Infiltration of scattered CD3 T-cells.


Inflammatory response. In this patient's ovarian teratoma.


Chest X ray before thoracentesis. It shows large right-sided pleural effusion.


CT scan chest before thoracentesis. It shows large right-sided pleural effusion, but no evidence of consolidation.


Post thoracentesis chest X-ray. It shows improvement in the right-sided pleural effusion, and absence of consolidation.


Magnetic resonance imaging sequences:. T1.


T2 images sequences.


Intraoperative photography of the tumor.


Serum sodium levels. . Note: Index date refers to start date of trimethoprim-sulfamethoxazole prescription.


Magnetic Resonance Imaging Findings. At first onset, MRI demonstrated patchy lesions in the medulla oblongata, and ,dorsal pons.


Magnetic Resonance Imaging Findings. At first recurrence, MRI demonstrated multiple lesions in the brain.


Magnetic Resonance Imaging Findings. At second onset, MRI demonstrated pons lesions, consistent with the diagnosis of multiple sclerosis.


Magnetic Resonance Imaging Findings. Before teriflunomide administration, MRI demonstrated new punctate enhancing lesions in the left frontal lobe, and ,abnormal signals in the thoracic spinal cord at T6-7 of the skull, and ,spinal cord.


Magnetic Resonance Imaging Findings. N) After 6 months of teriflunomide use, MRI demonstrated that the lesions were reduced, especially in the spinal cord; (O, P) After 1 year of teriflunomide use, MRI demonstrated that the patient's lesions were reduced. The arrowhead showing lesions in MRI. MRI, Magnetic resonance imaging.


A 53-year-old male presented to the emergency room with acute abdominal pain, Hematemesis, Malena non-contrast-enhanced computed tomography (axial and coronal reformatted sections) (a and b) - Abdomen shows an exophytic ulcerative lesion seen along the greater curvature of stomach associate with perigastric and peri splenic fat stranding (white arrow).


A 53-year-old male presented to the emergency room with acute abdominal pain, Hematemesis, Malena contrast-enhanced computed tomography (axial section and coronal) (a and b) - Abdomen shows an exophytic enhancing ulcerative component seen arising from the proximal body of the stomach and extending up to the splenic hilum with loss of fat plane (white arrow) and non-enhancing wedge-shaped area with the apex toward the splenic hilum - splenic infarction (yellow arrow).


A 53-year-old male presented to the emergency room with acute abdominal pain, Hematemesis, Malena contrast enhanced computed tomography - Abdomen on follow-up imaging shows an exophytic enhancing ulcerative component from the proximal body of the stomach and extending up to the splenic hilum with fistulous communication between the spleen and the stomach (white arrow) and few air pockets noted within (yellow arrow).


A 53-year-old male presented to the emergency room with acute abdominal pain, Hematemesis, Malena on follow-up scan - USG image shows - There is the presence of few echogenic foci (air pockets) in the splenic parenchyma (white arrow).


Multiple serial images of esophagogastroduodenoscopy at different angulation show.


Exudative material (indicated by the blue arrow).


Proliferative growth in the region of the gastric fundus (indicated by white arrows).


Fresh or altered blood (indicated by black arrows).


MR angiogram of the head reveals focal pseudoocclusion of the right M1.


Diffusion-weighted magnetic resonance image.


Noncontrast computed tomographic scan of the head. Show completed infarct.


Noncontrast CT scan of head shows hemorrhagic conversion of right MCA territory infarct.


Noncontrast CT scan of head after decompressive craniectomy showing improvement of midline shift.


Noncontrast CT scan of head shows increased intracerebral hemorrhage with midline shift associated with the ruptured mycotic aneurysm.


CT angiogram of head, thin-cut axial image, reveals right M1 ruptured mycotic aneurysm.


CT angiogram of head, coronal reconstruction, reveals right M1 ruptured mycotic aneurysm.


CT angiogram of head, sagittal reconstruction, reveals right M1 ruptured mycotic aneurysm.


Cerebral angiogram - early arterial phase, anteroposterior (AP) internal carotid artery injection - reveals right M1 mycotic aneurysm with occlusion of distal branches.


Cerebral angiogram - mid-arterial phase; AP internal carotid artery injection - reveals right M1 mycotic aneurysm with occlusion of distal branches.


