(A) Magnetic resonance imaging (MRI) T2 coronal images with marked edema and enhancement of the left adductor magnus and brevis muscles, with focal areas of nonenhancement consistent with myonecrosis (arrow).


(B) MRI T1 fast-spin coronal images with progression of the edema and development of a fluid collection in the proximal medial thigh measuring 3.9 x 10.3 x 8.5 cm (marked with arrow).


Axial T2-weighted magnetic resonance image shows progressive multifocal leukoencephalopathy with a large confluent hyperintense lesion in the left occipitotemporal region.


Axial T2-weighted, fluid-attenuated inversion recovery magnetic resonance image shows progressive multifocal leukoencephalopathy with a high signal intensity lesion involving the white matter of the dorsal right frontal lobe and right frontal operculum, as well as lateral left frontal and inferior left occipitotemporal region with no mass effect.


T2-weighted MRI revealed a distinct tiger-striped appearance with abnormally oriented folia in the left cerebellar hemisphere, extending to the vermis.


The cerebellar lesion exhibited a hyperperfusion on blood flow imaging (upper left) and a hypermetabolism on the metabolic rate of oxygen imaging (upper right), respectively, on 15O-gas PET. 99mTc-ECD (lower left) and 123I-iomazenil (lower right) SPECT show hyperactivity and a defect in the uptake of the lesion.


Surgical resection of the tumor. Tumor of 35 x 30 x 17 mm.


Photo of the tumor at low magnification (X50). Nodular and well limited tumor composed of sheets of eosinophilic cells with Hematoxylin Eosin and Saffron (HES) stain.


Photo of the tumor at high magnification (X200). Tumor cells are large with an abundant eosinophilic cytoplasm and round regular nuclei with small nucleoli, according with Leydig cells. Hematoxylin Eosin and Saffron (HES) stain.


Photo of the tumor at high magnification (X400). Tumors cells were diffusely stained with antibody to inhibin A(immunoperoxydase). All tumor cells present a diffuse and strong cytoplasmic staining.


Photo of the testicular biopsy at high magnification (X100). Histopathological micrograph with hematoxylin-eosin-green FCF stain. The testicular biopsy consists of tubules with hypospermatogenesis (white arrows) mixed with aplasia (black arrows).


Testicular Steroidogenesis.


Illustration of treatment escalation in refractory course of anti-NMDA receptor encephalitis with special focus on antibody titer in CSF and serum as well as the clinical development over 27 months. mRS: modified Rankin scale (0, No symptoms; 1, No significant disability; 2, Slight disability, able to look after own affairs without assistance, but unable to carry out all previous activities; 3, Moderate disability. Requires some help, but able to walk unassisted; 4, Moderately severe disability. Unable to attend to own bodily needs without assistance, and unable to walk unassisted; 5, Severe disability. Requires constant nursing care and attention, bedridden, incontinent, 6 - Dead).


Level of immunoglobulin classes and influence of daratumumab. (A) Immunoglobulins in serum.


Level of immunoglobulin classes and influence of daratumumab. (B) Immunoglobulins in CSF.


3D reconstruction with a catheter in the common hepatic artery (asterisk) and six electrodes placed alongside the metallic Wallstent.


Buckle infection by Serratia marcescens. (a) Explanted scleral buckle showing reddish-brown deposits over the exposed portion of the buckle.


Buckle infection by Serratia marcescens. (b) Scleral thinning with underlying uveal tissue noted.


Buckle infection by Serratia marcescens. (c) Growth on both chocolate and blood agar.


Buckle infection by Serratia marcescens. (d) Microscopic image showing Gram-negative rod-shaped bacillus identified as Serratia species.


(A) The blood cell and PCM1-JAK2 fusion transcript changes in patient 1 over the course of the disease.


(B) The blood cell changes in patient 2 over the course of the disease. WBC, white blood cells; HB, hemoglobin; PLT, platelet; Eo, eosinophils.


Ultrasound examination images. A; Ultrasound examination result at 30wk. A ventricular septal defect for 2.2 mm was shown as the arrow in the image. Abbreviations: LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle; VSD, ventricular septal defect.


Ultrasound examination images. B; Ultrasound examination result at 33wk. A ventricular septal defect (VSD) for 3.0 mm was shown as the arrow in the image.


Onset of NCSE (thick arrow) on initial EEG after admission. This epoch of the EEG shows onset of NCSE with diffuse slowing of 2- to 2.5-Hz delta and left greater than right hemispheric spikes (thin arrows).


The antibiotic susceptibility plate showing no zone of inhibition around the linezolid E-test strip along with the susceptibility pattern for other antibiotics by Kirby Bauer disc diffusion method for the linezolid resistant enterococcus isolate.


Clinical case 3: Images shown of the RE (left panel) and LE (right panel). Retinography (top panel of images), fluorescein angiography (middle panel of images) and SD-OCT (bottom panel of images). The most relevant OCT characteristics included the presence of outer photoreceptor segment disruption, dOPL, presence of central confluent ONLc and INLc, with a relatively equivalent distribution of cysts between both nuclear layers in both eyes. The case shows recurrent DME as the patient case was responsive to IVI of triamcinolone and PRP. Patient lived a long way from the hospital, had PDR in the LE (ie the non-vitrectomized eye).


Family pedigree.


Admission chest x-ray shows bilateral infiltrates and chronic emphysematous changes.


Admission chest computed tomography, transverse view of upper lobes, shows dominant right upper lobe intracavitary lesion. The central component is 2.1 x 2.3 cm (previously 2.0 x 2.3 cm). The mural nodule within this cavitation is 2.1 x 1.2 cm (previously 1.5 x 1.0 cm) and thin walled. Imaging shows progression of right upper lobe bullous emphysema and cystic bronchiectatic changes.


Admission chest computed tomography, transverse view of lower lobes, shows new onset diffuse interstitial pulmonary ground-glass airspace opacities.


Admission chest computed tomography, coronal view, shows increased mediastinal lymphadenopathy, likely reactive.


Follow-up chest computed tomography after 5 weeks, transverse view of upper lobes, shows the mural nodule in the right upper lobe intracavitary lesion at 3.1 cm and partially calcified.


