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


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


(Case 1) Chest X-ray on admission.


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


(Case 2) Chest X-ray on admission.


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


(Case 3) Chest X-ray on admission.


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


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


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


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


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


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


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


Follicular thyroid carcinoma invasion to the tumor capsule vessels.


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


Hands radiogram - osteoarthritic changes with geodes.


Legs ulcerations - healing progress. 13.07.2016.


Legs ulcerations - healing progress. 13.10.2016.


Legs ulcerations - healing progress. 27.01.2017.


Legs ulcerations - healing progress. 19.10.2017.


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


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


CT scan with bilateral pneumonic infiltrates.


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


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


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


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


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


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


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


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


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


Gross picture of the excised specimens.


Herpes vegetans facial lesions at initial presentation.


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


Facial lesions 2 months after presentation.


Chest radiograph showing milliary mottling.


Computed tomography-scan showing pulmonary interstitial emphysema.


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


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


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


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


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


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


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


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


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


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


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


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


Erythematous lesions in both the lower extremities.


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


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


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


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


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


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


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


Clinical images. A; Before therapy with IFNa.


Clinical images. B; During therapy.


Clinical images. C; After 2 months of therapy.


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


Chest computed tomography showed right side pleural effusion.


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


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


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


Clinical presentation of anterior abdominal wall cold abscess.


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


Immunohistochemical findings . GFAP.


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


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


Inflammatory response. In this patient's ovarian teratoma.


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


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


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


Magnetic resonance imaging sequences:. T1.


T2 images sequences.


Intraoperative photography of the tumor.


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


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


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


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


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


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


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


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


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


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


Multiple serial images of esophagogastroduodenoscopy at different angulation show.


Exudative material (indicated by the blue arrow).


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


Fresh or altered blood (indicated by black arrows).


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


Diffusion-weighted magnetic resonance image.


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


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


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


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


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


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


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


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


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


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


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


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


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


Dark skin over right leg and foot.


Hyperkeratotic purpuric eruptions on left leg.


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


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


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


Postoperative pathology of spleen. . Magnification x40.


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


Chest CTs showing multiple pulmonary nodular lesion.


Pulmonary cavitation . Abbreviation: CT, computed tomography.


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


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


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


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


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


Anteroposterior.


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


Medical image.


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


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


Lateral.


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


(A) X-ray indicates dextrocardia and cardiac enlargement.


CTA reveals transposition of the abdominal organs.


Confirming L-loop ventricular orientation and concordant atrioventricular connections.


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


The transesophageal echocardiography shows mitral chordae rupture.


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


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


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


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


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


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


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


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


HIV viral load results over time.


External photograph showing swollen periorbital tissue with proptosis.


External photograph showing melting central corneal ulcer with hypopyon.


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


Serial. Weight, and ,heart rate.


Thyroid function, and ,TRAb titres.


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


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


Chest CT shows multiple lung cancers.


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


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


Chest CT shows multiple lung cancers. Adenocarcinoma.


Relationship between pathology and somatic mutations.


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


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


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


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


Postexcision and skin grafting: Complete healing with minimal scarring.


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


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


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


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


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


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


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


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


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


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


Mainly right sided oculomotor paresis with elevation deficit and ptosis.


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


CT scan of chest without contrast showing multiple bilateral opacities.


Transthoracic echocardiogram, short axis of aorta view.


Subpulmonic valve stenosis and PV vegetation during open heart surgery.


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


Myometrium.


Testis with absent spermatogenesis.


Patient's karyotype - normal male - 46 XY.


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


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


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


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


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


A flexible bronchoscopy showing a 4-mm bronchopleural fistula.


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


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


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


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


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


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


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


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


Chest X-ray showed bronchopneumonia.


Chest MSCT showed emphysematous lungs.


Abdominal X-ray showed pneumoperitoneum.


Intraoperative finding of gastric perforation.


Chest X-ray showed atypical bronchopneumonia.


Abdominal X-ray showed small bowel obstruction suspected ileus.


Intraoperative finding of multiple intestinal strictures and stenosis.


Chest X-ray showed normal lung and heart.


Chest MSCT showed pleuritis.


Abdominal MSCT showed pancreatitis necroticans.


Intraoperative finding of pancreatitis necroticans.


Chest X-ray showed multiple metastatic nodules.


Chest MSCT showed multiple metastatic nodules.


Abdominal MSCT showed sigmoid tumour.


Intraoperative finding of rectosigmoid tumor.


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


Resolution of the lesions at 4 weeks after therapy.


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


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


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


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


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


Clinical course of the patient.


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


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


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


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


Treatment timeline for CRKP infection.


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


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


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


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


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


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


Magnetic resonance imaging.


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


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


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


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


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


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


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


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


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


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


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


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


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


Immunohistochemical staining showed that tumor cells were positive for CD20.


But not for CD30.


Cyclin D1.


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


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


A; Chart of the patient's medical procedures.


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


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


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


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


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


Nodular lesions on dorsum of both hands.


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


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


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


(D) Formalin fixed paraffin-embedded tissue used for in situ hybridization for Epstein-Barr virus-encoded early RNAs. The result was negative.


CfDNA monitoring of EGFR ex19del and EGFR T790M mutations. Each dot corresponds to a different liquid biopsy time point. AF, allele frequency; CT, chemotherapy with platinum-etoposide.


Drug screening in a primary cell line following osimertinib resistance. Primary cells were treated with 250 nM osimertinib, 0.150 mug/ml etoposide, and 0.05 mug/ml cisplatin. After 72 h, cell proliferation was assessed by CellTiter 96. AQueous One Solution Cell Proliferation Assay (MTS). Data are expressed as percent of cell viability vs. control cells and are means +- SD of three measurements. *p < 0.05.


MRI Brain (T2 axial) of the patient done five months after onset of neurological symptoms revealing normal study.


Electroencephalograph of the child (Monopolar montage, Sensitivity of 20 microvolt/mm, Speed 30 sec/page) showing periodic slow wave complexes lasting for 1.5 to 2 seconds occurring at a regular interval of 18 seconds.


Transesophageal echocardiographic examination showing a large atrial septal defect. Arrowheads).