Cerebral angiogram - early arterial phase, AP internal carotid injection - reveals coiled M1 mycotic aneurysm and parent vessel.


Noncontrast CT scan of head status post hematoma evacuation showing improvement of mass effect.


Lymphocyte count, cytomegalovirus (CMV) blood and cerebrospinal fluid (CSF) viral load, and the progression of symptoms and events over one year, in a 10-year-old girl who underwent allogeneic HSCT. Colour bars represent the timeline graph of antiviral treatments and their corresponding duration. After discontinuing the immune-suppressive regimen, the patient first experienced headaches with high blood CMV load, despite therapy with valganciclovir and foscarnet. Her symptoms then worsened until overt immune reconstitution inflammatory syndrome (IRIS) occurred, with high CSF CMV load, despite CMV clearance from the blood, together with an increase in lymphocyte count and severe bone marrow and renal toxicity. After the initiation of anti-CMV-specific immune globulins, the CSF viral load dropped rapidly, and symptoms improved. HSCT, hematopoietic stem cell transplantation; IST, immunosuppressive therapy; IRIS, immune reconstitution inflammatory syndrome; CMV, cytomegalovirus; CSF, cerebrospinal fluid.


Serum and cerebrospinal fluid (CSF) cytomegalovirus (CMV)-IgG antibodies (Ab) titre evaluation in CMV-IgG-positive patients undergoing the Cytotect CP treatment (Cytotect group, n = 15) and those not so treated (Control group, n = 15). In the Cytotect group, the CSF CMV Ab levels were significantly higher than serum Ab levels (P < 0.001) and CSF Ab levels of the Control group (P < 0.0001). CMV serum and CSF Ab evaluations were performed in triplicates, and their results are shown as mean +- SD. Statistical analysis was performed using the Mann-Whitney U-test.


Dark skin over right leg and foot.


Hyperkeratotic purpuric eruptions on left leg.


Red macular lesions of varying size over lower part of abdomen.


T2WI of splenic MRI showing high intensity signal, and low intensity signal in the periphery around some of the masses. . Abbreviations: MRI, magnetic resonance imaging; T2WI, T2-weighted image.


Postoperative pathology of spleen. . Notes:. Magnification x10.


Postoperative pathology of spleen. . Magnification x40.


T2WI of head MRI showing mass in the right frontal lobe. . Abbreviations: MRI, magnetic resonance imaging; T2WI, T2-weighted image.


Chest CTs showing multiple pulmonary nodular lesion.


Pulmonary cavitation . Abbreviation: CT, computed tomography.


Pedigree of the clustered SARS-Cov-2 infection cases. Arrow indicates the proband (case 1). Case 2, 3, and 4 are close contacts of case 1. Full black fills indicate the individuals with COVID-19 symptoms (case 1 and 2), while partial black fills indicate asymptomatic carriers of SARS-CoV-2 (case 3 and 4).


Chest CT images of the four family-clustered cases. (A) Case 1.


Chest CT images of the four family-clustered cases. (B) Case 2.


Chest CT images of the four family-clustered cases. (C) Case 3.


Chest CT images of the four family-clustered cases. (D) Case 4.


Anteroposterior.


Lateral. Radiograph of the patient showing reduced subtalar joint space with erosion of articular surfaces.


Medical image.


40. Broden views of the same patient showing the presence of subtalar joint arthritis.


(a and b) Histopathological appearance of the scrapped dirty granulation tissues showing epithelioid granuloma with plenty of giant cells; typical features suggestive of tuberculous infection.


Lateral.


Axial. Image taken at 6 weeks after second surgery and under cover of antituberculous drugs showing fusion in progress.


Colonoscopy image showing an oedematous and hyperaemic mucosa of the sigmoid tract with multiple erosions and ulcerations, tending to be confluent and circumferential.


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.


Janeway Lesion showing as painless, macular, hemorrhagic, irregularly-shaped lesions on patient's palm. Two pronounced lesions are seen at thumb and middle finger. Subungual splinter hemorrhages (arrowhead) are seen at the nail bed of thumb.


X-ray of Case 1's right hip showing a cemented hip arthroplasty with signs of chronic femoral infection: endosteal osteolysis, periosteal bone formation and thickening of the cortical bone.