Follow-up chest computed tomography after 5 weeks, transverse view of lower lobes, shows near complete clearing of bibasilar opacities. Bilateral partially calcified nodules and amorphous/nodular opacities (more on the right than on the left) are visible, as well as bilateral bronchiectasis (also more on the right than on the left).


Follow-up chest computed tomography after 5 weeks, coronal view, shows stable borderline mediastinal lymphadenopathy.


Chest X-ray of patient on admission to local hospital post-intubation.


Schematic overview of the timing and dosing of the BV-DHAP regimen. . Notes: Dosage in cycle 1 was reduced to 75%. Cycle 2 was administered at 100% as indicated. . Abbreviations: BV-DHAP, brentuximab vedotin and cisplatin/cytarabine; d, day; iv, intravenous; po, per os; sc, subcutaneous.


CT abdomen showing asymmetric gastric mucosal thickening.


Pathology H&E stains of core biopsy. Spindle cells are seen.


CT chest showing bilateral pleural effusions and moderate pericardial effusion with dilated cardiomyopathy.


Renal pathological presentation (kidney biopsy of the proband 15 days after admission). Brightfield microscopy (PAS stain x600). Mesangial, and ,endocapillary hypercellularity.


Renal pathological presentation (kidney biopsy of the proband 15 days after admission). Brightfield microscopy (PAS stain x600). Cellular crescent.


Renal pathological presentation (kidney biopsy of the proband 15 days after admission). Brightfield microscopy (PAS stain x600). Segmental scar/fibrous crescent.


Renal pathological presentation (kidney biopsy of the proband 15 days after admission). Brightfield (H & E stain x200). Interstitial infiltrates.


Renal pathological presentation (kidney biopsy of the proband 15 days after admission). Immunohistochemistry (x200). Interstitial infiltrates.


Renal pathological presentation (kidney biopsy of the proband 15 days after admission). Electron microscopy. Diffuse podocyte foot process effacement with prominent microvillous transformation.


Negative-pressure wound therapy with continuous instillation (NPWT-CI).


Hematoxylin and eosin (H&E) staining and immunohistochemical analyses of the resected tumor. (A) The tumor cells arrange in a diffuse pattern(x4). Melan-. Patchy).


Hematoxylin and eosin (H&E) staining and immunohistochemical analyses of the resected tumor. (B) Epithelioid tumor cells are oval or polygonal, with clear or granular eosinophilic cytoplasm. Nucleoli are prominent in the vesicular nuclei. Increased mitotic activity and dysplasia are observed (x20).


Hematoxylin and eosin (H&E) staining and immunohistochemical analyses of the resected tumor. Tumor cells are positive for. HMB-45 (strong, and ,diffuse).


Hematoxylin and eosin (H&E) staining and immunohistochemical analyses of the resected tumor.


Hematoxylin and eosin (H&E) staining and immunohistochemical analyses of the resected tumor.
TFE3 (modest, and ,diffuse).


Hematoxylin and eosin (H&E) staining and immunohistochemical analyses of the resected tumor. Are negative for. SMA.


(a) Gadolinium contrast-enhanced magnetic resonance imaging demonstrated inflammation of vertebral body at L3 and L4 with bilateral iliopsoas abscesses.


(b) Microscopy of the surgical specimen of the vertebral interbody revealed granuloma aggregating of histiocytes by hematoxylin and eosin staining at low magnification. A punctured specimen from the abscess of iliopsoas muscle demonstrated Mycobacterium tuberculosis in the Ziehl-Neelsen stain at high magnification (left upper).


Operative view: A lesionectomy was performed by opening the cerebellomedullary fissure, and a well-circumscribed mass with gray color encircled by arrowhead was identified (left).


Total mass resection was performed (right).


(a) Operative view: A lesionectomy was performed by opening the cerebellomedullary fissure, and a well-circumscribed mass with gray color encircled by arrowhead was identified (left). Total mass resection was performed (right). The size of the extracted mass was 3.5 cm. Pathology of the lesion revealed lymphocytes, macrophages, plasmacytes, and neutrophils aggregated around the tuberculoma by hematoxylin and eosin staining at 200-fold magnification (upper left).


(b) Postoperative MRI showed a total mass resection.


(H&E x100).


(H&E x200).


The cells demonstrate round to oval nuclei with variably prominent nucleoli, moderate eosinophilic cytoplasm and indistinct borders (C) (H&E x400).


The cells demonstrate irregular nuclei with prominent multiple eosinophilic nucleoli, abundant eosinophilic cytoplasm and indistinct borders (D) (H&E x400).


Bladder wall tumor): A highly cellular epithelioid (top right) and spindle cell (bottom left) malignancy involving the outer wall of the urinary bladder Immunohistochemistry shows diffuse reactivity for cytokeratin AE1/AE3 and calretinin (inset) (E) (IHC x100).


Remote abdominal tumor): A moderately cellular malignancy with intermixed spindled and epithelioid cells involving the outer gastric wall Immunohistochemistry shows reactivity for cytokeratin AE1/AE3 and negative calretinin (inset) (F) (IHC x100).


Levels of von Willebrand factor VIII Ag and Ristocetin Cofactor activity. (In the X axis, days from episode of bleeding is shown, while in the Y axis levels in U/mL are recorded).


Computed tomography scan shows the lesion, located in meta-diaphysial area.


Primary giant cell tumor of bone (Haematoxylin and Eosin).


MRI images (FLAIR) performed one month after the patient was bitten; hyperintensities in the basal ganglia (white arrows), thalamus, pons, and medulla.


Brain atrophy. Are shown.


Patient monitoring data are displayed as ICP (gray-filled line), gastroparesis (black line), and interventions: Salovum (black bar), Pentothal (gray bar). Critical ICP threshold according to the TBI algorithm (20 mm Hg) and threshold for gastroparesis are shown by horizontal black line. Patient 1.


Patient monitoring data are displayed as ICP (gray-filled line), gastroparesis (black line), and interventions: Salovum (black bar), Pentothal (gray bar). Critical ICP threshold according to the TBI algorithm (20 mm Hg) and threshold for gastroparesis are shown by horizontal black line. Patient 2.