A large parachute-shaped mass attached to aortic valve. Right arrowheads), and . A large mass in the left atrial appendage. Left arrowheads, Video 1), suggestive of vegetation in a patient with intravenous drug abuse and Pseudomonas endocarditis.


Transesophageal echocardiographic examination demonstrating multiple vegetation attached to mitral valve leaflets. Arrowheads) with a large fluttering saccular mass (1.4 cm x 4 cm) in the left atrium attached to the posterior mitral valve leaflet bulging into the left atrium suggesting mitral valve aneurysm. Arrowheads, Video 1) in a patient with intravenous drug abuse and Pseudomonas endocarditis.


Arrowheads) with a large fluttering saccular mass (1.4 cm x 4 cm) in the left atrium attached to the posterior mitral valve leaflet bulging into the left atrium suggesting mitral valve aneurysm. Arrowheads, Video 1) in a patient with intravenous drug abuse and Pseudomonas endocarditis.


Transesophageal echocardiographic examination showing a large left atrial vegetation intermittently resembling a "cat" face with prominent eyes, nose, and mouth (Video 2) measuring 4.9 cm x 1.9 cm in a patient with intravenous drug abuse and Pseudomonas endocarditis.


A 49-year-old male with a history of high-grade T1 urothelial cell carcinoma of the bladder undergoing induction bacillus Calmette-Guerin immunotherapy. Initial presentation with fevers and chills after 3 weeks (4 of 6 treatments) of intravesical bacillus Calmette-Guerin therapy. (a) Axial contrast-enhanced computed tomography scan of the abdomen through the level of the kidney showing mass-like low attenuation lesion (yellow star) in the interpolar region of the right kidney with moderate surrounding perinephric inflammatory changes (blue arrow).


A 49-year-old male with a history of high-grade T1 urothelial cell carcinoma of the bladder undergoing induction bacillus Calmette-Guerin immunotherapy. Initial presentation with fevers and chills after 3 weeks (4 of 6 treatments) of intravesical bacillus Calmette-Guerin therapy. (b) Coronal reformat contrast-enhanced computed tomography scan of the abdomen and pelvis showing mass-like low attenuation lesion (yellow star) in the interpolar region of the right kidney with moderate surrounding perinephric inflammatory changes (blue arrow). There is also mild diffuse bladder wall thickening (red arrow).


A 49-year-old male with a history of high-grade T1 urothelial cell carcinoma of the bladder undergoing induction bacillus Calmette-Guerin immunotherapy. Initial presentation with fevers and chills after 3 weeks (4 of 6 treatments) of intravesical bacillus Calmette-Guerin therapy. (a) Axial contrast-enhanced computed tomography of the abdomen through the level of the kidneys shows low attenuation lesions (yellow star) in the interpolar region of the right kidney with improving perinephric inflammatory changes 3 weeks later (blue arrow).


A 49-year-old male with a history of high-grade T1 urothelial cell carcinoma of the bladder undergoing induction bacillus Calmette-Guerin immunotherapy. Initial presentation with fevers and chills after 3 weeks (4 of 6 treatments) of intravesical bacillus Calmette-Guerin therapy. (b) Coronal reformat contrast-enhanced computed tomography scan through the abdomen showing low attenuation lesions (yellow star) in the interpolar region of the right kidney with improving perinephric inflammatory changes 3 weeks later (blue arrow).


A 49-year-old male with a history of high-grade T1 urothelial cell carcinoma of the bladder undergoing induction bacillus Calmette-Guerin immunotherapy. Initial presentation with fevers and chills after 3 weeks (4 of 6 treatments) of intravesical Bacillus Calmette-Guerin therapy. (a) Axial computed tomography of the abdomen through the level of the kidneys demonstrates a percutaneous computed tomography-guided biopsy of the lesion (blue circle).


A 49-year-old male with a history of high-grade T1 urothelial cell carcinoma of the bladder undergoing induction bacillus Calmette-Guerin immunotherapy. Initial presentation with fevers and chills after 3 weeks (4 of 6 treatments) of intravesical Bacillus Calmette-Guerin therapy. (b) Core needle biopsy from right renal mass showing marked chronic inflammation with granulomas (red circles). Special stains for acid-fast bacilli (Fite) and fungi (GMS) were negative (not shown).


A 49-year-old male with a history of high-grade T1 urothelial cell carcinoma of the bladder undergoing induction bacillus Calmette-Guerin immunotherapy. Initial presentation with fevers and chills after 3 weeks (4 of 6 treatments) of intravesical bacillus Calmette-Guerin therapy. (a) Axial contrast-enhanced computed tomography scan of the abdomen through the level of the kidneys showing interval resolution of the right renal lesions with mild residual cortical scarring 8 months later (blue arrow).


A 49-year-old male with a history of high-grade T1 urothelial cell carcinoma of the bladder undergoing induction bacillus Calmette-Guerin immunotherapy. Initial presentation with fevers and chills after 3 weeks (4 of 6 treatments) of intravesical bacillus Calmette-Guerin therapy. (b) Coronal reformat contrast-enhanced computed tomography scan showing interval resolution of the right renal lesions with mild residual cortical scarring 8 months later (blue arrow).


Contrast-enhanced computed tomography abdomen,. Coronal section showing. Multiple, tiny hypodense splenic lesions (thin arrow) with clustered pattern of distribution in subcapsular location and perisplenic extension (curved arrow).


Contrast-enhanced computed tomography abdomen,. Magnetic resonance imaging abdomen, axial section showing T2-weighted image.


Contrast-enhanced computed tomography abdomen,. Diffusion-weighted imaging. Showing multiple T2 hyperintense lesions with diffusion restriction in the spleen.


Previous treatment with corticosteroids. . Abbreviations: BM, betamethasone; FM, fluorometholone; PSL, prednisolone; HSK1, herpes simplex keratitis (geographic ulcer and stromal keratitis); TLO, trabeculotomy; TLE, trabeculectomy; HSK2, herpes simplex keratitis (stromal keratitis); PKP, penetrating keratoplasty; CI, corneal infiltration of unknown cause; FK, fungal keratitis.