Confirmation of talaromyces marneffei specific amplification from plasma by next-generation sequencing. (A) shows the reads mapped to talaromyces marneffei derived from NGS data. A total of 248 reads mapped to talaromyces marneffei in the reference database which contains about 8000 pathogen genomes, and got a total coverage of 0.0085% respectively.


Confirmation of talaromyces marneffei specific amplification from plasma by next-generation sequencing. (B) shows the distribution of bacterial sequences (N = 529 reads) identified in the patient's plasma included Talaromyces marneffei (N = 248;47%), Cutibacterium, Acinetobacter, Staphylococcus, Acidovorax, Corynebacterium, Malassezia.


Pedigree of CARD9 mutations (Due to death, no genetic analysis was performed for the second elder sister).


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.


Liver associated enzymes rapidly improve following initiation of anti-inflammatory therapy in a HIV-infected patient with autoimmune hepatitis and primary biliary cirrhosis overlap syndrome.


Left: Portal area showing marked chronic inflammation with numerous plasma cells and ductular reaction. Inset shows hepatocytes with a positive staining reaction for copper, indicative of chronic cholestasis. (H&E,x 200; inset: Copper stain, x 600). Right: Cytokeratin 7 stain showing infiltration of a bile duct by lymphocytes (arrow). Ductular reaction is present at the edges of the portal area (CK7 antibody, x400).


: Noncontrast head CT demonstrated intraventricular hemorrhage (IVH) a Initial head CT showing diffuse IVH in the bilateral lateral ventricles. b Follow-up head CT showing stable IVH.


MRI brain [fast low angle shot (FLASH) sequence] demonstrated intraventricular hemorrhage; no causative underlying vascular lesion was identified.


Catheter angiography of left vertebral artery demonstrated vasoconstriction. The arrows point to multifocal areas of irregular narrowing of the distal branches of the left posterior cerebral artery.


Preretinal hemorrhage in an eye that exhibited Valsalva-like retinopathy. A; Fundus photograph shows the hemorrhage over the central section of the eye.


Preretinal hemorrhage in an eye that exhibited Valsalva-like retinopathy. B; Optical coherence tomography image shows the preretinal hemorrhage that was located under the ILM. The posterior hyaloid membrane was demonstrated above the preretinal hemorrhage (arrows).


Preretinal hemorrhage in an eye that exhibited Valsalva-like retinopathy. C; Fluorescein angiography.


Preretinal hemorrhage in an eye that exhibited Valsalva-like retinopathy. D; Indocyanine green angiography. No visible retinal vascular abnormality was observed; however, the posterior pole was veiled due to the preretinal hemorrhage.


Retinopathy was resolved with a membranotomy. A; Fundus photograph taken 2 days after membranotomy.


Retinopathy was resolved with a membranotomy. B; Optical coherence tomography image shows the posterior hyaloid membrane (arrows) and the remaining ILM elevation.


Retinopathy was resolved with a membranotomy. C; Fluorescein angiography.


Retinopathy was resolved with a membranotomy. D; Indocyanine green angiography. No retinal vascular abnormality was demonstrated.


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.


Initial abdominal ultrasound (cat). Transmural thickening (about 9 mm) of the gastric body wall with loss of normal wall layering.


Initial endoscopy of the stomach (cat). Tumour-like gastric mass with an ulcerated depression at the level of the greater curvature between the fundus and gastric body.


Second endoscopy of the stomach (cat). Performed 2 months after the initial endoscopy, shows the presence of a large whitish thickened mucosal area with a central part covered by fibrin at the level of the greater curvature in front of the pyloric antrum, indicating a healing phase ulcer.


Gastric wall. Gram staining showing filamentous Gram-positive bacteria (arrow).


Third abdominal ultrasound (cat). Performed 4 months post-surgery, shows a complete healing of the gastric lesion with normal thickness and normal layering of the gastric wall.


Third abdominal ultrasound (cat). Performed 4 months post-surgery, evidences a focal asymmetric hypoechoic thickening with loss of normal layering of the jejunal wall.


External photos of the patient. (a) Ptosis of the left upper eyelid.


External photos of the patient. (b) Elevation of the ptotic eyelid with mouth opening, esotropia and hypotropia in the left eye.


Fundus photos of both eyes. (a) Healthy retina and optic disc in the right eye.


Fundus photos of both eyes. (b) Morning glory disc anomaly in the left eye.


