openmed-community/multicare-case-images

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PMC5180436_01_SNI-7-955-g001.jpg	PMC5180436_SNI-7-955-g001_a_1_4.webp	(a-c) Contrast-enhanced T1-weighted sequences show the brain abscess in the right parietal lobe; (d) diffusion-weighted magnetic resonance imaging	On contrast-enhanced magnetic resonance imaging (MRI), a ring-shaped lesion in the right parietal lobe was noted [Figure 1a-c]. The diffusion-weighted images showed an intensive hyperintense signal, which was strongly suspicious for a brain abscess [Figure 1d].	F1	PMC5180436_01	PMC5180436	file_0061572	PMC5180436_01	CC BY-NC-SA
PMC5180436_01_SNI-7-955-g002.jpg	PMC5180436_SNI-7-955-g002_a_1_2.webp	(a, b) Surgical site after durotomy. No pathological alteration of the brain surface under white light (a), intense fluorescent staining under YE560 (b)	The lesion could not be detected under white light, however, showed intensive fluorescent staining under the YE560 nm filter [Figure 2a and b].	F2	PMC5180436_01	PMC5180436	file_0061576	PMC5180436_01	CC BY-NC-SA
PMC5180436_01_SNI-7-955-g003.jpg	PMC5180436_SNI-7-955-g003_a_1_2.webp	(a, b) Surgical site after opening of the abscess. Drainage of pus under white light (a) and under YE560 (b). Note the nonfluorescence of the pus	After opening of the capsule, viscous pus poured out [Figure 3a] that was not fluorescing under filtered light [Figure 3b].	F3	PMC5180436_01	PMC5180436	file_0061578	PMC5180436_01	CC BY-NC-SA
PMC10157198_01_fneur-14-1078173-g0001.jpg	PMC10157198_fneur-14-1078173-g0001_A_1_4.webp	Preoperative CT and CTA images. (A) CT showing the extensive SAH, focusing on the left suprasellar cistern and the base of the Sylvian fissure. (B) Six days later, repeat CT showing absorption of the SAH. (C) CTA of the superior-inferior view showing the arterial network of the right proximal MCA (frame) and an aneurysm (arrow). (D) CTA of the posterior-anterior view showing the aneurysm in detail; the aneurysm (arrow) was located in the A1 segment of the ACA. ACA, anterior cerebral artery; A1, first segment of the ACA; A2, second segment of the ACA; BA, basilar artery; CT, computed tomography; CTA, CT angiography; MCA, middle cerebral artery; R, right; SAH, subarachnoid hemorrhage.	The computed tomography (CT) obtained at the local hospital showed a grade 1 subarachnoid hemorrhage (SAH) on the modified Fisher scale (Figure 1A). CT was repeated and showed that the SAH had been absorbed (Figure 1B). CT angiography showed the arterial network of the right proximal MCA and an aneurysm on the A1 segment of the ACA (Figures 1C, D).	F1	PMC10157198_01	PMC10157198	file_0003581	PMC10157198_01	CC BY
PMC10157198_01_fneur-14-1078173-g0002.jpg	PMC10157198_fneur-14-1078173-g0002_A_1_4.webp	Angioarchitecture of twig-like MCA. (A) Two-dimensional DSA of the right ICA showing a right twig-like MCA and an aneurysm (arrow) at the origin of the AccMCA from the A1 segment. (B) Three-dimensional DSA showing that the ICA (arrowhead) did not give off the branch supplying the twig-like MCA; the arrow indicates the aneurysm. (C) Three-dimensional DSA showing the AccMCA (arrowhead) as a collateral artery from the A1 segment supplying the twig-like MCA; the arrow indicates the aneurysm. (D) Three-dimensional DSA showing that the AchA (arrowhead) supplies the twig-like MCA. A1, first segment; AccMCA, accessory middle cerebral artery; ACA, anterior cerebral artery; AchA, anterior choroidal artery; DSA, digital subtraction angiography; ICA, internal carotid artery; MCA, middle cerebral artery.	A1 segment of the ACA, and the AccMCA was a collateral artery for the MCA twig (Figure 2). After the three-dimensional reconstruction of the DSA data, the best projection degree showed the aneurysm sac and its neck. An Echemon-10 microcatheter (Medtronic, Irvine, CA, USA) was used to perform the coiling [Axium Prime coils: 3.5 mm x 10 cm, 2 mm x 6 cm, 1.5 mm x 3 cm (Medtronic, Irvine, CA, USA)], and the aneurysm was completely embolized (Figures 3A, B).	F2	PMC10157198_01	PMC10157198	file_0003585	PMC10157198_01	CC BY
PMC10157198_01_fneur-14-1078173-g0003.jpg	PMC10157198_fneur-14-1078173-g0003_A_1_4.webp	Aneurysm coiling and follow-up CT. (A) DSA roadmap navigation of the right ICA showing that the microcatheter was positioned into the aneurysm sac (arrow); the arrowhead indicates the AccMCA. (B) Postoperative DSA of the right ICA showing that the aneurysm was completely coiled and that the AccMCA (arrowhead) was preserved. (C) Follow-up CT showing normal brain tissue. (D) CT reconstruction showing the coils (arrow). A1, first segment; AccMCA, accessory middle cerebral artery; CT, computed tomography; DSA, digital subtraction angiography; ICA, internal carotid artery; MCA, middle cerebral artery; R, right.	A1 segment of the ACA, and the AccMCA was a collateral artery for the MCA twig (Figure 2). After the three-dimensional reconstruction of the DSA data, the best projection degree showed the aneurysm sac and its neck. An Echemon-10 microcatheter (Medtronic, Irvine, CA, USA) was used to perform the coiling [Axium Prime coils: 3.5 mm x 10 cm, 2 mm x 6 cm, 1.5 mm x 3 cm (Medtronic, Irvine, CA, USA)], and the aneurysm was completely embolized (Figures 3A, B). A postoperative CT at the 3-month follow-up showed that the brain tissue was normal (Figures 3C, D).	F3	PMC10157198_01	PMC10157198	file_0003589	PMC10157198_01	CC BY
PMC6787949_01_1414-431X-bjmbr-52-10-e8823-gf001.jpg	PMC6787949_1414-431X-bjmbr-52-10-e8823-gf001_undivided_1_1.webp	Zone of hair loss.	In 2006, the patient experienced partial hair loss over an area ~1 cm in diameter on the head (Figure 1).	f01	PMC6787949_01	PMC6787949	file_0097396	PMC6787949_01	CC BY
PMC6787949_01_1414-431X-bjmbr-52-10-e8823-gf002.jpg	PMC6787949_1414-431X-bjmbr-52-10-e8823-gf002_undivided_1_1.webp	Ulceration of the oral mucosa.	In January 2014, the patient was admitted to the Stomatological Hospital, and physical examination showed that the oral lesions (Figure 2) resembled LP.	f02	PMC6787949_01	PMC6787949	file_0097397	PMC6787949_01	CC BY
PMC6787949_02_1414-431X-bjmbr-52-10-e8823-gf003.jpg	PMC6787949_1414-431X-bjmbr-52-10-e8823-gf003_A_1_3.webp	A, The medial mucosal surfaces of the labia minora had bright red-colored, defect-like lesions, and the vaginal orifice was stenosed with a diameter of 1 cm. Blue arrow: narrow urethral orifice; Black arrow: defect of the mucosa. B, The medial mucosa of the labia minora was smooth and slightly reddened, and the vaginal opening was slightly narrowed. C, The mucosa of the medial labia minora was slightly reddened, smooth, and without defects.	A small speculum was unable to expose the cervix (Figure 3A). Physical examination revealed that the mucosa of the labia minora was smooth, the frenulum labiorum pudendi was lightly chapped and the vaginal elasticity had improved, although the upper vagina still had a ring-like narrowing and no folds (Figure 3B). Gynecological examination showed that the mucosa of the medial labia minora was slightly reddened, smooth, and without defects, the elasticity of the vaginal mucosa was good, and two fingers could be accommodated (see Figure 3C).	f03	PMC6787949_02	PMC6787949	file_0097398	PMC6787949_02	CC BY
PMC6787949_02_1414-431X-bjmbr-52-10-e8823-gf004.jpg	PMC6787949_1414-431X-bjmbr-52-10-e8823-gf004_A_1_2.webp	Biopsy of right buccal mucosa (taken beside the ulcer) showing squamous epithelial mucosa and squamous epithelial dyskeratosis. A, Superficial zonular lymphocytes and plasma cells were distributed in the lamina propria, and there was small vessel hyperplasia. Scale bar: 100 mum. B, Lymphocytes were scattered within the epithelium (black arrows). Scale bar: 50 mum.		f04	PMC6787949_02	PMC6787949	file_0097401	PMC6787949_02	CC BY