Chest X-ray with left-sided pneumothorax and cervical subcutaneous emphysema.


(A) The patient's EEG after the first seizure in October 2020.


(B) The patient's EEG after the second seizure in October 2020. The pink box showed EEG becomes abnormal situation with sharp and slow waves.


Still picture of Supplementary Video S1 highlighting upper limb tremors and orofacial dyskinesias.


Axial magnetic resonance imaging (MRI) slice images of the brain: On admission:. T1-weighted contrast-enhanced (T1+C).


Axial fluid-attenuated inversion recovery (FLAIR) sequences illustrating contrast enhancement (white arrow) with sulcal hyper-intensity (black arrow) respectively.


Day 15:. T1+C.


FLAIR sequences illustrating resolution of MRI abnormalities.


The electroencephalography depicted a ss-rhythm, with an intermittently slow wave activity of 6-7/s. The independent component analyses showed a frontocentral topography (component 4, framed) compatible with tiredness.


Twenty-four hours of electrocardiogram showing signs of vegetative dysbalance with intermittent sinus tachycardia during daytime and sinus rhythm with stable frequencies during the night (presented are mean heart rates per minute). HF, heart rate; HFmax, maximum heart rate; HFmin, minimum heart rate.


Neuropsychological test results. t0 testing was performed before treatment, and t1 testing was performed 14 days after the steroid pulse treatment.


Colonies of
M. vaccae
 on a blood agar plate.


(A) Midsagittal MRI at age 3 showing no cerebellar changes at that time.


(B) Midsagittal MRI at age 11 showing evidence of asymmetric volume loss within the superior and middle components of the cerebellar vermis with preserved volume of the inferior component (red outline).


(C) Axial plane MRI exhibiting faint linear/T2 signal hypointensities within the Pons (red arrow).


Chromosomal microarray showing 1.422 megabase loss in the 13q12.12 region containing 14 different genes, including the SACS gene.


Chest radiographs of CMV pneumonia. (a) Initial chest radiograph with extensive right lung opacities, most prominent in the right middle lobe.


Chest radiographs of CMV pneumonia. (b) Chest radiograph on day 8 with an increase in right-sided infiltrates and new infiltrates at the left lung base.


Chest radiographs of CMV pneumonia. (c) Chest radiograph on day 22 with reduced infiltrates in the right lung field with a moderate overlying pleural effusion.


Transthoracic echocardiogram revealing a large pericardial effusion in the left parasternal long-axis.


Short-axis. View.


Chest CT images for case 2 showing a round-like mass shadow in the dorsal segment of the lower right lobe with a slight ground-glass opacity on the edge, a strip shadow in the local area of the left lower lobe, and an arc dense under the bilateral pleura on day 3 after symptom onset (A-D).


Chest CT images for case 5 showing bilateral scattered spots of shadows and consolidation in the upper right lobe on day 3 after symptom onset (A,B).


Time course depicting the clinical presentation of IgG4RD, laboratory results and treatment plans from 2009 to 2020. Chronic phase of the patient's disease: the upper part summarizes the specific features of clinical findings, biopsy, imaging, and immunological laboratory results; the lower part shows the therapy, specifying dose, duration, and dates for Rituximab infusions (deep red diamonds) and steroids (sky blue bars). Pulse treatment with methyl-prednisone (500mg i. v. ) is represented by the bottom scale blue bars and was usually followed by oral Prednisone (top scale blue bars); the dashed bar corresponds to the period when the patient did not adhere thoroughly to the prescribed therapy.


In the acute phase, the upper part shows the laboratory values for CFH (black, mug/ml), anti-CFH (pink, AU/ml), left y-axis, and thrombocytes (green, G/l) at the right y-axis. The normal reference values are shown with shades matching the colors of the different parameters. The lower part depicts the therapy including methylprednisolone/prednisone (sky blue bars, mg/d), plasma exchanges (deep blue arrows), and cyclophosphamide (purple triangles, 500 mg i. V. ). The time when TMA and COVID-19 were diagnosed are shown with symbols. AU, arbitrary units; BM, bone marrow; Covid-19; coronavirus disease 2019; CT, computed tomography; CTX, cyclophosphamide; HPF, high-power field; IgA, immunoglobulin A; IgG4-RD, immunoglobulin G4-related disease; i. V. , intra venous; PET-CT, positron emission tomography-computed tomography; PLEX, plasma exchange; RTX, Rituximab; SARS-CoV-2 severe acute respiratory syndrome coronavirus 2; TMA, thrombotic microangiopathy.


Identification of IgG4 anti-factor H autoantibodies: Plasma samples were analyzed for anti-factor H antibodies by a previously reported specific ELISA which was developed using Horse Radish peroxidase (HRP)-labeled secondary antibodies specific for human IgG, IgG4, and IgA, respectively. Data are shown as optic density at 490 nm (OD). (A) The patient's serum was tested in duplicates at different dilutions 1:100, 1:400, and 1:1,000 for both IgG (black bars) and IgG4 (grey bars). Controls included a normal human serum (NHS), a serum with known elevated anti-CFH IgG levels, and a serum with elevated IgG4 but no anti-CFH activity.


Light microscopy:. Glomeruli shows cellular crescents.


Glomeruli shows segmental necrotizing lesion.


EM: focal podocyte foot process effacement, no deposits, no tubuloreticular inclusions.


The chest CT showed nodules and patches in the upper lobe of the left lung on admission.


Enlarged lesions in the upper lobe of both lungs and bilateral pleural effusions were observed on the 13th day after admission.


Bilateral infiltrates, interstitial infiltrates, alveolar infiltrates and bilateral pleural effusion were observed on the 20th day after admission.


Yeast forms of Penicillium janthinellum in BAL washings stained with fluorescence. Original magnification X 400).


Gram stains. Original magnification X 1000).


Hexamine silver. Original magnification X 400).


Fungal morphology stained with medan lactate. Original magnification X 400).


Colony morphology in the obverse side was cultured in 28. C PDA medium for 5 days.


Colony morphology in the reverse side. Was cultured in 28. C PDA medium for 14 days.