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) X-ray indicates dextrocardia and cardiac enlargement.


CTA reveals transposition of the abdominal organs.


Confirming L-loop ventricular orientation and concordant atrioventricular connections.


(D) Three-dimensional CTA shows normal great artery development and connections.


The transesophageal echocardiography shows mitral chordae rupture.


Severe mitral regurgitation (LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle).


(A) Pre-printing digital file of the 3D model embedded with designated ablation lines.


(B) View of the three-dimensional printed model.


(C) Clamping on the model of the mitral isthmus line during the rehearsal process.


(A) Intraoperative view of the mirror-image dextrocardia.


(B) Ablation at the mitral line, black arrow indicates the ruptured chordae.


(C) Ablation to the tricuspid annulus, the jaw of the bipolar clamps are placed across the tricuspid annulus.


(D) Successful result of saline injection test after mitral valvuloplasty.


HIV viral load results over time.


External photograph showing swollen periorbital tissue with proptosis.


External photograph showing melting central corneal ulcer with hypopyon.


B-scan showing hyperechoic mass with surrounding exudative retinal detachment.


Serial. Weight, and ,heart rate.


Thyroid function, and ,TRAb titres.


Daily dose of oral carbimazole (CMZ) therapy, in a patient with T3-predominant Graves' hyperthyroidism. TSH was suppressed from 11/9/17 to 6/11/17 (8 weeks with low fT4 and normal fT3), further suppressed on 13/12/17 (T3 toxicosis) and went from suppressed to normal from 7/2/18 to 24/3/18 (6 weeks with low fT4 and normal T3).


Thyroid function profile before and within 24-hours after total thyroidectomy with intravenous levothyroxine 500 mcg loading.


Chest CT shows multiple lung cancers.


Chest CT shows multiple lung cancers. Adenocarcinoma,. Positron emission tomography computed tomography (PET-CT) of pleomorphic carcinoma.


Chest CT shows multiple lung cancers. Pleomorphic carcinoma,. PET-CT of adenocarcinoma.


Chest CT shows multiple lung cancers. Adenocarcinoma.


Relationship between pathology and somatic mutations.


Structural chromosome aberration analysis by OncoScan CNV. Common chromosomal aberrations were found in chromosomes 8 and 10, and the process that piled up independent chromosomal aberrations was inquired of these tumors having a common origin.


Large vegetation on the atrial face of anterior mitral valve leaflet.


Single, well defined, lobulated, tumoral swelling (5 cm x 6 cm x 7 cm in size) on the left cheek. Surface of the swelling showed few pearly white flat topped papules, ulceration with hemorrhagic crust and slough. Multiple, discrete, pearly white, umbilicated papules were present over surrounding skin.


The cut surface of the excised lesion showed multiple gyri like corrugations. At the base of the excised lesion, multiple pearly white papules are seen ( ).


Postexcision and skin grafting: Complete healing with minimal scarring.


Endoscopic findings. . Notes: (A) Mucosal erosion and ulceration in rectum.


Endoscopic findings. (B) The lesion got little improvement after 10-day course of metronidazole.


Endoscopic findings. (C) The lesion showed complete recovery of the ulceration.


Histopathological findings. (A) Hematoxylin-eosin stained, 100x.


Histopathological findings. (B) Immunohistochemistry for cytomegalovirus, 200x.


The diagram shows the timeline of treatment and the changes in visual acuity and central retinal thickness.


Fundus examination of both eyes at the initial consultation. Ultra-wide field fundus image revealed macular edema in both eyes (A, B).


Fundus examination of both eyes at the initial consultation. Ultra-wide field fundus image revealed macular edema in both eyes (A, B). Optical coherence tomography (OCT).


Fundus examination of both eyes at the initial consultation. The fluorescein angiograms did not reveal leakage from the parafoveal capillaries (C-F).


Fundus examination of both eyes at the initial consultation. Scans showed the cystoid edema with a foveal thickness of 485 microm on the right and 596 microm on the left.


Mainly right sided oculomotor paresis with elevation deficit and ptosis.


Responded positively to an intravenous test dose of 9 mg edrophonium chloride. Suggesting that double vision was caused by ocular manifestation of myasthenia gravis.