Patient monitoring data are displayed as ICP (gray-filled line), gastroparesis (black line), and interventions: Salovum (black bar), Pentothal (gray bar). Critical ICP threshold according to the TBI algorithm (20 mm Hg) and threshold for gastroparesis are shown by horizontal black line. Patient 3.


Patient monitoring data are displayed as ICP (gray-filled line), gastroparesis (black line), and interventions: Salovum (black bar), Pentothal (gray bar). Critical ICP threshold according to the TBI algorithm (20 mm Hg) and threshold for gastroparesis are shown by horizontal black line. Patient 4.


Patient monitoring data are displayed as ICP (gray-filled line), gastroparesis (black line), and interventions: Salovum (black bar), Pentothal (gray bar). Critical ICP threshold according to the TBI algorithm (20 mm Hg) and threshold for gastroparesis are shown by horizontal black line. Patient 5.


Timeline course of the patient's COVID-19 disease.


(A) Selected cases of Ewingella americana infection. Examples of clinical presentation after E. Americana infection with the associated antibiogram. To note, the prevalence of immunocompromised patients and the presence of only three previously reported pediatric cases (case n.1, 2, and 3). TMP/SMX, Trimethoprim/sulfamethoxazole; CKD, Chronic kidney disease; COPD, Chronic obstructive pulmonary disease.


(B) Clinical and laboratory findings in a newborn with E. Americana meningitis.


Antimicrobial susceptibility results of E. americana in our patient.


Heterogenous tumor within the right cerebello-pontine angle causing severe compression of the brainstem. This T2-weighted MRI image in the transversal plane illustrates the extrinsic nature of the lesion with a differential diagnosis of meningioma or Schwannoma.


Pedigree of the family with the SMARCE1 mutation. Current age is mentioned below the square/circle. + = mutation positive, - = mutation negative. Solid black = CCM patient, age of detection of CCM is mentioned below the current age. Solid white = clinically asymptomatic. ? = testing not started yet.


(A and B) Moderate-to-severe psoriasis, with a Psoriasis Area and Severity Index (PASI) score of 16, body surface area (BSA) score of 12 and Dermatology Life Quality Index (DLQI) score of 18 prior to treatment with biological therapy.


(C and D) Complete clinical response after 16 weeks of secukinumab.


Progression of diabetic tractional retinal detachment, by fundus photography and optical coherence tomography (OCT) of the left eye after a unilateral, right eye intraoperative intravitreal bevacizumab injection. . Notes: Fundus photograph.


Progression of diabetic tractional retinal detachment, by fundus photography and optical coherence tomography (OCT) of the left eye after a unilateral, right eye intraoperative intravitreal bevacizumab injection. OCT. Of the left eye before right eye intraoperative intravitreal bevacizumab injection, showing vitreoretinal adhesions and attached macula.


Progression of diabetic tractional retinal detachment, by fundus photography and optical coherence tomography (OCT) of the left eye after a unilateral, right eye intraoperative intravitreal bevacizumab injection. Fundus photograph.


Progression of diabetic tractional retinal detachment, by fundus photography and optical coherence tomography (OCT) of the left eye after a unilateral, right eye intraoperative intravitreal bevacizumab injection. OCT. Of the left eye after right eye intraoperative intravitreal bevacizumab injection, showing decreased perfusion of the neovascular tissue and progression of tractional retinal detachment.


Chest X-ray showing pulmonary congestion.


Transthoracic echocardiogram, parasternal L-A view showing the anterior leaflet saccular aneurysm of the mitral valve.


Transesophageal echocardiography, 4-C mid-esophageal view showing the perforated anterior leaflet aneurysm of the mitral valve.


Transesophageal echocardiography image demonstrating the anterior-posterior bicuspid aortic valve.


Flash-evoked visual potentials show prolonged N2 and P2 latencies in both sides at 9 months after disease onset.


Marked improvement 9 months later.


3T MRI coronal T2-weighted images show increased signals in both optic nerves, more prominent on the right (e).


Brain MRI at neurological presentation shows multifocal hyperintense lesions within the basal ganglia.


Midbrain.


Significantly reduced lesion load after 9 months.


Axial.


Coronal. Brain 18F-FDG PET slices showing reduced glucose uptake in the left caudate nucleus, putamen, thalamus and bilateral mesial temporal lobes.


Color fundus photograph of the left eye. (a) At presentation, the left eye shows a subretinal mass approximately of 1.5-disc diameter in size located near superotemporal arcade with surrounding subretinal fluid extending till fovea.


Color fundus photograph of the left eye. (b) At 2-week follow up, the choroidal tuberculoma did not show any significant change in the size.


Color fundus photograph of the left eye. (c) At the last follow-up visit, a regressed and partially scarred tuberculoma is seen.


Fundus fluorescein angiography of the left eye at 10 weeks of presentation. (a) A small area of hypofluorescence overlying the lesion surrounded by hyperfluorescence in the early phase.


Fundus fluorescein angiography of the left eye at 10 weeks of presentation. (b and c) There is progressive staining of lesion in the late phase.


Gel column hemagglutination with IgG weak positive reaction.


The variation of the tumor and inflammation in Chest CT. Pre-immunotherapy: the tumor was seen in the right lung.


The variation of the tumor and inflammation in Chest CT. 2 weeks after immunotherapy: patchy shadows appeared around the tumor, and ,air holes occurred in the tumor.


The variation of the tumor and inflammation in Chest CT. 4 weeks after immunotherapy: more air holes developed in the tumor, and ,patchy shadows.


The variation of the tumor and inflammation in Chest CT. 5 weeks after immunotherapy: the tumor, and ,patchy shadows were dissipating.


The variation of the tumor and inflammation in Chest CT. 8/12 weeks after immunotherapy: the tumor disappeared, with several linear shadows leaving.


The variation of the tumor and inflammation in Chest CT. 16 weeks after immunotherapy: the tumor reappeared in original site.


The variation of the tumor and inflammation in Chest CT. 18 weeks after immunotherapy: the tumor enlarged.


Myositis: the level of serum creatase was used to monitor immune related myositis after immunotherapy.