PMC6787949_02_1414-431X-bjmbr-52-10-e8823-gf005.jpg	PMC6787949_1414-431X-bjmbr-52-10-e8823-gf005_A_1_2.webp	Vaginal wall biopsy. A, Squamous epithelial mucosa, with simple and pseudoepithelioma-like hyperplasia (white arrow) in some epithelium, hyperkeratosis and incomplete keratosis, and hyperplasia of interstitial small vessels (black arrow) Scale bar: 100 mum. B, Squamous epithelial mucosa, atrophy of part of the squamous epithelium, scattered superficial dermis, infiltration of focal lymph and plasma cells, and formation of lymphoid follicles (yellow arrows). Scale bar: 100 mum.	The pathological sections were considered to have squamous epithelial mucosal tissue, partial epithelial atrophy, partial simple hyperplasia, hyperkeratosis and incomplete keratosis, scattered focal infiltration of lymphocytes and plasma cells in the superficial dermis with formation of lymphoid follicles, and small vessel hyperplasia (Figure 5A and B).	f05	PMC6787949_02	PMC6787949	file_0097403	PMC6787949_02	CC BY
PMC6787949_02_1414-431X-bjmbr-52-10-e8823-gf006.jpg	PMC6787949_1414-431X-bjmbr-52-10-e8823-gf006_A_1_2.webp	Measurement of urine flow rate. A, A maximum urine flow rate of 5.2 mL/s was measured before treatment with urethral dilatation and oral cyclosporine A. B, A maximum urine flow rate of 11.5 mL/s was measured after treatment with urethral dilatation and oral cyclosporine A.	Since the patient had not tolerated the adverse side effects of corticosteroid therapy during previous treatment and had fertility requirements, she was treated with oral cyclosporine A (125 mg/day) combined with physical dilatation of the urethra, and this resulted in an increase in urine flow rate to 11.5 mL/s (Figure 6B).	f06	PMC6787949_02	PMC6787949	file_0097405	PMC6787949_02	CC BY
PMC4524006_01_SNI-6-125-g001.jpg	PMC4524006_SNI-6-125-g001_a_1_4.webp	(a) T1-weighted magnetic resonance imaging axial section demonstration multiple cysts generating a hypointense signal. Multiple septations can be appreciated significant mass effect can be appreciated. (b) T2-weighted magnetic resonance imaging axial section representing multiple cysts with a hyperintense signal and the cyst walls generating a hypointense signal. (c) T1-contrast enhanced magnetic resonance imaging axial cut showing contrast enhancement of the cyst wall in some regions. (d) Fluid attenuated inversion recovery sequence coronal section showing multiple cysts as hypointense signals and significant mass effect	A magnetic resonance imaging (MRI) brain was performed which showed multiple intracranial cysts predominantly in the right frontal region with significant mass effect [Figure 1].	F1	PMC4524006_01	PMC4524006	file_0043872	PMC4524006_01	CC BY-NC-SA
PMC4524006_01_SNI-6-125-g002.jpg	PMC4524006_SNI-6-125-g002_a_1_4.webp	(a) Intraoperative photograph demonstrating the durotomy incision and the capsule of a huge hydatid cyst. (b and c) Photograph of daughter/secondary cysts in the brain parenchyma after the first cyst was removed. (d) The main cyst and two daughter cysts after excision with intact capsules	There was significant dural tension, and a c-shaped durotomy was done which revealed a huge hydatid cyst extending toward the lateral ventricle [Figure 2a]. A soft rubber catheter was inserted between the brain parenchyma and the cyst capsule (Dowling's technique); a cleavage plane was established using warm hypertonic saline and the cyst was delivered unruptured [Figure 2d]. Numerous daughter cysts were then identified which were carefully delivered unruptured using the same technique [Figure 2b and c].	F2	PMC4524006_01	PMC4524006	file_0043876	PMC4524006_01	CC BY-NC-SA
PMC5839875_01_10-1055-s-0038-1629898-i170271crc-1.jpg	PMC5839875_10-1055-s-0038-1629898-i170271crc-1_undivided_1_1.webp	Chest computer tomography with the venous stent dangling in the tricuspid valve apparatus.	One hour postprocedural echocardiography and computed tomography scan ( Fig. 1 ) revealed stent migration into the subvalvular chordal structures of the right ventricle causing significant tricuspid regurgitation.	FI170271crc-1	PMC5839875_01	PMC5839875	file_0078313	PMC5839875_01	CC BY-NC-ND
PMC5839875_01_10-1055-s-0038-1629898-i170271crc-2.jpg	PMC5839875_10-1055-s-0038-1629898-i170271crc-2_undivided_1_1.webp	Intraoperative finding: Removal of the stent from the tricuspid valve apparatus.	Despite the fact, that the stent was entrapped by subvalvular chordal structures of the tricuspid valve due to the stent design with wire brackets, it was possible to recover it without harming the tricuspid valve and adjacent structures ( Fig. 2 ).	FI170271crc-2	PMC5839875_01	PMC5839875	file_0078314	PMC5839875_01	CC BY-NC-ND
PMC8268003_01_fpsyt-12-572660-g0001.jpg	PMC8268003_fpsyt-12-572660-g0001_undivided_1_1.webp	Raw sleep indices measured in sleep on a given night.		F1	PMC8268003_01	PMC8268003	file_0120631	PMC8268003_01	CC BY
PMC8268003_01_fpsyt-12-572660-g0002.jpg	PMC8268003_fpsyt-12-572660-g0002_undivided_1_1.webp	Sleep stages chart on a given night.		F2	PMC8268003_01	PMC8268003	file_0120632	PMC8268003_01	CC BY
PMC8268003_01_fpsyt-12-572660-g0004.jpg	PMC8268003_fpsyt-12-572660-g0004_undivided_1_1.webp	Rem Latency and BDI-II scores during 3 month follow-up.	As shown in Figures 3, 4, Rem Latency was gradually reduced over the following weeks, followed by a significant reduction to 53 min.	F4	PMC8268003_01	PMC8268003	file_0120633	PMC8268003_01	CC BY
PMC6350110_01_gr1.jpg	PMC6350110_gr1_undivided_1_1.webp	Chest X-Ray: There is a giant soft tissue, well-demarcated, lobulated mass in the right hemithorax expanding and splaying the adjacent ribs.	A chest X-ray was performed showing a giant soft tissue, well-demarcated, well - demarked mass in the right hemithorax expanding and splaying the adjacent ribs, Fig. 1.	fig1	PMC6350110_01	PMC6350110	file_0088917	PMC6350110_01	CC BY-NC-ND
PMC7728115_01_RJME-61-1-219-fig1.jpg	PMC7728115_RJME-61-1-219-fig1_A_1_3.webp	Fine-needle aspiration cytology. First study: (A) Groups and microfollicles of clear balloon-shaped cells showing abundant fine vesicles in their cytoplasm. Second study: (B) A cluster and a microfollicle of clear balloon-shaped cells can be seen - nuclei are round with a visible nucleolus; (C) A microfollicle is displaying a central lumen - there is slight anisokaryosis. Papanicolaou (Pap) staining: (A-C) x400	There were groups of clear cells or microfollicular structures with a diffusely vacuolated cytoplasm (Figure 1A). Based on these findings the successive diagnoses in two samples were follicular neoplasia (Figure 1, B and C).	F1	PMC7728115_01	PMC7728115	file_0112907	PMC7728115_01	CC BY-NC-SA
PMC7728115_01_RJME-61-1-219-fig2.jpg	PMC7728115_RJME-61-1-219-fig2_undivided_1_1.webp	Total thyroidectomy. The right lower lobe contains a 2 cm diameter, solid, pale tan, nodular lesion	The right lower lobe contained a 2 cm diameter encapsulated, solid, pale tan, fleshy, nodular lesion (Figure 2).	F2	PMC7728115_01	PMC7728115	file_0112910	PMC7728115_01	CC BY-NC-SA
PMC10202565_01_10-1055-s-0043-1769007-i0220230463crc-2.jpg	PMC10202565_10-1055-s-0043-1769007-i0220230463crc-2_A_1_3.webp	Preoperative chest X-ray, preoperative coronary angiogram, and postoperative chest X-ray. Pseudoaneurysm (red arrow). Panels (A) and (C) Improvement in cardiac maximal dimensions between preoperative day 12 (A) and postoperative day 23 (C) with a reduction in cardiomegaly. Panel (B) Left heart coronary angiogram with dashed line delineating pseudoaneurysm neck.	TEE at our institution further characterized the dehisced mitral ring as well as the LVPA contained by the posterolateral pericardium ( Fig. 1 ). The patient subsequently underwent redo sternotomy for repair of the LVPA repair along with MVR ( Fig. 2 ).	FI0220230463crc-2	PMC10202565_01	PMC10202565	file_0005068	PMC10202565_01	CC BY-NC-ND
PMC10202565_01_10-1055-s-0043-1769007-i0220230463crc-3.jpg	PMC10202565_10-1055-s-0043-1769007-i0220230463crc-3_A_1_4.webp	Intraoperative repair of the pseudoaneurysm. Panel (A) Pseudoaneurysm neck (yellow arrow) and pseudoaneurysm sack (red arrow). Panel (B) Cut anterior leaflet of mitral valve (dashed yellow line). Panel (C) Bovine pericardial patch (blue stars). Panel (D) Surgeon's view: anterior annulus (dashed yellow line), patch (blue star), and noneverting pledgeted annular sutures (red arrows).	The pseudoaneurysm wall was then carefully cleaned of all thrombi with high power suction with an open-ended tip ( Fig. 3A ). The neck of the pseudoaneurysm was patched on the posterior aspect of the heart using a bovine pericardium patch and sewn to the underside of the mitral annulus extending to the anterior and medial aspects of the ventricle ( Fig. 3C ). Pledgeted sutures in a noneverting manner were placed from the ventricular side to the atrial side at the level of the A3-P3 commissure ( Fig. 3D ).	FI0220230463crc-3	PMC10202565_01	PMC10202565	file_0005071	PMC10202565_01	CC BY-NC-ND