Axial and Coronal Plane of CT Scan. A, Axial plane of CT scan showing a well-defined homogenous mass pushing the right globe anteriorly.


Axial and Coronal Plane of CT Scan. B, Coronal plane of CT scan showing the same mass eroded the right floor of frontal sinus and pushing the globe inferolaterally.


(A) Schematics show the treatment history of the patient. Enhanced computed tomography scan reveals the clinical response to chemotherapy, radiotherapy, nivolumab alone, and nivolumab combined with anlotinib. Red arrows point to the masses in pulmonary and lymph node metastases.


(B) Immunohistochemistry presents the programmed death ligand-1 expression of the lymphoepithelioma-like carcinoma (LELC) tissues in pulmonary LELC.


(C) The genetic testing result of the new metastatic lymph node in our patient, when her disease progressed after nivolumab monotherapy.


(D) The curves showed serum tumor marker CYFRA21-1 levels before and after the combined nivolumab and anlotinib therapy.


(E) The curves showed Epstein-Barr virus copy numbers in the serum before and after the combined nivolumab and anlotinib therapy.


Anterior view of the skin lesion diagnosed as Kaposi sarcoma and Molluscum contagiosum.


Posterior view of the skin lesion diagnosed as Kaposi sarcoma and Molluscum contagiosum.


Low power view of the coexisting Kaposi sarcoma (golden arrow) and Molluscum contagiosum (black arrow). Haematoxylin and eosin staining X 40.


(a) Section showing a lobular lesion composed of enlarged keratinocytes with central eosinophilic molluscum bodies.


(b) Section showing plump spindle cells with bland nuclei delimiting slit-like vascular spaces, consistent with Kaposi sarcoma. Haematoxylin and eosin staining X 200.


Direct Albert stain from the throat swab showing abundant green coloured bacilli with metachromatic granules arranged in cuneiform pattern.


Dry, rough, white, nonhaemolytic colonies with irregular margins observed on the blood agar plates.


Black, dry, rough, colonies with irregular margins observed on the potassium tellurite agar.


Postimplantation angiographic image showing a low deployment of the CoreValve prosthesis in the left ventricular outflow tract (white arrows) and the incomplete stent expansion (yellow arrows).


(a and b) Computed tomography angiography revealing the presence of an ascending aorta ulcer on the distal edge of the prosthetic valve stent (yellow arrows).


(c) The stent frame is grossly underexpanded (red asterisk).


Cell morphology, Gram staining and colony morphology of isolated bacterium. A) Gram-stain-negative rods from blood culture bottle were observed (magnification x1000).


Cell morphology, Gram staining and colony morphology of isolated bacterium. B) White and mucoid colonies on sheep blood agar after culture for 48 h at 35. C.


Cladogram phylogenetic tree of the 16S rRNA gene sequences of strain Naga 0113 =PAGU 1967; the tree was prepared by the neighbour-joining method. Numbers at nodes are bootstrap values, expressed as a percentage of 1000 replications. The scale bar represents one inferred nucleotide substitution per 100 nucleotides.


Necrosis of the frontal region of the mandibular alveolar ridge and three missing incisors.


Magnetic resonance imaging of the girl's mandible (T1 TSE fat sat contrast medium sequence) showed areas of bone necrosis (star) with peripheral reactive bone contrast enhancement (arrows) and enhancement of the soft tissue edema (arrowheads).


Histopathology of the biopsy specimens taken from the lower jaw (first biopsy). (a) Inflamed gingival mucosa with superficial erosions, with granulation tissue and dystrophic calcifications. Retrospectively, calcifications were "reinterpreted" as remains of destructed alveolar bone. HE, original magnification, x4.


Histopathology of the biopsy specimens taken from the lower jaw (first biopsy). (b) Recanalization of the small vessels in the inflamed gingival mucosa (mark). Note the intense mixed inflammatory infiltrate in the background and the swollen endothelial cells. HE, original magnification, x20.


(a) The patient underwent resection of the lesion for microbiological and histopathological examination. Histopathological examination of the brain specimen demonstrated thin, branching organisms of about 1-micron thickness, consistent with Nocardia species on hematoxylin and eosin staining (original magnification, x40).


(b) Grocott staining revealed thin, filamentous, and ramifying argyrophilic bacteria (original magnification, x40).