Myocarditis+ Hepatitis: cardiac markers, and ,hepatic transaminase were used to monitor myocarditis, and ,hepatitis, respectively, after immunotherapy.


Pituitary-Adrenal Axis: the level of COR, and ,ACTH were used to monitor the function of the pituitary-adrenal axis: COR, and ,ACTH both declined remarkably after ICI therapy, ACTH was maintained at a low level while COR was still lower than the normal value by glucocorticoid replacement therapy.


Pituitary-Gonad Axis: the level of FSH, LH, and ,TESTO were used to monitor the function of the pituitary-gonad axis: all of them fluctuated in the range of normal values, TSH, and ,FT4 were both normal in the pituitary-thyroid axis.


Autoimmune Reponse: IL-6, and ,TNF-alpha was used to monitor the autoimmune response induce by ICI: IL-6 fluctuated beyond the upper limit of normal (ULN) while TNF-alpha fell to normal gradually after glucocorticoid replacement therapy.


Tumor Marker: tumor markers was used to monitor efficacy of ICI.


The patient with fluctuant, tender nodules with overlying alopecia. (A and B) Posterior and lateral views to show enlarged nodules in the scalp.


(A) Before treatment.


(B) After 2 months of therapy showing partial hair regrowth.


Fundus photograph after initial treatment. Note the decreased vitritis, media haziness, and disk edema. A white linear subretinal lesion (nematode) is present in the inferonasal quadrant (white arrow) as well as a white intravitreal substance corresponding to the triamcinolone acetonide particles (black arrow).


Fundus photograph after worm mobilization.


Optical coherence tomography demonstrates the subretinal location of the worm presenting as two hyper-. reflective particles over the retinal pigment epithelium (white arrows).


Fundus photograph immediately after application of laser photocoagulation to the nematode.


Image of patient exhibiting edematous erythema, ulcer, and necrosis over the right nasal alae and upper lip.


Microscope image of biopsied lesion tissue showing numerous hyaline and septate hyphae with branches at acute angles scattered in the dermis (arrowhead) (periodic acid-Schiff, original magnification x 400).


Blood cell counts during hospitalization.


Clinical presentation of the case with IL12RB1 deficiency. Pictures were taken on different occasions:. Skin lesion in the form of multiple erythematous maculo-papular rash, over the upper limbs.


Clinical presentation of the case with IL12RB1 deficiency. Pictures were taken on different occasions: , lower limbs.


Clinical presentation of the case with IL12RB1 deficiency. Pictures were taken on different occasions: over the abdominal wall surrounding the umbilicus.


Clinical presentation of the case with IL12RB1 deficiency. Pictures were taken on different occasions: (D) A swelling is shown in the left groin, due to left inguinal lymphadenitis (arrowed).


Right thumb showing worsening cutaneous erythema and roughening of the eponychia.


Biopsy prepared with haematoxylin and eosin stain (20x magnification).


Timeline.


Family tree.


Diagnostic imaging. Echocardiography (A, B) showed a hypoechoic mass in the left ventricle and the anterolateral right ventricle.


Diagnostic imaging. Chest CT scan mediastinal window (C, D) with contrast enhancement showed that the heart shadow had increased. A round, soft-tissue mass was observed at the left edge of the Cardiac margin. Multiple lymph node shadows were observed at the left hilum of the lung and mediastinum.


Diagnostic imaging. The chest CT scan lung window (E, F) showed right pleural effusion and bilateral pneumonia.


Right paraventricular mass biopsy (200x). The H&E stain (A, B) showed poorly differentiated carcinoma infiltration in fibrous tissue.


Right paraventricular mass biopsy (200x). The immunohistochemical analysis (C-H) showed EGFR (+), CK (+), P63 (+), Ki67 (40%+), PD-L1 (CPS 80%+), and PD-L1.


Creatinine level changes.


Fifteen year-old tattoo made of black pigment with erythematous and painful infiltrative reaction with papules and plaques.


Contrast CT-scans performed during targeted therapy. Showing enlarged mediastinal lymph nodes.


After the definitive suspension of treatment showing reduction in the diameter of the previously reported lymph nodes.


The timeline of patient's treatment history and the response of the tumor lesions. Time line.


The timeline of patient's treatment history and the response of the tumor lesions. The radiographic imaging of pancreatic and metastatic liver lesions.


Schematic of the mutant genome. The in-frame deletion is not affecting the ORFS, but shortens pre-S2 and Pol by the corresponding two amino acids. A total of 1,380 truncates the polymerase to 82 amino acids.


During interictal EEG, diffuse irregular high amplitude slow waves of bilateral symmetry were found.


(A) Glomeruli show a lobular flocculus with a global and diffuse endocapillary proliferation associated with mesangial hypercellularity. Crescents with fibrinoid necrosis were present (arrow) (Trichrome stain: original magnification: 400x).


(B) By immunofluorescence, IgG deposits were diffusely observed and organized in a starry sky pattern (FITC: original magnification: 400x).


(C) Numerous subepithelial (humps) and mesangial dense deposits were observed by electronic microscopy. Arrow shows so called humps.


By immunofluorescence,. C3.


By immunofluorescence,. C5-9. Deposits were diffusely observed (FITC: original magnification: 400x).


Cerebral and cerebellar atrophy, deepening of the cerebral sulci on cranial computed tomography in case 3.


Appearance of bilateral paramediastinal infection on computed tomography of the thorax suggesting invasive fungal infection in the lung in case 4.


Homozygous nonsense mutation in exon 6 (c.700 C>T) (P. Arg234Ter) in the purine nucleoside phosphorylase gene in case 4.


T1-weighted images coronal: Well-defined cerebrospinal fluid signal intensity in prepontine, interpeduncular, suprasellar, anterior third ventricle with dilatation of third and both lateral ventricles.


T1-weighted images axial: Well-marginated cerebrospinal fluid signal intensity cystic lesion in prepontine, interpeduncular, suprasellar, anterior third ventricle with moderate dilatation of third and both lateral ventricles.


T1-weighted image axial: Ventricular dilatation has significantly decreased with near normal size ventricles.


T2 sagittal: Gross dilatation of body of lateral and third ventricle with fenestrations of cyst at superior and inferior aspect.


Cyst bulging into foramen of monro.