(a) Skull CT in axial cut without contrast showing expansive frontal lesion with hyperdense margin with thinning of the frontal bone.


(b) Skull CT in axial cut with contrast showing contrast enhancement at the margin lesion.


Intraoperative picture.


CT axial cut postoperatively.


Transthoracic echocardiography preoperatively showing a giant biatrial mass with the size of 44.06 mm x 109.44 mm in the right atrium.


17.85 mm x 23.87 mm in the left atrium.


Color Doppler flow imaging showing severe mechanical hemodynamic obstacles in the right atrium primarily occupied by the giant tumor tissue.


Cardiac CT showing a biatrial mass with the atrial septum infiltrated.


Abdominal CT showing an angiomatous mass in the right posterior lobe of the liver (arrow) (transverse view).


Coronal.


Sagittal.


Plane; cardiac MRI showing a giant biatrial mass with tricuspid valve involved.


PET-CT showing a giant mass with increased glucose metabolism in the right atrium.


Intraoperative view of the tumor: right atrium was enlarged. With the tumor inside the chamber.


The right side of the tumor was visualized with the opening of the right atrium.


The biatrial mass together with the infiltrated septum was resected.


The biatrial mass together with the infiltrated septum was resected . The right atrial lesion was grossly composed of two parts. Arrows).


Immunohistochemistry post-operatively confirm the diagnosis of the cardiac myxoma with interstitial fibrous hyperplasia.


Hemorrhage , necrosis, and plasmacytes infiltrate.


Pedigree of the proband.


(a) Head CT scan showing diffuse and thick SAH on admission.


(b) 3D image of left IC angiography showing a paraclinoid aneurysm.


(c) The aneurysm was successfully obliterated with coiling.


(d) Head CT scan on day 3 showing most of the SAH was washed out.


Neuroimages obtained at the onset of deafness. (a) MR angiogram showing severe vasospasm in the right MCA and moderate vasospasm in the left MCA.


Neuroimages obtained at the onset of deafness. (b) DW image showing high signal intensity at the right insular cortex and the left superior temporal gyrus, indicating acute infarction due to vasospasm.


Neuroimages obtained at the onset of deafness. (c) ASL images show bilateral superior temporal gyri.


Clinical response to long-term immunotherapy and the effect of surgery. (A) Schematics showing the time line of patient's diagnosis, treatment and response.


Clinical response to long-term immunotherapy and the effect of surgery. (B) Computed tomography scans and Magnetic resonance imaging showing clinical response to immunotherapy and the effect of surgery.


Clinical response to long-term immunotherapy and the effect of surgery. (C) The result of PD-L1 staining before immunotherapy.


Clinical response to long-term immunotherapy and the effect of surgery. (D) PET-CT scan before Lung tumor resection. TC, paclitaxel+carboplatin; Pembro, pembrolizumab.


Examination of specific markers expression of ganglioneuroblastoma (case 1). A) Hematoxylin and eosin staining of the tumor sample (HE; 200x).


Examination of specific markers expression of ganglioneuroblastoma (case 1). B) NB84 expression in the tumor (immunohistochemistry NB84; 400x).


Examination of specific markers expression of ganglioneuroblastoma (case 1). C) Protein S100 immunoreactivity on the cells of the tumor (in this case ganglioneuroblastoma, S100; 400x).


Examination of specific markers expression of ganglioneuroblastoma (case 1). D) CD56 also called neural cell adhesion molecule (NCAM) immunoreactivity on the ganglioneuroblastoma cells (CD56; 200x).


Examination of specific markers expression of ganglioneuroblastoma (case 1). E) Positive expression of neuron specific enolase in the tumor sample (NSE) (NSE; 200x).


Examination of specific markers expression of ganglioneuroblastoma (case 1). F) PGP9.5 expression in the tumor sample (PGP9.5; 200x).


CT of the abdomen - heterogeneous tumor with calcifications (70 x 70 x 100 mm) localized in retroperitoneal left space near left kidney (case 2).


Scarring alopecia over scalp.


Non-scarring alopecia was present over the pubic region.


Multiple follicular-oriented papules over the abdomen and trunk.


Optical coherence tomography of the lesions of the right.


Left. Eye showing choroidal lesions causing elevation of the retinal pigment epithelium and subretinal fluid.


Pedigree and clinical phenotype of proband. (A) Pedigree, with affected individual (the proband) in black and unaffected individuals in white. PIK3R1 genotyping of the pedigree identified a de novo mutation in the proband; WT, wild type.


Pedigree and clinical phenotype of proband. (B) Peripheral vasculitis of digits and heel.


Pedigree and clinical phenotype of proband. (C) Facial gestalt reminiscent of SHORT syndrome (short stature, hyperextensibility of joints and/or inguinal herniae, ocular depression, rieger anomaly of the eye, and teething problems): ocular depression, nasal deviation, and prominent mandible present in the proband (see main text and Supplemental Table 1).


Pedigree and clinical phenotype of proband. (D) Sanger sequencing confirmed a heterozygous splice site G/A mutation (black/green overlapping line) at position c.1425 + 1 of PIK3R1 gene in family member II-2 only.


Pedigree and clinical phenotype of proband. This mutation is absent (single black line corresponding to wild type "G" allele) in the other family members 1,. . 2, II-1, and II-3).


The timeline from the episodes of care of both patients.


Chest radiography images. Before.


After nine months of isoniazid treatment for the patient who progressed to active disease following the latent tuberculosis infection treatment.


Funduscopic appearance at 15-month follow-up showed relatively good retinal condition.


Sagittal.


Axial MRI of the lumbosacral spine revealed L1-L2 spondylodiscitis/osteomyelitis with a small, noncompressive anterior epidural collection and bilateral psoas muscle abscesses.


(a) Sagittal CT reconstructions of the lumbosacral spine demonstrate an extensive lytic process involving the L1 and L2 vertebral bodies. There is a significant involvement and narrowing of the L1-L2 disc space with endplate erosion.


Medical image.


MRI of the lumbar spine confirms CT findings and suggests L1-L2 spondylodiscitis. In addition, there is a progression of a large enhancing anterior epidural collection, which is compressing the thecal sac at L1-L2 and bilateral psoas muscle abscesses are demonstrated.