(a and b) T1-enhanced axial, sagittal magnetic resonance image showing infratentorial lesion affecting deep structures, including the cerebellar vermis. The lesion is juxtaventricular (fourth ventricle), but not cause obstructive hydrocephalus.


(c) Fluid-attenuated inversion recovery demonstrated brain edema around the lesion.


(d) Diffusion-weighted image showing a restricted lesion of abscess.


Brain magnetic resonance imaging performed 1 year after the surgery shows disappearance of the inflammatory tissue and purulent collection.


CT scan of chest without contrast showing multiple bilateral opacities.


Transthoracic echocardiogram, short axis of aorta view.


Subpulmonic valve stenosis and PV vegetation during open heart surgery.


Clinical milestones and treatment course of the illustrative case. Schematic representation of the clinical course and the treatment divided into three vertical categories (dotted line): clinical milestones, first-line immunotherapy, and second-line immunotherapy. The X-axis indicates the day of hospitalization, and the gray area indicates the time of bortezomib administration. Anti-NMDA-R, anti-N-methyl-D-aspartate receptor; CSF, cerebrospinal fluid; ICU, intensive care unit; IVIg, intravenous immunoglobulin; LP, lumbar puncture; PLEX, plasma exchange.


Myometrium.


Testis with absent spermatogenesis.


Patient's karyotype - normal male - 46 XY.


Changes in. Impact of Event Scale - Revised (IES-R).


Hospital Anxiety and Depression Scale (HADS) over time in a 33-year-old man following treatment for COVID-19 in an intensive care unit.


MR enterography for case #2. Red arrow depicts the mural edema and circumferential thickening of the cecum and ascending colon.


A; PET-CT scan revealing the presence of a 7-cm left lung neoformation with no nodal involvement.


Chest CT-scan showing the presence of extensive pulmonary infarction in the residual parenchyma.


A flexible bronchoscopy showing a 4-mm bronchopleural fistula.


Chest CT scan revealing a non-homogeneous increase in density, diffuse GGO and consolidations at the right lung.


An almost complete recovery revealed by a new chest CT scan.


(A) Patient A, right inguinal squamous cell carcinoma 2 weeks after first cycle of experimental immune therapy. Tumor surface became smooth and epithelial margins symmetric compared to original tumor state.


Tumor images of patients A and B. (B) 11 weeks after second experimental treatment, the patient returned for the last cycle of intratumoral vaccinations and topical imiquimod therapy. The tumor measured 2 cm3.


(C) Patient B, hematoxylin and eosin stain of recurrent cervical cancer showing areas of invasive focally keratinizing, moderately differentiated squamous carcinoma involving entire thickness of the stroma (x20 magnification, scale 100 microm).


(D) Patient B, tumor identified and biopsied 3-4 weeks after completion of chemo-radiation for stage 3B squamous cell cancer of the cervix, pelvic exam, PET/CT, and biopsies confirmed radiation-refractory, recurrent disease.


(E) Radical hysterectomy and bilateral salpingo-oophorectomy following failed curative chemo-radiation (8,500 cGy total to point A) followed by two cycles of intratumoral vaccinations and imiquimod. No residual squamous cell carcinoma on pathological evaluation and negative HPV-HR testing of the cervix. Vaginal cuff ThinPrep. 6 weeks post-operatively was negative for dysplasia/malignancy and HPV-HR DNA.


FA of the LE at presentation, showing impregnation but not diffusion.


Chest X-ray showed bronchopneumonia.


Chest MSCT showed emphysematous lungs.


Abdominal X-ray showed pneumoperitoneum.


Intraoperative finding of gastric perforation.


Chest X-ray showed atypical bronchopneumonia.


Abdominal X-ray showed small bowel obstruction suspected ileus.


Intraoperative finding of multiple intestinal strictures and stenosis.


Chest X-ray showed normal lung and heart.


Chest MSCT showed pleuritis.


Abdominal MSCT showed pancreatitis necroticans.


Intraoperative finding of pancreatitis necroticans.


Chest X-ray showed multiple metastatic nodules.


Chest MSCT showed multiple metastatic nodules.


Abdominal MSCT showed sigmoid tumour.


Intraoperative finding of rectosigmoid tumor.


Computed tomography angiogram showed pulmonary emboli in the right upper lobe pulmonary arteries.