Thinned out third ventricular floor.


Minimal decrease in cerebrospinal fluid density cystic lesion and obstructive hydrocephalus.


(a) Ultrasound image of the brachial plexus between the anterior and middle scalene muscle.


Arrows indicate brachial plexus (BP); (b) Ultrasound image of spreading the drugs around the brachial plexus. Arrowheads indicate the needle. Arrows indicate BP. ASM anterior scalene muscle, MSM middle scalene muscle, SCM sternocleidomastoid muscle, * injected drug surrounding the BP.


Picture of severe bruise after fall due to dizziness of adverse effect of medication in Case 2.


Ultrasound image of the lumbar plexus block in the posterior part of the psoas muscle (PM). Arrows indicate lumbar plexus (LP). Arrowheads indicate the needle. ESM erector spinae mescle, PM psoas muscle, TPL4 transverse process of L4, TPL5 transverse process of L5.


Patient A: preoperative, axial T1 postcontrast weighted magnetic resonance (MRI) imaging showing enhancing disease.


Postoperative, axial T1 postcontrast weighted MRI imaging showing enhancing, residual disease.


Radiation therapy (RT) planning using volumetric arc therapy (VMAT) resulted in excellent coverage of the planning target volume (PTV) (red) by the 100% isodose line (yellow) corresponding to 5940 cGy.


Follow up gallium-68 dotatate positron emission tomography (PET) after more than 6 years showing hypermetabolic, recurrent disease in the left tentorial leaflet and physiologic uptake in the pituitary.


Patient B: preoperative, axial T1 postcontrast weighted MRI imaging showing enhancing disease.


Postoperative PET showing hypermetabolic, residual disease.


RT planning using VMAT resulted in excellent coverage of the 6000 cGy (red) and 5400 cGy (blue) PTVs by the 100% (yellow) and 90% (green) isodose lines, respectively.


Biallelic inactivation of BAP1 by differing mechanisms. Aligned sequence data from Patient A show the pathogenic BAP1 variant is heterozygous in the germline (top track) and tumor (bottom track).


Biallelic inactivation of BAP1 by differing mechanisms. ; the second hit is a somatic frameshift mutation.


Biallelic inactivation of BAP1 by differing mechanisms. In contrast, aligned sequence data from Patient B.


Biallelic inactivation of BAP1 by differing mechanisms. Show the germline variant approaching homozygosity in the tumor VarScan tumor allele frequency plot for heterozygous germline variants on chromosome 3 of Patient B indicates chromosome-level LOH across chromosome 3.


Computed tomography of the chest one day after admission to the intensive care unit showing bilateral infiltrates and airspace consolidation of the left lower lobe.


Tc-99m MDP whole body images show multiple sites of increased tracer uptake, including the skull and facial bones, multiple ribs, pelvis and bones of both lower limbs. The "pirate sign" indicates involvement of the right sphenoid wing.


Non-contrast CT scan of the chest shows bony expansion and deformity of the right ribs, where intense osteoblastic activity was detected.


PET-CT scan showing no FDG uptake in the pleura.


CT scan showing pneumothorax and centrilobular nodular shadows with ipsilateral increasing pleural effusion.


T2 weighted lumbar sagittal MRI view demonstrating spinal stenosis at L4-L5 and L5-S1.


PA x-ray of lumbar spine demonstrating adequate contrast spread at the right L4 nerve root.


Head CT showing a large right parieto-occipital hemorrhage with edema secondary to the septic embolus. Note also the presence of marked mass effect as indicated by obliteration of the occipital pole of the right lateral ventricle.


Crusted VZV lesions (sacrum) and reddish-blue painful lesion on left buttock.


Chest X-Ray showing pulmonary infiltrates and cardiomegaly.


Echocardiography showing prolapse of mitral valve (arrow).


Computed tomography (CT) thorax showing the sternoclavicular mass as indicated by the two arrows.


X-ray of the left elbow joint shows osteomyelitis and destruction of the joint as indicated by the arrow.


Digital subtraction angiography of left subclavian artery of the patient. Digital subtraction angiography of the patient performed sixteen months after the initial presentation revealed significant stenosis of the left subclavian artery and stenosis at the origin of left vertebral artery. Other major branches of aorta including renal arteries were normal.


Showing multiple papules, pustules over the forearms.


A low-power histopathological photograph showing neutrophilic infiltration (arrow) around eccrine glands with necrosis.


Ulcers covered with pus and slough seen over the left side of the neck, left axilla and lateral chest wall.


Non pigmented.


Smooth colonies on Lowenstein-Jensen medium on 7th day of inoculation at 37 C. Ziehl-Neelsen stain of the culture showing acid fast bacilli.


Surgical view of the reconstructed RA. (A) Resection of infected RA tissue.


Surgical view of the reconstructed RA. (B,C) RA reconstruction using autologous LAA.


Surgical view of the reconstructed RA. (D) The reconstructed RA. Right arrow, infected RA tissue; blue arrow, LAA.


Post-operative findings in a patient with infective endocarditis and paravascular abscess of the RA. (A) Immediately postoperative TTE of the RA and TCV.


Post-operative findings in a patient with infective endocarditis and paravascular abscess of the RA. (B) TTE showed no shrinkage of the reconstructed RA 6 months after surgery.


ECHO view of vegetative growth over the mitral posterior leaflet (arrow).


Abdominal CT view of encapsulated hypodense splenic lesion suggestive of splenic infarction (arrow).


Brain MRI view of lesion suggestive of brain infarction with bright signal intensity on diffusion-weighted.


Contrast-enhanced T1-weighted. Images in the right fronto-parieto-occipital cerebral area (arrows).


Enhanced abdominal CT scan findings. (A) Enhanced abdominal CT on admission. Around the head of the pancreas, the density of the adipose tissue was increased. There was a fluid collection but no swelling of the pancreas (arrow).


Enhanced abdominal CT scan findings. (B) Abdominal CT on hospital day 11. The fluid collection has disappeared and there were no cystic changes in the pancreas.


Clinical Course. PAM: pralidoxime methiodide, ABPC/SBT: Sulbactam/Ampicillin, PLA2: Phospholipase A2, HDF: Hemodiafiltration.