PMC4898297_01_gr1.jpg	PMC4898297_gr1_undivided_1_1.webp	49-year-old woman with retinoic acid arthropathy. Anteroposterior radiograph of the right elbow shows hyperostosis, especially involving the lateral humeral epicondyle at the origin of the extensor tendons (white arrow). Hyperostosis is also seen involving the sublime tubercle (yellow arrow).	Bilateral elbow radiographs demonstrated hyperostosis, especially involving the proximal ulnas, bilateral triceps tendon insertions, and the right lateral humeral condyle (Figure 1, Figure 2, Figure 3).	fig1	PMC4898297_01	PMC4898297	file_0054891	PMC4898297_01	CC BY-NC-ND
PMC4898297_01_gr2.jpg	PMC4898297_gr2_undivided_1_1.webp	49-year-old woman with retinoic acid arthropathy. Anteroposterior radiograph of the asymptomatic left elbow shows hyperostosis at the sublime tubercle (arrow).	Bilateral elbow radiographs demonstrated hyperostosis, especially involving the proximal ulnas, bilateral triceps tendon insertions, and the right lateral humeral condyle (Figure 1, Figure 2, Figure 3).	fig2	PMC4898297_01	PMC4898297	file_0054892	PMC4898297_01	CC BY-NC-ND
PMC4898297_01_gr3.jpg	PMC4898297_gr3_undivided_1_1.webp	49-year-old woman with retinoic acid arthropathy. Lateral radiograph of the right elbow shows hyperostosis involving the olecranon process, but no soft-tissue swelling adjacent to this site, joint effusion, or fracture.	Bilateral elbow radiographs demonstrated hyperostosis, especially involving the proximal ulnas, bilateral triceps tendon insertions, and the right lateral humeral condyle (Figure 1, Figure 2, Figure 3). No fracture, dislocation, joint effusion, or radiographic evidence of triceps tendon tear was evident in the right elbow (Fig. 3).	fig3	PMC4898297_01	PMC4898297	file_0054893	PMC4898297_01	CC BY-NC-ND
PMC4898297_01_gr4.jpg	PMC4898297_gr4_undivided_1_1.webp	49-year-old woman with retinoic acid arthropathy. Lateral radiograph of the thoracic spine shows flowing ossification of the anterior longitudinal ligament of several thoracic vertebral bodies. The disc spaces and vertebral body heights are normal.	Although no prior elbow radiographs were available for comparison, radiographs of the thoracic spine from two years prior also showed flowing ossification of the anterior longitudinal ligament with relatively maintained disc spaces (Fig. 4).	fig4	PMC4898297_01	PMC4898297	file_0054894	PMC4898297_01	CC BY-NC-ND
PMC4898297_01_gr5.jpg	PMC4898297_gr5_undivided_1_1.webp	49-year-old woman with retinoic acid arthropathy. AP radiograph of the pelvis shows enthesopathy at the iliolumbar ligament insertions (black arrow), anterior superior iliac spines (white arrow), and hamstring tendon (yellow arrow) attachments bilaterally.	An AP radiograph of the pelvis from one year prior showed multiple sites of hyperostosis, including at the iliac crests (Fig. 5).	fig5	PMC4898297_01	PMC4898297	file_0054895	PMC4898297_01	CC BY-NC-ND
PMC7533312_01_gr1.jpg	PMC7533312_gr1_undivided_1_1.webp	MRI head revealing right frontal subgaleal abscess along with involvement of the right frontal bone.	MRI head confirmed the findings (Fig. 1).	fig0005	PMC7533312_01	PMC7533312	file_0109382	PMC7533312_01	CC BY-NC-ND
PMC8077640_02_PAMJ-38-178-g001.jpg	PMC8077640_PAMJ-38-178-g001_undivided_1_1.webp	first day, hyperpigmentation macules accompanied by crusting, squama, and macular erythema in the posterior trunk area	Dermatological examination of the posterior trunk region found hyperpigmented macules accompanied by crust, squama and erythematous macules (Figure 1).	F1	PMC8077640_02	PMC8077640	file_0116739	PMC8077640_02	CC BY
PMC8077640_02_PAMJ-38-178-g002.jpg	PMC8077640_PAMJ-38-178-g002_undivided_1_1.webp	examination of 10% KOH showing clustered spores and pseudo hyphae	Direct microscopic of the skin scrapings on the back using 10% KOH showed clustered spores and pseudohyphae (Figure 2).	F2	PMC8077640_02	PMC8077640	file_0116740	PMC8077640_02	CC BY
PMC8077640_02_PAMJ-38-178-g003.jpg	PMC8077640_PAMJ-38-178-g003_undivided_1_1.webp	macroscopic culture in Sabouraud's Dextrose Agar (SDA) media showing mucoid brownish white colonies with a smooth surface	Culture in Sabouraud Dextrose Agar (SDA) media added with chloramphenicol incubated at 25 -30 C showed mucoid brownish white colonies with smooth surfaces on the third day (Figure 3), typical of the fungus Candida sp.	F3	PMC8077640_02	PMC8077640	file_0116741	PMC8077640_02	CC BY
PMC8077640_02_PAMJ-38-178-g004.jpg	PMC8077640_PAMJ-38-178-g004_A_1_2.webp	A) gram staining showed purple-colored fungal colony, yeast cells and budding spores; B) LCB (lactofenol cotton blue) staining showed positive results for candida	One week later, gram staining was carried out and positive purple color mildews were obtained (Figure 4).	F4	PMC8077640_02	PMC8077640	file_0116742	PMC8077640_02	CC BY
PMC8077640_02_PAMJ-38-178-g005.jpg	PMC8077640_PAMJ-38-178-g005_undivided_1_1.webp	carbohydrate fermentation test resulted in a change in colour from purple to orange in glucose, sucrose, and lactose, and gas formation	Further examination was carried out using carbohydrate fermentation to determine the type of candida which showed a change in color from purple to orange in glucose, sucrose, and lactose and gas formed in each of the reagents (Figure 5).	F5	PMC8077640_02	PMC8077640	file_0116744	PMC8077640_02	CC BY
PMC8077640_02_PAMJ-38-178-g006.jpg	PMC8077640_PAMJ-38-178-g006_undivided_1_1.webp	dermatologic examination on the fifth day showed the lesions on the posterior trunk had dried out	On the fifth day of treatment the lesion showed marked improvement (Figure 6).	F6	PMC8077640_02	PMC8077640	file_0116745	PMC8077640_02	CC BY
PMC5778723_04_SNI-9-3-g004.jpg	PMC5778723_SNI-9-3-g004_undivided_1_1.webp	Axial CT scans of patient #4. Left: Discovery CT scan showing a colloid cyst of 13 mm with dilatation of the lateral ventricles and slight asymmetry on the right. Right: CT scan at 6-year follow-up demonstrating absence of the colloid cyst	CT scan of the brain [Figure 4, Left] revealed that there was evidence of a hyperdense colloid cyst within the right third ventricle at the junction of the foramen of Monro with mild dilation of the right lateral ventricle. The most recent axial CT without contrast [Figure 4, Right] from October 2015 demonstrates that the previously noted hyperdense presumed colloid cyst is no longer present.	F4	PMC5778723_04	PMC5778723	file_0076440	PMC5778723_04	CC BY-NC-SA
PMC4073032_01_AnnGastroenterol-27-276-g001.jpg	PMC4073032_AnnGastroenterol-27-276-g001_undivided_1_1.webp	Axial section of a contrast-enhanced computed tomography scan of the abdomen and pelvis showing the sigmoid tumor (marked with arrow)	A contrast-enhanced computed tomography of the abdomen and pelvis was performed which revealed a sigmoid tumor (Fig. 1).	F1	PMC4073032_01	PMC4073032	file_0034688	PMC4073032_01	CC BY-NC-SA
PMC4073032_01_AnnGastroenterol-27-276-g002.jpg	PMC4073032_AnnGastroenterol-27-276-g002_undivided_1_1.webp	Intraoperative photograph showing the perianal scar at the site of excised fistula and the perianal abscess (marked with arrows)	A day before the surgery he developed another perianal abscess (Fig. 2).	F2	PMC4073032_01	PMC4073032	file_0034689	PMC4073032_01	CC BY-NC-SA
PMC4073032_01_AnnGastroenterol-27-276-g003.jpg	PMC4073032_AnnGastroenterol-27-276-g003_undivided_1_1.webp	Photograph of the abdominoperineal resection specimen showing the perianal scar at site of the excised fistula, the perianal abscess and the sigmoid tumor (marked with arrows)	Surgery consisted of abdominoperineal resection (APR) with excision of the sigmoid mass, perianal mass and the scar site of excised fistula (Fig. 3).	F3	PMC4073032_01	PMC4073032	file_0034690	PMC4073032_01	CC BY-NC-SA