Computed tomography angiogram which showed a pulmonary embolus involving the segmental branch of the left upper lobe pulmonary artery.


Clinical case 1;. Transthoracic echocardiography five chamber view showing a vegetation in the aortic valve (arrow).


Transesophageal echocardiography showing abscess in aortic root (star) with Doppler signal showing aorta regurgitation.


(A) Characteristic furrowing of the hypothenar eminence seen in our patient with palmaris brevis syndrome.


(B) There was no visual evidence that the non-dominant hand was similarly affected.


(C) Worsening of palmaris brevis contractions triggered by grasping a pipettor.


(D) Patient's workspace shows evidence of extreme wear with erosion of the countertop (arrow). He did not use a mouse pad or wrist support while handling the mouse.


(E) EMG recording of spontaneous activity from the right palmaris brevis muscle.


Brain MRI of a 3-year-old girl with anti-N-methyl-d-aspartate receptor encephalitis. . Notes: T1-weighted with gadolinium-enhanced MRI revealed. Prominence of leptomeningeal enhancement at bilateral frontoparietal areas (axial view).


Brain MRI of a 3-year-old girl with anti-N-methyl-d-aspartate receptor encephalitis. Nodular enhancement along the tentorium edge (coronal view).


Brain MRI of a 3-year-old girl with anti-N-methyl-d-aspartate receptor encephalitis. T1-weighted (axial view).


Brain MRI of a 3-year-old girl with anti-N-methyl-d-aspartate receptor encephalitis. T2-weighted (axial view) MRI showing tiny white-matter lesions over bilateral frontal lobes. . Abbreviation: MRI, magnetic resonance imaging.


Showing the egg of Hymenolepis diminuta containing six central hooklets (x100).


The fundus photo of the left eye in 2013, 6 months after the single intravitreal injection of ranibizumab, shows decreased vascularization of the hemangioma and mild fibrosis.


Two-weeks follow up after topical therapy with 20% KOH solution.


Resolution of the lesions at 4 weeks after therapy.


(a and b) Setup of the overhead transparent plastic barrier with powered suction technique.


(a-c) Demonstration of a patient and anesthesiologist using the overhead transparent plastic barrier with powered suction technique.


Tumour molecular profiling and treatment strategy. Sequential therapeutic strategy of ALK tyrosine kinase inhibitors (TKI) and chemotherapy over the course of time together with detected molecular findings in patient tissue and plasma. FISH, fluorescent in situ hybridisation; MAF, mutant allele frequency; NGS, next generation sequencing.


The treatment procedures and corresponding leukocyte counts in the patient's cerebrospinal fluid. Monocytes were predominant among CSF white cells; they had a proportion of approximately between 60 and 90%. The CSF protein level was also elevated to 95.00-125.20 mg/dl. mNGS. P, metagenomic next-generation sequencing of cerebrospinal fluid detected Sarocladium strictum positive; Culture. P, Sarocladium strictum was positive in cerebrospinal fluid culture.


Enhanced abdominal CT taken on day 14. Part of the intestine was dilated and there was gas and fluid accumulation, and the gas-liquid level was visible.


Clinical course of the patient.


(a) Single-photon emission computed tomography with low-dose screening computed tomography of the pelvic region showing increased tracer concentration in the articular margin erosions with adjoining sclerosis in bilateral sacroiliac joints.


(a) STIR coronal section of the pelvis showing bilateral sacroiliitis with peripherally enhancing collection around bilateral sacroiliac joints (Right > Left).


(b) T1-weighted magnetic resonance imaging image showing bilateral sacroiliitis with peripherally enhancing collection around bilateral sacroiliac joints (Right > Left).


T2 SPAIR axial section showing hyperintensity in the right iliopsoas muscle.


Treatment timeline for CRKP infection.


Alpha and beta diversity of the gut microbiota of the donor and the patient pre- and post-FMT. Histograms compared Chao1 index.


Alpha and beta diversity of the gut microbiota of the donor and the patient pre- and post-FMT. Shannon index. Of the fecal microbiome in the donor and the patient pre- and post-FMT.


Alpha and beta diversity of the gut microbiota of the donor and the patient pre- and post-FMT. PCoA plots showed the microbial community variation of the donor and the patient pre- and post-FMT based on weighted UniFrac distance.