(a) Shows cystic like hyperlucent area on the left posterior-basal segment of the lung (arrow).


(b) Thoracic computed tomography confirms cystic changes in the left lower lobe, the largest of them is located in the left lower lobe posterior basal segment.


Chronological trend of liver enzymes during the postoperative course.


Radiographs of a patient who presented with multiple foot abscesses, showing osteopenic bones without erosive changes.


CT of abdomen and pelvis without contrast, showing large right-sided retroperitoneal mass (10x11x16 cm) concerning for hematoma of varying age.


Brain MRI showing new areas representing subacute watershed infarctions with several punctate areas of acute infarction within the bilateral anterior cerebral artery/middle cerebral artery watershed territories.


The mNGS and bone marrow result detected in Case 1. (A) The genome coverage of the detected reads of Leishmania shedunii.


The mNGS and bone marrow result detected in Case 1. (B) The abundance of detected microbe and their reads numbers. A total of 5074 specific reads (98.87%) of Leishmania were detected in the blood sample.


The mNGS and bone marrow result detected in Case 1. (C) The examination of a bone marrow aspirate revealed amastigotes.


The dose of liposomal amphotericin B (L-AmB) and changes of temperature in Case 1. The initial dosage of L-AmB in the first patient was 10mg/day and the patient's temperature decreased as the dose of L-AmB was escalated. Dose escalation was performed as follows: 10 mg on day 1, 30 mg on day 2, 80 mg on day 3, and 120 mg on day 4. However, the appearance of hypotension on day 4 of the treatment protocol forced the dose reduction on day 5 (80 mg/d). There was mild renal impairment on day 6. Therefore, treatment was interrupted on days 6-11, and his renal function gradually recovered during treatment cessation. Treatment was restarted at a dose of 10 mg/kg from day 12, and the dose was gradually increased at a rate of 10 mg/(kg day). The dose was increased to 40 mg on day 15. Since the patient's renal function was still slightly abnormal at day 15, the dose of L-AmB was not increased, but maintained at 40 mg during the next 12 days (day 16-27). Finally, we stopped the medication until the accumulating dose reached 890 mg(12.6 mg/kg) on the day 27. Polymerase chain reaction of Leishmania in a bone marrow smear was negative on day 17.


Liposomal amphotericin B (L-AmB) administration protocol and temperature changes in Cases 2-4. TAD, total accumulated dosage. Normalization of body temperature. Negative PCR result for bone marrow aspirate. To avoid complications associated with adverse drug reactions, the dosing regimens of L-AmB in case 2-4 were similar to those used for case 1, starting with a low dose that was gradually increased until the maximum tolerated dose was reached. This dosage was used for maintenance therapy. The initial dose for case 2 was 5 mg (~0.1 mg/kg) on day 1. The dose was increased to 10 mg on day 2-3, and no complications occurred. Therefore, the patient received L-AmB in 10 mg dose increments up to a dose of 60 mg (~1.2 mg/kg) on day 8. This dosage (60mg) was used for maintenance therapy until the cumulative dose of L-AmB reached 765 mg (13.9 mg/kg) on day 17. Her body temperature returned to normal on day 4. Polymerase chain reaction (PCR) for Leishmania in bone marrow aspirate was negative on day 12, when the dose of L-AmB was 405 mg. The trapezoidal regimen of L-AmB in case 3 was initiated at a dose of 5 mg (~0.1 mg/kg). The dosage of L-AmB was increased by 5 mg every 2 days as tolerated from day 1 to day 8 and increased by 10 mg every 2 days from day 9 to day 13 to 50 mg (~1.0 mg/kg), which was administrated as maintenance therapy on days 14-22. Treatment was stopped when the cumulative dose of L-AmB reached 740 mg(14.8 mg/kg) on day 22 of protocol. The patient's body temperature had returned to normal on day 4. PCR for Leishmania in bone marrow aspirate was negative on day 15, when the cumulative dose of L-AmB was 400 mg. In case 4, L-AmB treatment was initiated at a dose of 10 mg and increased in increments of 10 mg (~0.14 mg/kg) daily, reaching 70 mg (~1.0mg/kg) on day 7 of the protocol. To avoid complications, instead of further increasing the L-AmB dose, we used a dose of 70 mg as maintenance therapy until the cumulative dose reached 910 mg (13 mg/kg) on day 16. His body temperature returned to normal on day 7. PCR for Leishmania in bone marrow aspirate was negative on day 9, when the cumulative dose of L-AmB was 420 mg.


The figure shows a TEE long axis view of the aortavalve and ascending aorta. The arrow denotes the vegetation on the bicuspid valve.


CT abdomen. Huge right suprarenal mass measuring 16.5 x 6.5 x 8.7 cm.


CT abdomen. Right adrenal mass with break down areas and calcifications.


Images showing no evidence of PTB pre-treatment ,. (A) Initial disease progression (2 Apr 2014).


While. Show development of PTB during administration of nivolumab. (B,C) PTB infection during nivolumab treatment (22 Apr 2016).


(D) shows a follow-up radiological investigation demonstrating cancer progression. (D) Progression of disease (9 May 2016).


Circinate lesions present over glans before treatment.


Lesions present on under surface of prepuce before treatment.


Various psoriasiform changes seen on histopathological examination.


Post-treatment complete resolution of lesions from glans.


Post-treatment complete resolution of lesions from under surface of prepuce.


Medical image.


Microcephaly. Gastric biopsy: EBV-encoded small ribonucleic acid (EBER1) in situ hybridization shows positive nuclei EBER+ in the T cells lymphocytes.


(D) Clinical evolution, EBV load and therapeutics.


Photographic images of vitiligo with isolated areas of pigmentation on the upper limbs.


Trunk.


Highlighted by dermatoscopic examination.


Reflectance confocal microscopy images of apparently normal skin with low pigmentation in the dermal layer.


Vitiligo lesions , showing disappearance of the normal ring structures at the dermo-epidermal junction level with only a shadow of the pre-existing dermal papillary rings and no bright structures detected in the upper epidermal layers.


X-ray (lateral view) images illustrating the cannula and probe positions during the CRFA procedure:. At C4 medial branch.