PMC4073032_01_AnnGastroenterol-27-276-g004.jpg	PMC4073032_AnnGastroenterol-27-276-g004_A_1_4.webp	(A) Sections showing moderately differentiated adenocarcinoma of the sigmoid (H& E x 100x); (B) and anal fistula tract lined by inflammatory granulation tissue (H& E x 40x); (C) with tiny foci of adenocarcinoma in the fistulous tract along with pools of extracellular mucin (H& E: 40x); (D) and high magnification showing similar tumour in anal fistula tract as in the sigmoid (H& E: 100x)	Pathological results of the sigmoid tumor revealed moderately differentiated adenocarcinoma with focal signet ring cell morphology up to subserosal fat without lymph node involvement of 12 lymph nodes dissected (T3N0M0) with MSI-H histology (Fig. 4 A). The perianal fistula tract (Fig. 4 B,C) also revealed moderately differentiated adenocarcinoma with extracellular mucin amidst acute inflammation. The histologic appearances of the two malignancies were similar (Fig. 4 A,D).	F4	PMC4073032_01	PMC4073032	file_0034691	PMC4073032_01	CC BY-NC-SA
PMC4073032_01_AnnGastroenterol-27-276-g005.jpg	PMC4073032_AnnGastroenterol-27-276-g005_A_1_4.webp	(A) Sections showing sigmoid adenocarcinoma immunopositive for cytokeratin 20; (B) while immunonegative for cytokeratin 7; (C) and perianal adenocarcinoma immunopositive for cytokeratin 20; (D) while immunonegative for cytokeratin 7	Both the sigmoid cancer and the perianal tumor were CK7- and CK20+ and showed a similar pattern (Fig. 5A-D).	F5	PMC4073032_01	PMC4073032	file_0034695	PMC4073032_01	CC BY-NC-SA
PMC3909696_01_PAMJ-16-18-g002.jpg	PMC3909696_PAMJ-16-18-g002_undivided_1_1.webp	Pelvic computed tomography (CT) shows a hydroaeric level and a pneumo bladder with air bubbles at the level of the vesical wall	An abdominal pelvic computed tomography (CT) without injection of intravenous contrast showed a vesical globe containing air (Figure 2, Figure 3) and the presence of the sight at the level of the left pyelon (Figure 4) confirming the diagnosis of cystitis and pyelonephritis emphysematous.	F0002	PMC3909696_01	PMC3909696	file_0029862	PMC3909696_01	CC BY
PMC3909696_01_PAMJ-16-18-g003.jpg	PMC3909696_PAMJ-16-18-g003_undivided_1_1.webp	Computed tomography scan of the pelvic shows air bubbles at the level of the vesical wall	An abdominal pelvic computed tomography (CT) without injection of intravenous contrast showed a vesical globe containing air (Figure 2, Figure 3) and the presence of the sight at the level of the left pyelon (Figure 4) confirming the diagnosis of cystitis and pyelonephritis emphysematous.	F0003	PMC3909696_01	PMC3909696	file_0029863	PMC3909696_01	CC BY
PMC3909696_01_PAMJ-16-18-g004.jpg	PMC3909696_PAMJ-16-18-g004_undivided_1_1.webp	The computed tomography scan with the arrow pointing to the emphysematous pyelitis	An abdominal pelvic computed tomography (CT) without injection of intravenous contrast showed a vesical globe containing air (Figure 2, Figure 3) and the presence of the sight at the level of the left pyelon (Figure 4) confirming the diagnosis of cystitis and pyelonephritis emphysematous.	F0004	PMC3909696_01	PMC3909696	file_0029864	PMC3909696_01	CC BY
PMC5015792_01_OC-06-02-g-004.jpg	PMC5015792_OC-06-02-g-004_A_1_2.webp	A) OCT of the left eye at presentation reveals subretinal fluid overlying the macular lesion. B) OCT image three weeks after presentation and before treatment demonstrates complete anatomical resolution.	Indocyanine green angiography (ICGA) revealed persistent leakage of the choriocapillaris and hypofluorescence areas in the early and late phases (Figure 4 (Fig. 4)).	F4	PMC5015792_01	PMC5015792	file_0058683	PMC5015792_01	CC BY
PMC10035883_01_fneur-14-1124540-g0001.jpg	PMC10035883_fneur-14-1124540-g0001_A_1_2.webp	(A) Cervical plexus MRI: fluid attenuation inversion recovery (FLAIR) shows slightly thickened bilateral nerve roots at C4/C5-C6/C7. (B) Lumbosacral plexus MRI: fluid attenuation inversion recovery (FLAIR) shows bilateral nerve root thickening at the L1/L2-L4/L5 intervertebral space, with slightly higher signal intensity, especially at L2/L3-L4/L5.	An MRI of the cervical plexus is shown in Figure 1A, an MRI of the lumbosacral plexus in Figure 1B, and musculoskeletal ultrasounds are shown in Figure 2.	F1	PMC10035883_01	PMC10035883	file_0000892	PMC10035883_01	CC BY
PMC8329363_01_fmed-08-691686-g0001.jpg	PMC8329363_fmed-08-691686-g0001_A_1_6.webp	The main clinical manifestation of the patient before surgery. (A) shows the obvious cataract in the right eye of the patient. (B) shows the exudative retinal detachment in the inferior part of the retina, accompanied by naevus-like multifocal reddish patches in the superior part of the fundus. Total retinal detachment was observed in the posterior pole of the retina when the patient was in the supine position (C). (D-F) show the similar clinical manifestation of the left eye.	A slit-lamp examination of the anterior segment of the eyes showed obviously tortuous and dilated episcleral vessels (Supplementary Figure 1), significantly decreased depth of anterior chamber, iris bombe, slight eversion of iris pigment at the pupillary margin and prominent cortical opacity of the lens (Figure 1). There were no signs of synechia, neovascular membranes in the iris, or active inflammation (Figure 1). Color fundus retinal photography revealed typical exudative retinal detachment in both eyes (Figure 1), accompanied by naevus-like multifocal reddish patches under RPE in the superior part of the fundus.	F1	PMC8329363_01	PMC8329363	file_0122036	PMC8329363_01	CC BY
PMC8329363_01_fmed-08-691686-g0002.jpg	PMC8329363_fmed-08-691686-g0002_A_1_3.webp	Pathological examination of biopsies collected from the choroid during surgery. (A) shows hematoxylin-eosin (HE) staining of the biopsies, which revealed a predominant spindle-shaped melanocytic cell mass. Immunohistochemical staining showed that the tissue was positive for antibodies against S-100 (B) and negative for antibodies against Ki67 (C).	Haematoxylin-eosin (HE) staining for biopsies from the choroid suggested predominantly spindle-shaped melanocytic cell masses, while immunohistochemistry showed that the samples were positive for antibodies against S-100, and negative for antibodies against Ki67, LCA, PAX-5, and SOX-10 (Figure 2).	F2	PMC8329363_01	PMC8329363	file_0122042	PMC8329363_01	CC BY
PMC7369465_01_gr1.jpg	PMC7369465_gr1_undivided_1_1.webp	PET-CT: Increased metabolic activity of FDG at the level of a tumor of the right adrenal gland (36 x 29 mm), possibly pheochromocytoma.		fig0005	PMC7369465_01	PMC7369465	file_0105791	PMC7369465_01	CC BY-NC-ND
PMC7369465_01_gr3.jpg	PMC7369465_gr3_undivided_1_1.webp	USG of the thyroid gland: right lobe with one heterogeneous node 7 mm and multiple calcinates, intronodular vascularity.		fig0015	PMC7369465_01	PMC7369465	file_0105792	PMC7369465_01	CC BY-NC-ND
PMC7369465_01_gr4.jpg	PMC7369465_gr4_undivided_1_1.webp	Macroscopic view of the thyroid gland, 8 x 3 cm.	Total thyroidectomy was performed, macroscopic examination revealed multinodular thyroid gland with dimensions 8 x 3 cm (Fig. 4).	fig0020	PMC7369465_01	PMC7369465	file_0105793	PMC7369465_01	CC BY-NC-ND
PMC5356200_01_CG-CGCR170004F001.jpg	PMC5356200_CG-CGCR170004F001_undivided_1_1.webp	EGD showing a large, benign-appearing mass in the duodenum.	Further evaluation with esophagogastroduodenoscopy (EGD) and colonoscopy revealed a large, benign-appearing mass in the duodenum (Figure 1).	F1	PMC5356200_01	PMC5356200	file_0065489	PMC5356200_01	CC BY-NC-ND
PMC5356200_01_CG-CGCR170004F002.jpg	PMC5356200_CG-CGCR170004F002_undivided_1_1.webp	EUS revealing 3 x 4-cm subepithelial mass (arrows) arising from the submucosa with numerous cystic spaces and mixed echogenicity.	Subsequent endoscopic ultrasound (EUS) revealed a 3 x 4-cm subepithelial mass arising from the submucosa with numerous cystic spaces and mixed echogenicity (Figure 2).	F2	PMC5356200_01	PMC5356200	file_0065490	PMC5356200_01	CC BY-NC-ND