Alpha and beta diversity of the gut microbiota of the donor and the patient pre- and post-FMT. And unweighted UniFrac distance FMT 1W, FMT 3W and FMT 2M represented 1 week, 3 weeks and 2 months after FMT.


Farewell reception by hospital staff at the Medical Center of Aurora to the COVID-19 survivor discharging to rehabilitation on hospital day 28.


Embolia cutis medicamentosa. A reticulate, nonblasnching, nonindurated, coalesced areas of mottled erythemato-violaceous patches over the right superior gluteal distribution with extension to the lateral aspect of the thigh, and right lumbar paraspinal area, with satellite lesions measuring in its maximum diameter 23 cm x 18 cm.


Magnetic resonance imaging.


Magnetic resonance imaging. T2-weighted sagittal spine magnetic resonance imaging revealed a longitudinally extensive altered signal intensity from T7 level to conus level with. (T2-weighted axial magnetic resonance imaging at T10 level) centromedullary cord involvement.


(A) Magnetic resonance brain images with fluid attenuated inversion recovery (FLAIR) sequences of October 2017, when patient presented with recurrent seizures. Images show distinct cerebral small vessel disease.


(B) Diffusion weighted imaging sequences of the same examination show point-shaped infarction in left-sided MCA-territory (white arrow).


(C) FLAIR sequence of April 2018 when patient deteriorated clinically with clear increase of white matter damage.


(D) FLAIR sequence of October 2018, when patient presented for fifth cycle of cyclophosphamide treatment and with a marked clinical improvement. Images show a clear reduction of small vessel disease.


Timeline of clinical and diagnostic events. Weeks since initial presentation (antecedent pneumonia) are presented as gray blocks of 1 week each (bottom row). Clinical events are presented (top row) with inpatient weeks in dark gray and outpatient weeks as light gray blocks. Diagnostic testing and corresponding results, as well as selection and duration of antibiotics are indicated.


The Goldman visual field test showed constriction of visual fields in both eyes.


Paratesticular tumour composed of interlacing fascicles of spindled smooth muscles (hematoxylin-eosin, objective 20x).


Different treatment periods of cranial MRI. (A-C) Multiple enhancing masses were shown in the corpus callosum and around the ventricles before our interventions.


Different treatment periods of cranial MRI. (D-F) Partial response after two cycles of treatment.


Different treatment periods of cranial MRI. (G-I) No obvious masses after finishing our treatment.


Different treatment periods of cranial MRI. (J-L) 30 months follow-up.


(A) Haematoxylin-eosin (H&E) staining of biopsy samples (40x magnification).


Immunohistochemical staining showed that tumor cells were positive for CD20.


But not for CD30.


Cyclin D1.


CT images after respiratory failure happened. Mediastinal emphysema was occurred after receiving invasive mechanical ventilation. Mediastinal window.


CT images after respiratory failure happened. Mediastinal emphysema was occurred after receiving invasive mechanical ventilation. And lung window.


A; Chart of the patient's medical procedures.


CSF parameters according to different antibiotic treatments and colistin MIC values. . Notes: CSF WBC (cells/muL) <img>; CSF glucose (mg/dL) <img>; Colistin MIC <img>. R: colistin breakpoint=4 (EUCAST). . Abbreviations: CSF, cerebrospinal fluid; EUCAST, European Committee on Antimicrobial Susceptibility Testing; EVD, external ventricular device; MIC, minimum inhibitory concentration; WBC, white blood cell.


Clinical features of dermatomyositis with shawl-like rash affecting neck, chest and back. A; Flagellate erythema upper back.


Clinical features of dermatomyositis with shawl-like rash affecting neck, chest and back. B; 'V' neck distribution of erythema.


The lung infiltration resolved in the chest X-ray following the treatment.


Infiltrated plaques on nose, left dorsum of wrist and on index finger of right hand.


Nodular lesions on dorsum of both hands.


(A) Sagittal T2-weighted magnetic resonance imaging scan revealing a well-defined high signal intensity mass, 3.1 cm in size, at the anterior aspect of the endocervix, along with multiple uterine myomas less than 9 cm in size.


(B) Macroscopically, the cervix was open at 12 o'clock.


(C) The cells had large, ill-defined cytoplasmic borders, abundant cytoplasm, prominent nucleoli, and syncytial growth patterns (H&E, x200).