At C3 and C5 medial branches.


Gastric tissue sections from a patient with metastatic gastric cancer and rare severe immune-related cholestatic hepatitis and subsequent severe late-onset pneumonia after pembrolizumab therapy. Representative photomicrographs show H&E staining.


Gastric tissue sections from a patient with metastatic gastric cancer and rare severe immune-related cholestatic hepatitis and subsequent severe late-onset pneumonia after pembrolizumab therapy. Immunohistochemical staining with programmed death-ligand 1 (PD-L1) , using a PDL1 antibody (DACO, 22C3).


The timeline of diagnosis, treatment and related immune-side effects of this patient since diagnosis.


Reprensentative images of magnetic resonance cholangiopancreatography.


Abdominal computed tomography. In a patient with metastatic gastric cancer and rare severe immune-related cholestatic hepatitis and subsequent severe late-onset pneumonia after pembrolizumab therapy. No obvious biliary obstruction was observed.


Midesophageal long-axis view showing anterior mitral leaflet aneurysm and healed vegetation on the Aortic valve.


Midesophageal two-chamber view showing anterior mitral leaflet aneurysm that expands during systole with severe mitral regurgitation.


CT image. . Notes: (A) Infiltration of the right upper lobe of the lung before treatment.


CT image. (B) Infiltration of the right upper lobe of the lung after IL-2 therapy.


CT image. (C) Infiltration of the right upper lobe of lung worsened after PD-1 inhibition.


CT image. (D) Infiltration of the right upper lobe of lung absorbed after 6 weeks of anti-TB treatment. . Abbreviations: CT, computed tomography; TB, tuberculosis.


Histopathological findings of TB granuloma from the lung biopsy. . Notes: A large amount of caseous necrosis surrounded with epithelioid cells and diffused infiltrating lymphocytes (paraffin-embedded tissue by H&E staining). (A) Original magnification (20x). Local magnification of. (400x). Solar marking: caseous necrosis; blue arrows: epithelioid cells. . Abbreviation: TB, tuberculosis.


Histopathological findings of TB granuloma from the lung biopsy. . Notes: A large amount of caseous necrosis surrounded with epithelioid cells and diffused infiltrating lymphocytes (paraffin-embedded tissue by H&E staining).


Palmar injection site locations (representation only, not a patient photo).


Abdominal CT scan revealing marked air within the gastric wall (green arrows), extensive prominent looping of the small bowel (red arrows), and air within the portal vein (blue arrows).


Gross specimen of the stomach retrieved from autopsy showing areas of hyperemia and necrosis suggestive of emphysematous gastritis.


The X-ray shows bilateral and extensive interstitial infiltrates.


The violaceous rash extension with atypical targetoid elements (at day 3 from clinical onset) is depicted in a. b shows the complete resolution (after 6 weeks).


The extensive skin detachment is showed in a (at day 5) and its favorable evolution at 6 weeks in (b).


The figure shows the extensive disepithelialization with subcutaneous oozing and bleeding.


Proximal nailfold demonstrating several enlarged capillaries.


Telangiectasias along the marginal gingivae (arrow) and interdental papillae.


Alpaca (case no. 1), ear pinnae. Evolution of skin lesions from severe crusting dermatitis, hyperkeratosis, focal ulceration, alopecia, and scaling.


Alpaca (case no. 1), ear pinnae. To moderate to severe crusting, hyperkeratosis, scaling, erythema and alopecia.


Alpaca (case no. 1), ear pinnae. To mild to moderate alopecia, erythema and scaling.


Alpaca (case no. 1), ear pinnae. To mild alopecia and erythema.


Morphological features of Sarcoptes scabiei mites.


Llamas (case no. 2), skin lesions. Hind limb (after clipping): alopecia, moderate to severe erythema, severe scaling, and ,focal crusts.


Llamas (case no. 2), skin lesions. Hind limbs, perianal, peri vulvar region, and ,ventral aspect of the tail: alopecia, mild erythema, and ,scaling, and ,mild, focal lichenification.


Llamas (case no. 2), skin lesions. Ventral abdomen and axillae: extensive alopecia, moderate to severe erythema and focal hyperpigmentation.


ECG tracing in the emergency room. Sinus rhythm of 100 bpm, QT of 400 ms, and QTc of 516 ms.


ECG tracing before TdP. Sinus rhythm of 83 bpm, QT of 600 ms, and QTc of 707 ms.


The monitoring electrocardiogram shows that TdP is induced by the short-long cardiac cycles and is followed by an initiating PVC (A). The initiating PVC appears after the T-wave peak of the last beat before the onset of TdP. The red asterisk indicates atrial premature complexes not conducted to the ventricle.


However, if the atrial impulse propagates through the atrioventricular node and into the cardiac ventricles, it may induce TdP (B).


TdP strip (C).


ECG tracings at 4 h . (A) Sinus rhythm of 68 bpm, QT of 640 ms and QTc of 682 ms.


3 days. After successful effective cardio-pulmonary resuscitation and electric defibrillation. (B) Sinus rhythm of 54 bpm, QT of 680 ms and QTc of 643 ms.


Phylogenetic analysis. The red arrows indicate the sequences in this case: clone 1 A2, HBV/A2 (Fig. 1a). Clone 2 G/A2, HBV/G/A2 recombinant (Fig. 1b).


(A) Slit-lamp examination of the left eye demonstrates 2+ conjunctival injection with a central, feathery infiltrate and corneal edema. A 1 mm hypopyon is also present.


(B) Fluorescein staining confirmed the presence of an overlying epithelial defect.


(C) Lactophenol-cotton-blue stained microscopy reveals typical branched and densely clustered phialides.


(D) Violaceous-red-rose pigmented and velvety colonies grew on Sabouraud agar.


Histology of the surgical specimen. (A) Calcitonin-positive medullary thyroid cancer is adjacent to normal thyroid tissue (immunohistochemistry, x10).


Histology of the surgical specimen. (B) Solid nests of metastatic medullary thyroid cancer (arrows) in a lymph node (hematoxylin and eosin, x10).


(A) Transverse plane of cranial MRI in constructive interference in steady state (CISS) sequence showing left-sided abducens nerve hypoplasia. Both abducens nerves are indicated by a white arrow.