PMC5356200_01_CG-CGCR170004F003.jpg	PMC5356200_CG-CGCR170004F003_undivided_1_1.webp	Resected 3 x 12-cm polyp.	Transduodenal resection per hepatobiliary surgery revealed a 3 x 12-cm polyp (Figure 3).	F3	PMC5356200_01	PMC5356200	file_0065491	PMC5356200_01	CC BY-NC-ND
PMC5356200_01_CG-CGCR170004F004.jpg	PMC5356200_CG-CGCR170004F004_undivided_1_1.webp	Brunner's gland hyperplasia with secondary polyp formation that extends to the margin.	The transition from small nests of Brunner's glands and other submucosal elements to a multinodular proliferation composed entirely of closely spaced Brunner's glands was also noted (Figure 4).	F4	PMC5356200_01	PMC5356200	file_0065492	PMC5356200_01	CC BY-NC-ND
PMC7399133_01_fneur-11-00763-g0001.jpg	PMC7399133_fneur-11-00763-g0001_A_1_4.webp	No abnormalities are detectable on the T1-weighted (A) and T2-weighted (B) magnetic resonance imaging (MRI) sequences. The diffusion-weighted imaging (DWI; C) shows the typical features of "cortical ribboning" in the cortex and subcortex of bilateral frontal, temporal, and occipital lobes on DWI (C). On the apparent diffusion coefficient map (ABC; D), there is low signal intensity in the cortex and subcortex of the bilateral frontal, temporal, and occipital lobes.	However, abnormal high signal in two or more cerebral cortex regions, referred to as "cortical ribboning" (Figure 1), and/or the basal ganglia, was incidentally found in the DWI of all four patients, which alerted physicians to suspect a diagnosis of CJD.	F1	PMC7399133_01	PMC7399133	file_0106399	PMC7399133_01	CC BY
PMC7399133_01_fneur-11-00763-g0002.jpg	PMC7399133_fneur-11-00763-g0002_undivided_1_1.webp	The typical presence of periodic sharp wave complexes (PSWCs) on the electrocephalogram of patient 1.	Patients 1 and 3 had characteristic period sharp wave complexes (PSWCs; Figure 2) recorded by EEG.	F2	PMC7399133_01	PMC7399133	file_0106403	PMC7399133_01	CC BY
PMC6296698_01_ijcn-13-107-g002.jpg	PMC6296698_ijcn-13-107-g002_left_1_2.webp	Brain CT scan without contrast (left) on first day showing dim hypodensity in the left cerebellar hemisphere and sagittal plane of brain MRI (right) on second day	The first EEG report was mildly abnormal due to some spike and wave discharges (Figure 2 Left) and in the last EEG report, there were some background attenuations without epileptiform activity (Figure 2 Right).	F2	PMC6296698_01	PMC6296698	file_0086987	PMC6296698_01	CC BY
PMC6296698_01_ijcn-13-107-g003.jpg	PMC6296698_ijcn-13-107-g003_left_1_2.webp	First EEG; Taken while the patient is sleep (left), Second EEG; Taken while the patient is awake (right).	Findings on the first brain CT scan were a dim hypodensity in the left cerebellar hemisphere accompanied by a mild generalized ventriculomegaly (Figure 3 Left). In the MRI report, there were abnormal low T1 and high T2 signal intensity in left cerebellar hemisphere involving superior and middle cerebellar peduncles in the same side as well (Figure 3 Right , Figure 4 Middle), restriction was noted in this region.	F3	PMC6296698_01	PMC6296698	file_0086989	PMC6296698_01	CC BY
PMC6296698_01_ijcn-13-107-g004.jpg	PMC6296698_ijcn-13-107-g004_left_1_3.webp	Cerebellar diffusion-weighted image (ADC map) (left) and axial T2 image (middle) showing infarcts at left cerebellar hemisphere on the second day and normal brain MRV (right).	The MRV's result was also normal (Figure 4 Right). In the MRI report, there were abnormal low T1 and high T2 signal intensity in left cerebellar hemisphere involving superior and middle cerebellar peduncles in the same side as well (Figure 3 Right , Figure 4 Middle), restriction was noted in this region. DWI findings were consistent with cerebellar infarction in this region (Figure 4 Left).	F4	PMC6296698_01	PMC6296698	file_0086991	PMC6296698_01	CC BY
PMC6296698_01_ijcn-13-107-g005.jpg	PMC6296698_ijcn-13-107-g005_left_1_3.webp	Brain CT scan on fourth day showing infarction on the same area along with obstructive hydrocephaly (left), Brain CT scan after inserting the drain in left lateral ventricle (middle), Brain CT scan after hemispherectomy of the left hemisphere of the cerebellum and extracting the drain (right).	On the second brain CT scan that was 48 h after the MRI, there was an intense hypodensity arising from cytotoxic edema in the left cerebellar hemisphere with concomitant cortical entanglement exerted pressure on fourth ventricle and had resulted in hydrocephaly, severe ventriculomegaly was also seen in the CT scan (Figure 5 Left) . On the third brain CT which was after the patient's surgery, there were evidence of craniotomy in occipital bone on the left side and hemispherectomy of the left hemisphere of the cerebellum, the drain in the left lateral ventricle was in its appropriate position (Figure 5 Middle). The last brain CT scan had no new findings and the drain was extracted from the brain (Figure 5 Right).	F5	PMC6296698_01	PMC6296698	file_0086994	PMC6296698_01	CC BY
PMC3959373_01_AnnGastroenterol-25-268-g001.jpg	PMC3959373_AnnGastroenterol-25-268-g001_undivided_1_1.webp	Small bowel videocapsule endoscopy (PillCam SB 2, Given Imaging, Israel, magnification x8) showing linear whitish lesions surrounded by reddish mucosa	A small bowel videocapsule endoscopy (SBVCE) study showed mucosal areas of denuded villi and prominent small bowel submucosal vessels in the jejunum, multiple linear whitish lesions surrounded by reddish mucosa (Fig. 1), and parasites within the ileal fluid, entering the ileal mucosa (Fig. 2).	F1	PMC3959373_01	PMC3959373	file_0032009	PMC3959373_01	CC BY-NC-SA
PMC6175750_01_gr5.jpg	PMC6175750_gr5_undivided_1_1.webp	Flexible sigmoidoscopy three months after a stapled TAMIS.	On follow-up rigid proctosigmoidoscopy, the residual stellate scar, which was less than 1 cm, was confirmed to be at 14 cm from the anal verge in the left lateral position (Fig. 5).	fig0025	PMC6175750_01	PMC6175750	file_0085057	PMC6175750_01	CC BY-NC-ND
PMC2259370_01_1752-1947-2-30-1.jpg	PMC2259370_1752-1947-2-30-1_undivided_1_1.webp	Supine shows distended bowel loops.	Abdominal radiographs revealed features of intestinal obstruction, with gaseous distension of the bowel especially of the small bowel with multiple air fluid levels and paucity of gas in the pelvis (see Figures 1 and 2).	F1	PMC2259370_01	PMC2259370	file_0011491	PMC2259370_01	CC BY
PMC2259370_01_1752-1947-2-30-2.jpg	PMC2259370_1752-1947-2-30-2_undivided_1_1.webp	Erect film shows multiple air-fluid levels.	Abdominal radiographs revealed features of intestinal obstruction, with gaseous distension of the bowel especially of the small bowel with multiple air fluid levels and paucity of gas in the pelvis (see Figures 1 and 2).	F2	PMC2259370_01	PMC2259370	file_0011492	PMC2259370_01	CC BY
PMC4531034_01_ijnrd-8-077Fig1.jpg	PMC4531034_ijnrd-8-077Fig1_A_1_8.webp	Microscopic finding of kidney biopsy with hematoxylin and eosin stain Periodic acid Schiff (PAS) stain, and Jones methionine silver (JMS) stain.. Notes: (A) Nodular sclerosis (big arrow) and thickened basement membrane (small arrow) - JMS. (B) Mesangial proliferation - PAS. (C) Neutrophil infiltration - PAS. (D) Cellular crescent. (E) RBC cast (arrow). (F) Focal acute tubular injury - JMS (arrow). (G) IF: C3 glomerulus. (H) IF: IgA glomerulus. G and H show the "starry sky" appearance.. Abbreviations: RBC, red blood cell; IF, Immunofluorescence; PIGN, post infectious glomerulonephritis.	The glomerular basement membranes appear diffusely thickened with focal duplications. (Figure 1A) Superimposed on this nodular sclerosis, there is mild to moderate mesangial hypercellularity and segmental to global endocapillary proliferation (Figure 1B) including infiltrating neutrophils. (Figure 1C) There is endocapillary and focal extracapillary proliferative and exudative features: cellular/fibrocellular crescents; arteries and arterioles are narrowed by moderately severe intimal sclerosis; (Figure 1D) RBC casts (Figure 1E) and focal acute tubular injury. Figure 1F; the immunofluorescence (IF) findings of granular global mesangial and "starry-sky" pattern of glomerular capillary wall positivity for IgA and C3 (Figure 1G and H) support IgA-dominant post-infectious glomerulonephritis (IgA-PIGN) with endocapillary and focal extracapillary proliferative and exudative features associated with staphylococcal infection.	f1-ijnrd-8-077	PMC4531034_01	PMC4531034	file_0043996	PMC4531034_01	CC BY-NC