Cranial magnetic resonance axial section in sequence Standardized T1 weighted 3D Turbo Field Echo (sT1W 3D TFE).


Elbow and wrist flexors in paretic left upper limb in patient before being treated with incobotulinumtoxinA.


Postoperative X-ray of the right hip 4 days after operation.


8 years later . The X-ray 8 years later (B) was done in an external clincic, so unfortunately the complete endosprosthesis is not illustrated. The metaphyseal part shows no loosing. The patient is content and has no symptoms or complaints. Therefore, a current x-ray imaging is unnecessary.


Axial computed tomography study of the brain. . Notes: Minute cortical and subcortical calcifications located in bilateral frontal lobe.


Spin-Echo T2-weighted sagittal projections on magnetic resonance imaging study of the brain. . Notes: A "cobblestone" appearance is evident in the bilateral frontal opercular region.


Electroencephalogram showing diffusely deregulated cerebral electrical activity together with ubiquitous fast paroxysms, prevalent in the left temporal area.


Performing ERCP on a 73-year-old female patient presented with acute pancreatitis secondary to JPDD related CBD stone. (A) CT scan shows the inflammation and swelling of the pancreas and a mildly enlarged gallbladder. A diverticular pouch was present at the junction of second and third portions of the duodenum (yellow arrows).


Performing ERCP on a 73-year-old female patient presented with acute pancreatitis secondary to JPDD related CBD stone. (B) MRCP coronal haste thin slice image confirmed shows the presence of periampullary diverticulum, which causes extrinsic compression upon the CBD (yellow arrow). Note the possible CBD stone associated with dilation of the distal end of CBD.


Performing ERCP on a 73-year-old female patient presented with acute pancreatitis secondary to JPDD related CBD stone. (C) ERCP confirm the CBD stone and divericulum exerting compression upon the CBD outlet.


Performing ERCP on a 73-year-old female patient presented with acute pancreatitis secondary to JPDD related CBD stone. (D) The stone was successfully removed though the ERCP procedure.


(A-C) HCWs adhere to Level 2 biosafety requirement during the procedure. ERCP Endoscopy personnel precautions and dress code as follows: prior to ERCP procedure, the patient's status of COVID-19 was verified among the ERCP team. HCW wore PPE in the following order: respirator (N95, NK95, or the equivalent); impermeable gown; a first pair of gloves (over the impermeable gown that cover the wrist); lead aprons, thyroid shields, and dosimeters; boot covers; goggles and face shield; disposable isolation gown; and a second pair of gloves (over the isolation gown which cover the wrist). Washing hands with soap and water or alcohol-based hand rub were mandatory before and after patient interaction, contact with potentially infectious sources, and before putting on and upon removal of PPE.


The VNS device and an intraoperative photograph of the left vagosympathetic trunk. The pulse generator (width 45 mm, height 32 mm, depth 6.9 mm, and weight 16 g) (A).


The VNS device and an intraoperative photograph of the left vagosympathetic trunk. The electrode (B).


The VNS device and an intraoperative photograph of the left vagosympathetic trunk. The left vagosympathetic trunk wrapped by the two helical electrodes and anchor tether (C). VNS, vagus nerve stimulation.


The number of FS-GTCS and FS-GTCS clusters per month (A).


The number of FS and FS clusters per month (B).


The number of seizure days (FS-GTCS and FS) per month (C). The asterisk indicates that VNS therapy was initiated in this month. Months -5 to 0 indicate the retrospective period; months 1 to 12 indicate the follow-up period. FS-GTCS, focal seizures evolving into generalized tonic-clonic seizures; VNS, vagus nerve stimulation.


Cardiac magnetic resonance imaging included cine MRI (left column), native T1 mapping (middle column), and late gadolinium enhancement (LGE) imaging (right column) and demonstrated several myocardial metastases on the two-chamber views (green arrows) and three metastases in the four-chamber views (cyan arrows). The metastases were best seen on T1 mapping and cine MRI and had long T1 and T2 (not shown) relative to myocardium.


MRI-scan two days after symptom onset. Emerging white matter lesions with slight restricted diffusion but without Gadolinium (Gd) enhancement. T1 Gd-enhanced.


MRI-scan two days after symptom onset. Emerging white matter lesions with slight restricted diffusion but without Gadolinium (Gd) enhancement. T2-FLAIR (fluid attenuated inversion recovery).


MRI-scan two days after symptom onset. Emerging white matter lesions with slight restricted diffusion but without Gadolinium (Gd) enhancement. DWI (diffusion-weighted imaging).


MRI-scan 10 days after symptom onset. Progressive widespread white matter lesions with restriction in diffusion but still unaffected blood-brain-barrier. T1 Gd-enhanced.


MRI-scan 10 days after symptom onset. Progressive widespread white matter lesions with restriction in diffusion but still unaffected blood-brain-barrier. T2-FLAIR.


MRI-scan 10 days after symptom onset. Progressive widespread white matter lesions with restriction in diffusion but still unaffected blood-brain-barrier. DWI.


MRI-scan at 1-year follow-up visit. Markedly reduced white matter lesions. Right occipital hyperintensity on T2 reflects brain biopsy area. T2.


MRI-scan at 1-year follow-up visit. Markedly reduced white matter lesions. Right occipital hyperintensity on T2 reflects brain biopsy area. T2-FLAIR.


MRI-scan at 1-year follow-up visit. Markedly reduced white matter lesions. Right occipital hyperintensity on T2 reflects brain biopsy area. DWI.


Anti-NMDA receptor antibodies in patient's cerebrospinal fluid and serum. Anti-NMDA receptor antibodies were positive in cerebrospinal fluid (IgG, 1:32) ,serum (IgG.


Anti-NMDA receptor antibodies in patient's cerebrospinal fluid and serum. 1:320). Before immunotherapy.


Anti-NMDA receptor antibodies in patient's cerebrospinal fluid and serum. 1:32). After 5 months of immunotherapy. . Abbreviation: NMDA, N-methyl-D-aspartate.