(B) Coronal plane of cranial MRI in native T1 sequence illustrating relative atrophy of the lateral rectus muscle (white arrow) in comparison to the contralateral right side.


(a) Diagrammatic representation of the bicanalicular retrograde intubation dacryocystorhinostomy technique.


(b) The direction of the silicon tube through the common internal opening into the canaliculi.


Capillary zone electrophoresis. A decrease of the alpha-1 globin peak is notable.


Transthoracic echocardiography in a parasternal long-axis view showing an aneurismal sac posterior to aorta (arrow).


Transesophageal echocardiography in a four-chamber view showing aneurismal sac with neck (arrow) communicating with the LVOT.


Transesophageal echocardiography in four chamber view showing aneurismal sac in MAIF with rupture (arrow) into LA with color Doppler showing a turbulent jet resulting in supra-annular MR.


Axial view of a computed tomography scan of the abdomen at presentation demonstrating one of the large intra-abdominal collections measuring 129x58 mm.


Gram-stain demonstrating small Gram-negative bacilli (red arrow) in the presence of polymorphonuclear cells (blue arrow) on high power field microscopy.


Growth of tiny white colonies after 48 h on horse blood agar under anaerobic conditions at 37 degrees Celsius with section magnified.


Chest CT images of two cases with COVID-19. (A) The Chest CT images of the Case 1 showed ground-glass opacities in basal segment of the lower lobe of the right lung on January 2.


Chest CT images of two cases with COVID-19. (B) The Chest CT images of the Case 1 showed almost normal on March 23.


Chest CT images of two cases with COVID-19. (C) The Chest CT images of the Case 2 showed almost normal on April 7.


Chest CT images of two cases with COVID-19. (D) The Chest CT images of the Case 2 showed almost normal on June 21.


Representative picture showing results from three independent endoscopic evaluations of the intestine of the patient obtained at different times before he was started on antibiotic therapy. There was no opportunity for further evaluations during treatment.


(A) Heavy shedding of typical MAP bacilli as seen in ZN staining: 4+ (positive).


(B) Negative for MAP bacilli at the end of 12 months of treatment.


Right lateral thoracic radiographs. Prior to treatment, and . This finding is not evident in (A).


After 4 years of treatment for MUO. (B) Mineralization in the right and left pulmonary arteries (arrow) is seen as an elongated heterogeneous mineral opacity overlying and extending slightly dorsal and ventral to the carina.


Reconstructed. Dorsal.


Three-dimensional (3D) computed tomographic images obtained post-mortem show amorphous mineral attenuation within the right and left pulmonary arteries (arrows).


Horizontal abdominal MRI image in May 2006 shows multiple solid nodules in the right lobe of the liver (arrows indicated).


Profound Aspergillus hyphae were observed in the necrotic liver specimen. Magnification at 400x, bar = 200 mum.


After receiving two courses of caspofungin acetate first-line therapy, follow-up horizontal abdominal MRI image showed evident remission.


Chest X-ray upon first admission. . Cardio-mediastinal silhouette is within normal limits with the heart being normal in size. . No pleural effusion / pneumothorax/consolidative patches identified.


Chest X-ray upon his most recent admission. . Mildly prominent hilar vascular markings identified (red arrows) with minimal blunting of the left costophrenic angle (blue arrows) and mild elevation of the left hemidiaphragm. But Cardio-mediastinal silhouette.


Chest CT upon recent admission. . Congestive pulmonary changes in the form of ground glass opacities and pleural effusion at the posterior inferior aspects of both lungs, more on the left. (Arrow heads) Circumferential pericardial effusion (red arrow).


Pleural and Pericardial Biopsy Histopathology report. . A. Light microscopic view showing well-defined epithelioid granuloma engulfing parasitic egg (H&E x400).


Pleural and Pericardial Biopsy Histopathology report. . B. The cuticle of the parasitic egg is polarizable (H&E x400 with polarizer/analyzer lens).


Ptosis and mydriasis resolved.


Repeat magnetic resonance imaging brain axial images after 3 months showing partial resolution of the previous hyperintense signals in bilateral cerebellar hemispheres:. T1-weighted image.


T2-weighted image.


Fluid-attenuated inversion recovery image.


Atrophic tongue with fasciculation in patient 4.


(A-C) Erythema around the nail and insignificant Gottron's signs can be seen on the patient's hands.


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


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


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


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


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


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


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


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


A set of antibiotic-loaded articulate spacers that were implanted.


Histopathological analyses of brain biopsy. (A) Images show a mild hypercellularity.


Histopathological analyses of brain biopsy. (B) Diffuse infiltration by T cells (CD3-positive).


Histopathological analyses of brain biopsy. (C) Marked microglial activation (HLA-DR-positive). Magnification 200x. Scale bar corresponds to 100 microm.


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


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


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


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


Thyroid ultrasonography at the diagnosis of Graves' disease of our patient (left panel: both lobes without Doppler; mid panel: right lobe with Doppler; right panel: left lobe with Doppler).


Pre-operative detection showed swelling and intermediate cuneiform displacement in the left foot. Distinct swelling, and ,2 x 3-cm sized ulcer presented on the surface of left-foot dorsum.


Pre-operative detection showed swelling and intermediate cuneiform displacement in the left foot. X-ray detection revealed intermediate cuneiform fracture and displacement. The red arrows indicate the position of displaced intermediate cuneiform.


Post-operative detection showed successful debridement and ebonation. Alleviated swelling presented on the surface of left-foot dorsum after debridement.


Post-operative detection showed successful debridement and ebonation. X-ray film view showed that the displaced intermediate cuneiform was removed. The red arrows indicate the position of removed intermediate cuneiform.


Wound conditions at the. 7th.


40th day of posttherapy showed the gradual healing of ulceration.


The timeline. Of the treatment process from the day of operation (day 0) to the day of healing (day 40).


Images recorded at the initial visit. A; Lower gastrointestinal endoscopy showing mucosal petechiae in the descending colon.


Images recorded at the initial visit. B; Computed tomography of the abdomen showing slight thickening of the descending colonic wall.


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


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


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


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


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


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).