PMC4246683_01_OL-09-01-0131-g00.jpg	PMC4246683_OL-09-01-0131-g00_A_1_3.webp	(A) Marginal facial asymmetry was observed on the left side of the patient's face. (B and C) Intraoral images were captured showing a large mass located in the buccal and palatal aspect of the edentulous alveolus of the left maxilla, in the area between the second premolar and the first molar. The mucosal surface was covered with rough hemorrhagic papules, which were pink-red in color.	Extraoral examination revealed marginal left-sided facial asymmetry and tenderness (Fig. 1A); however, the patient experienced no abnormal sensation in the left buccal area. The intraoral examination revealed a mass, 25x35-mm in diameter, located in the buccal and palatal aspect of the edentulous alveolus of the left maxilla, in the area between the second premolar and the first molar (Fig. 1B and C).	f1-ol-09-01-0131	PMC4246683_01	PMC4246683	file_0037296	PMC4246683_01	CC BY
PMC4246683_01_OL-09-01-0131-g01.jpg	PMC4246683_OL-09-01-0131-g01_undivided_1_1.webp	A panoramic radiograph revealed a dome-shaped radiopaque mass with well-defined margins extending from the left maxilla to the maxillary sinus.	The lesion caused the floor of the antrum to be elevated (Fig. 2).	f2-ol-09-01-0131	PMC4246683_01	PMC4246683	file_0037299	PMC4246683_01	CC BY
PMC4246683_01_OL-09-01-0131-g03.jpg	PMC4246683_OL-09-01-0131-g03_A_1_2.webp	(A) Axial 18F-fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography revealed FDG accumulation in the lesion in the left maxilla (maximum standardized uptake value, 12.2). (B) No other abnormal FDG accumulation was detected elsewhere by FDG-PET.	A section of the elevated sinus floor had been destroyed (Fig. 3C). 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) detected FDG uptake in the left maxilla [maximum standardized uptake value, (SUVmax), 12.4; Fig. 4A] and in two submandibular lymph nodes (SUVmax, 2.2). No abnormal FDG uptake that would have been indicative of another primary tumor or distant metastasis was detected on the FDG-PET images (Fig. 4B).	f4-ol-09-01-0131	PMC4246683_01	PMC4246683	file_0037300	PMC4246683_01	CC BY
PMC4246683_01_OL-09-01-0131-g04.jpg	PMC4246683_OL-09-01-0131-g04_A_1_3.webp	Histopathological observations. (A) The tumor mass was located in the center of the maxilla and extended to the surface epithelium. The epithelium of the maxillary sinus was not involved. (B) The tumor cells formed atypical squamous epithelium, exhibiting features of squamous cell carcinoma (magnification, x2). (C) The surface of the mass was covered by non-cancerous oral mucosa with ulcers, indicating an intraosseous origin (magnification, x2).	The histopathological examination of the excised specimen revealed tumor cells consisting of atypical squamous epithelial cells with enlarged nuclei, which had invaded the submucosal connective tissue and bone (Fig. 5A-C).	f5-ol-09-01-0131	PMC4246683_01	PMC4246683	file_0037302	PMC4246683_01	CC BY
PMC4352650_01_AJNS-10-60b-g001.jpg	PMC4352650_AJNS-10-60b-g001_undivided_1_1.webp	Postcontrast sagittal magnetic resonance image showing a heterogeneously enhancing tumor involving the lateral, third and fourth ventricles. Tumor is noted to extend into the cistrna magna (arrow)	Magnetic resonance imaging demonstrated a well-defined lobulated intraventricular mass lesion occupying lateral ventricles, third ventricle, fourth ventricle and extending into cisterna magna through foramen of magendi [Figure 1 and 2].	F1	PMC4352650_01	PMC4352650	file_0040258	PMC4352650_01	CC BY-NC-SA
PMC4352650_01_AJNS-10-60b-g002.jpg	PMC4352650_AJNS-10-60b-g002_undivided_1_1.webp	Postcontrast coronal magnetic resonance image demonstrates tumor extension into both lateral ventricles. It extends through the third ventricle into the fourth ventricle	Magnetic resonance imaging demonstrated a well-defined lobulated intraventricular mass lesion occupying lateral ventricles, third ventricle, fourth ventricle and extending into cisterna magna through foramen of magendi [Figure 1 and 2].	F2	PMC4352650_01	PMC4352650	file_0040259	PMC4352650_01	CC BY-NC-SA
PMC10310325_01_can-17-1562fig1.jpg	PMC10310325_can-17-1562fig1_undivided_1_1.webp	Echocardiogram with transthoracic Doppler showing a mass in the region. Source: Image provided by the patient.	She underwent transthoracic echocardiography (Figure 1), which showed cavitary enlargement of the left atrium, moderate to important mitral stenosis with mass adhered to the anterior leaflet, a systolic function of the left ventricle preserved at rest and mild aortic and tricuspid insufficiencies.	figure1	PMC10310325_01	PMC10310325	file_0007345	PMC10310325_01	CC BY
PMC10310325_01_can-17-1562fig2.jpg	PMC10310325_can-17-1562fig2_undivided_1_1.webp	Immune-histochemistry. Source: Image provided by the patient.	The morphology described was myxoid fusocellular tumour with cellular anaplasia, and the immunohistochemical study with desmin (Figure 2) showed that the neoplastic cells were positive for D33 and smooth muscle actin 1-4; and negative for CD34, AE1/AE3, FSD and protein S100; findings compatible with undifferentiated high-grade LMS in the left atrium.	figure2	PMC10310325_01	PMC10310325	file_0007346	PMC10310325_01	CC BY
PMC8728800_02_PAMJ-40-181-g001.jpg	PMC8728800_PAMJ-40-181-g001_A_1_4.webp	histologic and immunohistochemical findings in the left ovary; (A) a hematoxylin-eosin stained image of an ectopic adrenal tissue in the left ovary; microscopic examination shows pale cells with spongy-appearing cytoplasm and polygonal cells with acidophilic granular cytoplasm, which is reminiscent of zona fasciculata and zona reticularis of the adrenal cortex ((A) x20, (B) x100); (C, D) immunohistochemical stains are positive for inhibin-A ((C) x200) and Melan-A ((D) x200)	The tissue consisted of pale cells with spongy-appearing cytoplasm and polygonal cells with acidophilic granular cytoplasm, which is reminiscent of zona fasciculata and zona reticularis of the adrenal cortex (Figure 1A, Figure 1B). The ectopic tissue was reactive for inhibin-A and Melan-A, which favored the diagnosis of ectopic adrenal tissue (Figure 1C, Figure 1D).	F1	PMC8728800_02	PMC8728800	file_0129375	PMC8728800_02	CC BY
PMC5437796_01_JPN-12-72-g002.jpg	PMC5437796_JPN-12-72-g002_a_1_4.webp	(a) Postoperative midsagittal computed tomography showing adequate reduction. (b) Coronal computed tomography showing correction of vertical dislocation with C1-C2 joints drilled flat with spacers along with screws in C2 body and C1 lateral masses. (c) Parasagittal showing the spacers and screws. (d) Posterior view of reconstructed computed tomography showing bone grafts form occiput to C4	Immediate postoperative scan revealed good reduction of the dislocation and was discharged after a week [Figure 2].	F2	PMC5437796_01	PMC5437796	file_0068117	PMC5437796_01	CC BY-NC-SA
PMC5437796_01_JPN-12-72-g003.jpg	PMC5437796_JPN-12-72-g003_undivided_1_1.webp	X-ray in the 2nd postoperative week showing right lower lobe pneumonia	Although his improved neurological status was maintained, the chest X-ray showed right lower lung showing pneumatic patch [Figure 3].	F3	PMC5437796_01	PMC5437796	file_0068121	PMC5437796_01	CC BY-NC-SA
PMC5422736_01_crg-0011-0201-g01.jpg	PMC5422736_crg-0011-0201-g01_undivided_1_1.webp	Ascitic fluid protein electrophoresis showing M spike in the beta-globulin region.	Protein electrophoresis of the ascitic fluid showed an M spike in the beta-globulin region (Fig. 1).	F1	PMC5422736_01	PMC5422736	file_0067631	PMC5422736_01	CC BY-NC