Marked mixed pulmonary pattern with diffuse radiographic lesions in a 7-month-old Miniature Poodle presented with respiratory decompensation while receiving appropriate antimicrobials. Right.


Marked mixed pulmonary pattern with diffuse radiographic lesions in a 7-month-old Miniature Poodle presented with respiratory decompensation while receiving appropriate antimicrobials. Left lateral radiographic projections showing bilateral diffuse lesions characterized by marked diffuse small airway thickening (white arrow), peribronchial cuffing and multifocal alveolar pattern (*) with air bronchograms (arrowheads). Incidentally, intra-thoracic tracheal luminal diameter (doubleheaded arrows) varied on average 28% between both lateral projections suggesting dynamic tracheal collapse. The tracheal bifurcation and principal bronchus were narrowed on the left lateral projection.


Marked mixed pulmonary pattern with diffuse radiographic lesions in a 7-month-old Miniature Poodle presented with respiratory decompensation while receiving appropriate antimicrobials. (C) On the ventrodorsal projection, the left cranial lung lobe is completely opacified (*) and the cardiac silhouette is shifted to the left (long horizontal arrow). The lesions are centered around the lobar and segmental bronchi (short arrows) and decrease in severity toward the periphery. The left caudal lung lobe (LCd; flared arrows) is the second most severely affected lobe after the left cranial lobe.


Transverse (3 mm-thick) computed tomographic (CT) images of a Miniature Poodle obtained at 9 months. Using a single slice CT).


8 years. Using a 64-detector row CT) of age displayed from the same level side by side. On the first study, the left cranial lung lobe (single opened arrow) is completely collapsed with almost complete absence of air in the airways. The caudal branch of the left cranial lobar bronchus is narrowed but filled with air (ventral to opened arrow on C). The left caudal lung lobe is also severely reduced in volume and thus, increased in attenuation with several air-filled end on airways (double arrows). The right lung is hyperinflated with the right cranial (RCr) and accessory (RAcc) lobes extending to the left of midline. Mosaic pattern characterized by a well circumscribed hypoattenuating area is seen in the accessory lobe (arrowhead). The parenchyma is otherwise relatively normal. By 8 years of age and after undergoing left cranial lobectomy as a puppy, the entire hyperinflated right lung has developed severe patchy parenchymal lesions consisting of ground-glass opacification (black arrows) and consolidation (*). This latter is most severe surrounding medium- to large-caliber dilated airways. Traction bronchiectasis (black arrowheads) in areas of architectural distortion is seen at the periphery of several of these airways, a common feature seen with pulmonary fibrosis. The mosaic pattern previously recognized in the accessory lobe (white arrowheads) is accentuated. Several cystic air-filled structures (white arrows) of varying size occupy the left caudal lobe.


Five years post left cranial lobectomy, radiographic lesions were still present especially in the left caudal lung lobe of a 6-year-old Miniature poodle. (A) Left lateral projection showing several areas of increased opacity in the cranioventral, caudoventral and caudodorsal lung field (arrows). In the caudodorsal lung field, a large bronchus (arrowhead) is dilated and does not taper as it extends toward the periphery indicating bronchiectasis. In the more severe opacified areas, small air bronchograms are seen (white arrow).


Five years post left cranial lobectomy, radiographic lesions were still present especially in the left caudal lung lobe of a 6-year-old Miniature poodle. (B) Right lateral projection revealing radiographic lesions (black and white arrows) similar to those on the left and most prominent in the caudodorsal lung field. They are less extensive in the ventral aspect of the thorax in comparison to the left lateral view. Note that some lesions maybe less distinct due to motion artifact.


Five years post left cranial lobectomy, radiographic lesions were still present especially in the left caudal lung lobe of a 6-year-old Miniature poodle. (C) As expected following left cranial lobectomy, leftward mediastinal shift remains visible (black arrow) on the ventrodorsal projection. The borders of the left caudal lobe appear retracted (arrowhead) and the lung lobe is increased in opacity. Lesions are most severe centrally and less extensive toward the periphery. Similarly, radiographic opacity is increased (white arrows) surrounding major lobar structures (vessels and bronchus) of the right lung and gradually diminish in periphery of the lung.


Chest computed tomography, showing perihilar consolidations at both sides with underlying bronchiectasis. In the periphery of the lungs smaller nodular infiltrates are visible. These are indicated by the arrows.


Microscopy after kinyoun staining of
M. microti
 in culture. This culture became positive after 75 days of incubation. The microscope used was a Zeiss Axioskop, the magnification x100.


Computed tomography of the left hip, showing bone destruction of the anterior side of the collum. Next to this site, multiple fluid collections are visible, which are highly suspicious for abscesses. These collections infiltrate in the adjacent muscles. The largest collection in this view measures 64.5 by 37.1 mm and has a very thick wall.


Pathological findings. Brain biopsy from the left frontal lobe. (A) Hematoxylin and eosin staining.


Pathological findings. Brain biopsy from the left frontal lobe. (B) CD20 immunohistochemical staining.


Pathological findings. Brain biopsy from the left frontal lobe. (C) Ki-67 immunohistochemical staining.


Pathological findings. Brain biopsy from the left frontal lobe. (D) CD3 immunohistochemical staining.


Contrast-enhanced brain MRI recorded 1 month after brain biopsy shows a spotty gadolinium enhancement in the left periventricular white matter (arrow) and post-biopsy scar (arrowhead).


With T2 hyperintensities.


(C) This lesion does not show abnormal hyperintensities on diffusion-weighted imaging (DWI).


Peripheral blood smear showing multiple areas of red blood cell agglutination (arrows).


Ultrasound and contrast-enhanced computed tomography (CT). (A) Ultrasound at first visit (Day 1): a 1-cm low echo cyst-like region in the right kidney (arrowhead).


Ultrasound and contrast-enhanced computed tomography (CT). (B) First contrast-enhanced CT (Day 36): the kidney is enlarged. Poorly enhanced masses with enhanced borders were found in both kidneys (arrowhead). Two to three patchy poorly contrasted areas were found in both kidneys, but it was difficult to identify if they were cysts or infectious lesions (arrow).