PMC3616049_01_amjcaserep-13-75-g001.jpg	PMC3616049_amjcaserep-13-75-g001_undivided_1_1.webp	MRI revealed right basilar meningeal enhancement concerning for meningitis and acute infarction of the right basil ganglia.	MRI of the brain and Neurologic consult where obtained. MRI with and without contrast revealed right basilar meningeal enhancement with an acute right basil ganglia infarction (Figures 1,2).	f1-amjcaserep-13-75	PMC3616049_01	PMC3616049	file_0024260	PMC3616049_01	NO-CC CODE
PMC3616049_01_amjcaserep-13-75-g003.jpg	PMC3616049_amjcaserep-13-75-g003_undivided_1_1.webp	CT Thorax findings consist of right upper lobe cluster of nodules with central cavitations.	CSF where negative for acid fast bacilli, and PCR of the CSF was negative for TB on two different occasions. CT of the chest was obtained to look for possible source of infection and revealed right upper lobe nodules with central cavitations (Figures 3,4).	f3-amjcaserep-13-75	PMC3616049_01	PMC3616049	file_0024261	PMC3616049_01	NO-CC CODE
PMC3616049_01_amjcaserep-13-75-g005.jpg	PMC3616049_amjcaserep-13-75-g005_undivided_1_1.webp	CT guided biopsy right lung nodule reveals acid fast bacilli (arrows).	Biopsy of the lung was performed and pathology revealed necrotizing granulomatous inflammation with acid fast bacilli (Figures 5,6).	f5-amjcaserep-13-75	PMC3616049_01	PMC3616049	file_0024262	PMC3616049_01	NO-CC CODE
PMC4643352_01_gr1.jpg	PMC4643352_gr1_undivided_1_1.webp	CTA imaging of below knee vessels.	An arterial duplex ultrasound and CT Angiogram (Fig. 1) found that the anterior tibial artery (ATA), which was the target angiosome vessel, was occluded.	fig0005	PMC4643352_01	PMC4643352	file_0046839	PMC4643352_01	CC BY-NC-ND
PMC4643352_03_gr6.jpg	PMC4643352_gr6_a_1_4.webp	(a) Angiogram of left distal PTA. (b) Unsuccessful attempt at passage of wire towards distal PTA. (c) Crossing the PTA beyond the retrograde puncture point. (d) Post angioplasty of PTA.	However, the guide wire was not able to re-enter the true lumen of the distal PTA, despite using a supporting catheter and a multitude of wires (Fig. 6a and b). There was good flow into the medial plantar artery on completion (Fig. 6c and d).	fig0030	PMC4643352_03	PMC4643352	file_0046840	PMC4643352_03	CC BY-NC-ND
PMC8668381_04_10-1055-s-0041-1740321-i200532cr-2.jpg	PMC8668381_10-1055-s-0041-1740321-i200532cr-2_A_1_2.webp	( A ) This is the surgeon's view of posterolateral incision of right thoracotomy. Yellow loop encircles the esophagus. The esophageal anastomosis was intact. Red vessel loop encircles the anomalous vessels supplying to right lower lobe. Blue loop encircles esophageal connection that enters into the right lower lobe which is being retracted by retractors. ( B ) Postoperative upper gastrointestinal contrast image after definitive surgery.	The right lower lobe was separated from the esophagus, by ligating and dividing these two fistulous connections, which bore more resemblance to bronchial type tissue, followed by a partial lobectomy ( Fig. 2A ). A postoperative upper GI contrast series identified a patent esophageal anastomosis, no leakage, and no fistulous connections ( Fig. 2B ).	FI200532cr-2	PMC8668381_04	PMC8668381	file_0128477	PMC8668381_04	CC BY
PMC10046697_01_OTO2-7-e26-g001.jpg	PMC10046697_OTO2-7-e26-g001_undivided_1_1.webp	Computed tomography sinus. It shows frontal ethmoid mucocele destroying the left lamina papyracea. Note intact frontal sinus.	A computed tomography sinus was then done in the office that revealed an expansile mass destroying the left lamina papyracea and fiberoptic laryngoscopy demonstrated a mass in the posterior nasopharynx adjacent to the left orbit and posterior to the left middle turbinate (Figure 1).	oto226-fig-0001	PMC10046697_01	PMC10046697	file_0001127	PMC10046697_01	CC BY
PMC10046697_01_OTO2-7-e26-g002.jpg	PMC10046697_OTO2-7-e26-g002_undivided_1_1.webp	Fiberoptic photo. It displays a "knife" like object penetrating the left orbital tissue. The open frontal sinus can be seen above.	A video endoscopy in the office revealed a sharp object penetrating the left orbital tissue (Figure 2).	oto226-fig-0002	PMC10046697_01	PMC10046697	file_0001128	PMC10046697_01	CC BY
PMC3921775_01_CEJU-65-00181-g001.jpg	PMC3921775_CEJU-65-00181-g001_A_1_2.webp	A. (left), Histopathological examination shows moderately differentiated adenocarcinoma (Gleason score 3 + 4 = 7) (H & E staining, x200). B. (right), The biopsy of the swollen inguinal lymph node shows adenocarcinoma. The tumor cell cytoplasm shows vacuolar degeneration (H & E staining, x200).	The pathological finding was a moderately differentiated adenocarcinoma (Gleason score 3 + 4 = 7) (Fig. 1A). Pathological findings revealed metastatic prostate cancer (Fig. 1B).	F0001	PMC3921775_01	PMC3921775	file_0030663	PMC3921775_01	CC BY-NC-ND
PMC3921775_01_CEJU-65-00181-g002.jpg	PMC3921775_CEJU-65-00181-g002_A_1_2.webp	A. (top), A CT scan shows the swollen left inguinal lymph nodes with maximum size of 2cm in diameter. B. (bottom), The maximum size of the lymph nodes decreased to 8 mm in diameter due to secondary hormonal therapy.	Twenty-one months after the biochemical recurrence, the PSA level increased to 10.4 ng/mL and a CT scan showed left inguinal lymphadenopathy (Fig. 2A). The size of the lymph node decreased to 8 mm in diameter, and no other metastatic lesions were found (Fig. 2B).	F0002	PMC3921775_01	PMC3921775	file_0030665	PMC3921775_01	CC BY-NC-ND
PMC4031092_02_PAMJ-16-150-g002.jpg	PMC4031092_PAMJ-16-150-g002_undivided_1_1.webp	Pre-operative Digital subtraction arteriography showing the popliteal artery occlusion	An arteriography was performed and clearly showed a popliteal artery occlusion opposite the incision (Figure 2).	F0002	PMC4031092_02	PMC4031092	file_0033829	PMC4031092_02	CC BY
PMC4031092_02_PAMJ-16-150-g003.jpg	PMC4031092_PAMJ-16-150-g003_undivided_1_1.webp	Intraoperative image: popliteal artery repaired with a reversed saphenous vein interposition graft	The popliteal artery wall was repaired by veinous graft after vascular clamps were applied (Figure 3).	F0003	PMC4031092_02	PMC4031092	file_0033830	PMC4031092_02	CC BY
PMC4559873_01_12907_2015_15_Fig1_HTML.jpg	PMC4559873_12907_2015_15_Fig1_HTML_a_1_2.webp	Gross examination and histologic finding of the cutaneous melanoma. The pigmented skin is located on the lower right leg (black arrow) (a). The resected specimen contained granular, brown, cytoplasmic pigmented cells (white arrow) (hematoxylin-eosin stain, x400) (b)	In August 2008, a 44-year-old female had undergone surgery for resection of a malignant melanoma in the right lower leg and a right inguinal metastatic lymph node (Fig. 1), followed by chemotherapy with doxorubicin, adriamycin, vincristine, and interferon beta (DAV-feron).	Fig1	PMC4559873_01	PMC4559873	file_0045476	PMC4559873_01	CC BY
PMC4559873_01_12907_2015_15_Fig2_HTML.jpg	PMC4559873_12907_2015_15_Fig2_HTML_a_1_3.webp	Sequential images of abdominal computed tomography (CT). These images are from September 2012 (a), November 2012 (b), and December 2012 (c). There is a metastatic tumor in the right lobe of the liver (a). Initially, the hepatic metastases considerably respond to vemurafenib treatment, and they become almost invisible (b). Later, they grow rapidly and rupture, resulting in a large amount of free fluid within the peritoneal cavity surrounding the liver (c). The yellow arrow demonstrates the same tumor in each image	A retrospective and sequential analysis of the CT images suggested that a part of the liver metastases had enlarged rapidly and then ruptured with intratumoral hemorrhage during vemurafenib treatment (Fig. 2).	Fig2	PMC4559873_01	PMC4559873	file_0045478	PMC4559873_01	CC BY
PMC4559873_01_12907_2015_15_Fig3_HTML.jpg	PMC4559873_12907_2015_15_Fig3_HTML_a_1_2.webp	Cross-sectional and histologic findings of the liver at autopsy. The ruptured region (white asterisk) and subcapsular hematoma surrounding the liver (white arrow) (a). The metastatic tumor is well demarcated by a fibrous capsule (yellow arrow) (hematoxylin-eosin stain, x40) (b)	The background liver was completely normal, whereas exposed necrotic tissue and intratumoral hemorrhage were observed at the site of tumor rupture (Fig. 3).	Fig3	PMC4559873_01	PMC4559873	file_0045481	PMC4559873_01	CC BY