Magnetic resonance imaging (Day 60). (A) T2-weighted images: 2-mm high-signal small patchy shadows were found in both kidneys (arrow).


Magnetic resonance imaging (Day 60). (B) T2-weighted images: thick walls in the right kidney as low signals and mass as high signals were found in the interior (arrowhead). Diffusion-weighted images: masses as high-signal areas of thick-walled structures at the same site as. (arrowhead). Apparent diffusion coefficient (ADC) map: low-signal mass at the same site as. (arrowhead).


Magnetic resonance imaging (Day 60).


Magnetic resonance imaging (Day 428). (A) Diffusion-weighted images showed that the mass with high-signal areas of thick-walled structures disappeared (arrowhead).


Magnetic resonance imaging (Day 428). (B) Low-signal masses are also not visible on apparent diffusion coefficient (ADC) map (arrowhead).


Pruritic follicular papules over back.


(a) On dermoscopy the hairs were seen like loops.


(b) Solid papules over back seen on dermoscopy.


(a) Hairs coming out of the skin and again re-entering.


(b) Solid papules had bend hairs inside.


Coiled up strongyloides larvae.


Double bulb esophagus.


Primordial genital primordium.


Embryonated egg.


Histological diagnosis of synchronous nodular tuberculosis and EBV-associated lymphoproliferative disorder. Biopsy of a cervical lymph node performed on day +36 showed effacement of the architecture due to numerous granulomas (low magnification.


Histological diagnosis of synchronous nodular tuberculosis and EBV-associated lymphoproliferative disorder. , which were composed of epithelioid cells.


Histological diagnosis of synchronous nodular tuberculosis and EBV-associated lymphoproliferative disorder. Between the granulomas a polymorphous lymphoid infiltrate was noted containing blasts as well as plasma cells (c).


Histological diagnosis of synchronous nodular tuberculosis and EBV-associated lymphoproliferative disorder. The blasts were latently EBV-infected as shown in the immunohistochemical demonstration of EBNA2 (d).


Radiological diagnosis of disseminated tuberculosis. CT scan of the thorax on day +43 after allogeneic stem cell transplantation revealed a borderline sized mediastinal lymph node with central necrosis.


Radiological diagnosis of disseminated tuberculosis. As well as multiple pulmonary nodules.


Histopathological examination of the papule (HE; x100).


Expression of CD63 on basophils in Patient 1, an atopic control, and a non-atopic control, after incubation with American and Korean ginseng.


CT showing infected aneurysm of the splenic artery (arrow) with complete distal obliteration.


The spleen showing multiple large purulent loculations (arrows).


Timeline of symptoms, diagnostic, interventions, and outcomes.


Shoot from brain MRI of May 8 in :. Show T2-FLAIR acquisition.


Shoot from brain MRI of May 8 in (C) Shows occipital lesion in T2-FLAIR acquisition.


Shoot from brain MRI of May 8 in (D) Shows parietal lesion in T2-FLAIR acquisition.


Shoot from brain MRI of May 8 in (E) Shows occipital lesion positive in DWI.


Shoot from Brain MRI of June 16: (F,G) show T2-FLAIR acquisition.


A; Chest CT on February 6, 2018 (before the administration of SOF/VEL), showed pleural effusion in the lower part of the right lung. The white arrows show pleural effusion.


B; Abdominal CT on February 6, 2018 (before the administration of SOF/VEL), showed ascites in the lower part of the liver. The white arrows show ascites.


A; Chest CT on September 25, 2019 (after the administration of SOF/VEL), showed that the pleural effusion in the lower part of the right lung had disappeared completely.


B; Abdominal CT on September 25, 2019 (after the administration of SOF/VEL), showed that the ascites in the lower part of the liver had disappeared completely.


Time course of serum ammonia level after SOF/VEL administration.


Time course of serum albumin level after SOF/VEL administration.


(A) Erythema and lots of tiny pustules on the abdomen.


(B) Many pustules on the basis of erythema on the lower abdomen.


(A) Lots of tiny pustules on the trunk.


(B) Many tiny pustules and some scales on the upper limbs.


Timeline of the case after admission. (A-C) Time course of CK, myoglobin, plasma creatinine, and levels of uPCR and uACR.


Timeline of the case after admission. (D) Time of treatment regimens and kidney biopsy. CK, creatinine kinase; CYC, cyclophosphamide; uACR, urinary albumin-to-creatinine ratio; uPCR, urinary protein-to-creatinine ratio.


Histopathological findings in a kidney biopsy confirming pauci-immune crescentic GN. Representative photomicrographs of the kidney biopsy including staining for IgA (scale bar: 50 mum), IgG (scale bar: 50 mum), IgM (scale bar: 50 mum), C1q (scale bar: 50 mum), and C3c (scale bar: 50 mum); periodic acid-Schiff staining showing a glomerulus with crescent formation (scale bar: 50 mum); and hematoxylin/eosin staining with myoglobin casts (asterisks, scale bar: 100 mum) and tubulointerstitial inflammation with prominent eosinophilic infiltration (scale bar: 100 mum). C1q, complement component 1q; C3c, complement factor 3 conversion product; IgA, immunoglobulin A; IgG, immunoglobulin G; IgM, immunoglobulin M; GN, glomerulonephritis.


Concurrent CRRT, VA-ECMO and TPE. O2, oxygen, CO2, carbon dioxide, others as per Figure 1.


A-c Slit-lamp photographs on POD 5 (1 day after flap lift and irrigation). A; Right eye with improving peripheral keratolysis.


B; High magnification of peripheral keratolysis in the left eye.


C; Left eye with persistent peripheral keratolysis.


E Photographs at postoperative month 6, showing resolved keratitis with mild peripheral stromal scarring in the right eye. And left eye.


Electron microscopy of the renal biopsy showing subepithelial membranous deposits (arrow) and adjacent foot process effacement (description courtesy of John Higgins, MD, and Christina Kong, MD, Department of Pathology, Stanford University School of Medicine, Stanford, Calif. , USA).


Course of body temperature and clinical events. . Notes: Pyrexia was not seen on the day of admission. On postoperative day 2, body temperature suddenly rose. Thereafter, pyrexia was controlled with daily administrations of acetaminophen. Three days after discharge, severe pain in both shoulders and morning stiffness suddenly occurred. Body temperature was controlled by daily acetaminophen administration and remained normal after switching to prednisolone. . Abbreviation: P, prednisolone; URTI, upper respiratory tract infection.


Head computed tomography images of a 64-year-old man with asymptomatic symptom for coronavirus disease 2019. (a) Axial showing subarachnoid space dilated associated with cortical atrophy (Red arrows).


Head computed tomography images of a 64-year-old man with asymptomatic symptom for coronavirus disease 2019. (b) Choroid plexus calcification in the lateral ventricles (Red arrows).


Chest computed tomography (CT) images of a 64-year- old man with asymptomatic symptom for coronavirus disease 2019. Axial plane chest CT scans showing lymph nodes larger than 1 cm (Red arrows).


Erythematous and maculopapular rashes on the upper and lower extremities.


Sagittal T1-weighted magnetic resonance imaging (MRI) of the brain with gadolinium contrast. A) Preoperative image demonstrates a 2.6 x 1.6 cm enhancing mass with surrounding edema.


Sagittal T1-weighted magnetic resonance imaging (MRI) of the brain with gadolinium contrast. B) Axial diffusion-weighted MRI demonstrating perilesional edema but no solid areas of restricted diffusion to suggest abscess.


Sagittal T1-weighted magnetic resonance imaging (MRI) of the brain with gadolinium contrast. C) Postoperative image one day after surgery demonstrating gross total resection.


Sagittal T1-weighted magnetic resonance imaging (MRI) of the brain with gadolinium contrast. D) Postoperative image four months after surgery showing no recurrence.


Intraoperative images of tumor. Superficial mass with well defined margins and surrounding normal brain tissue.


Intraoperative images of tumor. Resection cavity.


Pathological examination of tumor. A) Hematoxylin and eosin staining show necrotizing granulomas with peripheral palisading epithelioid histiocytes, giant cells.


Pathological examination of tumor. B) Acid fast bacillus.


Chest computed tomography on admission of an asymptomatic 64-year-old woman infected with severe acute respiratory syndrome coronavirus-2. Ground-glass opacities were observed in the peripheral areas under the pleura on the right lower lobe (posterior basal).


Photographs of the anterior eye of the patients before and after treatment. A, b Case 1. A; A brown pigmented infiltrate in the paracentral cornea with few satellite lesions in the superior peripheral cornea 1 week after cataract surgery.


Photographs of the anterior eye of the patients before and after treatment. B; The corneal ulcers developed into scars after the treatment.


Photographs of the anterior eye of the patients before and after treatment. C, d Case 2. C; A corneal infiltrate with central brownish pigments on top of the lesion at presentation.


Photographs of the anterior eye of the patients before and after treatment. D; Scar tissue and vascularization replaced the corneal ulcer, with small foci of epithelial defects remaining after 1 month of treatment.


A; Potassium hydroxide preparation showing numerous dark septate fungal hyphae. Magnifications: x400.


B; Numerous fungal elements detected on calcofluor white staining. Magnifications: x400.


C; Microscopic analysis of b showing fungal hyphae and conidia. X100.


D; Dark pigmented colonies of F. Pedrosoi growing on Sabouraud's dextrose agar.


Results of Sanger sequencing of BLM of the proband. The red arrows indicate the c.1544delA (p. Asn515Metfs*16) (A) and c.692T>G (p.


Results of Sanger sequencing of BLM of the proband. The red arrows indicate the c.1544delA (p. Leu231*) (B) heterozygous variants.


Family pedigree. Filled black symbols represent individuals with diabetes. The red arrow indicates the proband.


Parotid fistula and Frey's syndrome.


The parotid region is divided into four quadrants. The injection points are at 1 cm from each other.


Intra-operative condition of the lesion located at middle of upper clivus region. The lesion was very tough, and ,firm (the arrow).


Intra-operative condition of the lesion located at middle of upper clivus region. The lesion was stick to the brain stem and basal artery (1: brain stem; 2: basal artery; 3: abducent nerve).


Histological features of the lesion revealed an IgG4-related inflammatory pseudotumor. Hematoxylin, and . Eosin (H&E) stain showed the lesion was composed of sclerosing fibrosis associated with dense lymphoplasmacytic infiltration. X40.


Histological features of the lesion revealed an IgG4-related inflammatory pseudotumor. Hematoxylin, and . . X100).


Histological features of the lesion revealed an IgG4-related inflammatory pseudotumor. Immunohistochemical analysis revealed over 400 IgG4-positive cells per high-powered field, and . A high IgG4/IgG ratio. IgG, x200.


Histological features of the lesion revealed an IgG4-related inflammatory pseudotumor. Immunohistochemical analysis revealed over 400 IgG4-positive cells per high-powered field, and . . IgG4, x200).


Histological features of the lesion revealed an IgG4-related inflammatory pseudotumor. Immunohistochemical staining of CD38. Immunohistochemical staining of Ki-67.


Histological features of the lesion revealed an IgG4-related inflammatory pseudotumor. (F) Immunohistochemical staining of Ki-67.


Chest radiography revealed consolidation in the right lower lung field at the initial visit.


Pulmonary findings of chest high-resolution computed tomography. (A) At the initial visit, subpleural consolidation with volume reduction in the right lower lobe and localized ground-glass opacity in the left lower lobe were present.


Pulmonary findings of chest high-resolution computed tomography. (B) Two weeks after she began receiving prednisolone (PSL), consolidation had not improved.


Pulmonary findings of chest high-resolution computed tomography. (C) Two months after discontinuation of PSL, bilateral consolidation developed. Then, a surgical lung biopsy (SLB) of the right upper lobe was performed (arrow).


(A) Mechanic's hand (arrows).


(B) Gottron's papules on the dorsum (arrowheads).


Pulmonary findings of chest high-resolution computed tomography. (A) One month after the surgical lung biopsy, bilateral subpleural consolidation and ground-glass opacity had worsened.