PMC10183579_01_fcimb-13-1159891-g001.jpg	PMC10183579_fcimb-13-1159891-g001_A_1_4.webp	Representative results of sample culture and antibiotic susceptibility testing in patients. (A) On day 14, P. aeruginosa was positive in the blood culture and bacterial culture of wound tissues. (B) On day 28, tiny, nonhemolytic, and transparent colonies were observed on the Columbia blood agar plate. (C) Fried-egg-type colonies were observed on mycoplasma medium after 5 days of incubation. (D) The results of antibiotic susceptibility testing showed that M. hominis was susceptible to doxycycline, minocycline, and josamycin but resistant to azithromycin, clarithromycin, norfloxacin, ciprofloxacin, roxithromycin, sparfloxacin, spectinomycin, and levofloxacin.	On day 14, P. aeruginosa was positive in the bacterial culture of wound tissues ( Figure 1A ) and was identified as a multiple-resistant strain with antibiotic susceptibility testing (AST; Kirby-Bauer method), thus amikacin (0.4 g/day) was added to the anti-infective regimen. On day 26, tiny, nonhemolytic, and transparent colonies grew on the Columbia blood agar plate of four blood sample cultures ( Figure 1B ), possibly representing M. hominis. A subculture of blood and wound tissue samples on mycoplasma medium presents as fried-egg-type colonies after 5 days of incubation ( Figure 1C ). The AST with a commercial kit (broth dilution method, Zhongaisheng, Hebei, China) showed that M. hominis was susceptible to doxycycline, minocycline, and josamycin but resistant to azithromycin, clarithromycin, norfloxacin, ciprofloxacin, roxithromycin, sparfloxacin, spectinomycin, and levofloxacin ( Figure 1D ).	f1	PMC10183579_01	PMC10183579	file_0004514	PMC10183579_01	CC BY
PMC10183579_01_fcimb-13-1159891-g002.jpg	PMC10183579_fcimb-13-1159891-g002_undivided_1_1.webp	Phylogenetic analyses of M. hominis isolated from wound tissue and blood samples.	Colonies were then identified to be M. hominis by the matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and further confirmed by 16S rRNA sequencing (primers: 27F, AGAGTTTGATCMTGGCTCAG; 1492R, GGTTACCTTGTTACGACTT) and phylogenetic tree analysis ( Figure 2 ; GenBank Accession No.	f2	PMC10183579_01	PMC10183579	file_0004518	PMC10183579_01	CC BY
PMC10183579_01_fcimb-13-1159891-g003.jpg	PMC10183579_fcimb-13-1159891-g003_undivided_1_1.webp	Timelines of patient's diagnosis and treatment. Red, the anti-infective drugs for P. aeruginosa. Blue, the anti-infective drugs for M. hominis. Abbreviations: CXM, cefuroxime; CSL, cefoperazone-sulbactam; LVX, levofloxacin; MEM, meropenem; TEC, teicoplanin; AMK, amikacin; MFX, moxifloxacin; CAZ-AVI, ceftazidime-avibactam; POL, polymyxin B; MNO, minocycline.	Details regarding the diagnosis and treatment are shown in Figure 3 .	f3	PMC10183579_01	PMC10183579	file_0004519	PMC10183579_01	CC BY
PMC7395541_01_SNI-11-195-g001.jpg	PMC7395541_SNI-11-195-g001_a_1_2.webp	(a) Noncontrast head CT (axial cut) at time of presentation, showing large bifrontal mass (light blue lines) surrounded by brain edema (red lines), causing significant mass effect. (b) Sagittal cut. The tumor has destroyed the frontal bone, extending into the paranasal sinuses (arrow) and intracranially, involving the anterior skull base.	Extended peritumoral brain edema with significant mass effect was also noted [Figure 1].	F1	PMC7395541_01	PMC7395541	file_0106246	PMC7395541_01	CC BY-NC-SA
PMC7395541_01_SNI-11-195-g002.jpg	PMC7395541_SNI-11-195-g002_a_1_6.webp	(a) Histological examination for hematoxylin and eosin (H&E) stain showing a tumor comprised small to medium size cells, some of them with clear cytoplasm. Rhabdoid cells were not noted. The tumor shows areas of necrosis. (b) H&E, x20. (c) The stain for INI1 was negative (loss of expression). Immunohistochemical stains were diffusely and strong positive for EMA (d) and partially positive for SMA (e) and GFAP (f).	The tumor shows areas of necrosis and high levels of mitotic and apoptotic activity [Figure 2a and b]. INI1 was negative (loss of expression) [Figure 2c]. Immunohistochemical stains were diffusely and strong positive for epithelial membrane antigen (EMA) [Figure 2d] and P63, partially positive for smooth muscle antigen (SMA) [Figure 2e], glial fibrillary acidic protein (GFAP) [Figure 2f], B-cell lymphoma 2, and vimentin (VIM), focally positive for pan-KER and KER 8, and negative for OLIG2, S100, desmin, synaptophysin, NEU-N, and chromogranin.	F2	PMC7395541_01	PMC7395541	file_0106248	PMC7395541_01	CC BY-NC-SA
PMC3558351_01_1471-2369-14-13-1.jpg	PMC3558351_1471-2369-14-13-1_A_1_6.webp	Pathologic findings in a patient with rifampin-associated acute tubulointerstitial nephritis and Fanconi syndrome. Light microscopy revealed the extensive mononuclear cell infiltrates including epithelioid histiocytes and eosinophils, mild interstitial fibrosis and tubular atrophy (A: original magnification X 100; B: original magnification x 400). Immunofluorescent stains showed focal granular deposits of immunoglobulin A (C) and complement 3 (D) in mesangial spaces and tubules. Subendothelial electron-dense deposits (E) and expanded mesangial spaces with electron dense deposits (F) were visible using electron microscopy.	A renal biopsy showed extensive mononuclear cell infiltrates, including epithelioid histiocytes and eosinophils, mild interstitial fibrosis, and tubular atrophy (Figure 1A and B). Focal granular deposits of immunoglobulin A (IgA) and complement 3 (C3) were demonstrated in the tubules (Figure 1C and D). The same immunofluorescent positivity was also shown in glomerular mesangium, and electron microscopy showed electron-dense deposits in the subendothelial and mesangial spaces (Figure 1E and F).	F1	PMC3558351_01	PMC3558351	file_0023060	PMC3558351_01	CC BY

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(a-c) Contrast-enhanced T1-weighted sequences show the brain abscess in the right parietal lobe; (d) diffusion-weighted magnetic resonance imaging

On contrast-enhanced magnetic resonance imaging (MRI), a ring-shaped lesion in the right parietal lobe was noted [Figure 1a-c]. The diffusion-weighted images showed an intensive hyperintense signal, which was strongly suspicious for a brain abscess [Figure 1d].

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(a, b) Surgical site after durotomy. No pathological alteration of the brain surface under white light (a), intense fluorescent staining under YE560 (b)

The lesion could not be detected under white light, however, showed intensive fluorescent staining under the YE560 nm filter [Figure 2a and b].

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(a, b) Surgical site after opening of the abscess. Drainage of pus under white light (a) and under YE560 (b). Note the nonfluorescence of the pus

After opening of the capsule, viscous pus poured out [Figure 3a] that was not fluorescing under filtered light [Figure 3b].

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Preoperative CT and CTA images. (A) CT showing the extensive SAH, focusing on the left suprasellar cistern and the base of the Sylvian fissure. (B) Six days later, repeat CT showing absorption of the SAH. (C) CTA of the superior-inferior view showing the arterial network of the right proximal MCA (frame) and an aneurysm (arrow). (D) CTA of the posterior-anterior view showing the aneurysm in detail; the aneurysm (arrow) was located in the A1 segment of the ACA. ACA, anterior cerebral artery; A1, first segment of the ACA; A2, second segment of the ACA; BA, basilar artery; CT, computed tomography; CTA, CT angiography; MCA, middle cerebral artery; R, right; SAH, subarachnoid hemorrhage.

The computed tomography (CT) obtained at the local hospital showed a grade 1 subarachnoid hemorrhage (SAH) on the modified Fisher scale (Figure 1A). CT was repeated and showed that the SAH had been absorbed (Figure 1B). CT angiography showed the arterial network of the right proximal MCA and an aneurysm on the A1 segment of the ACA (Figures 1C, D).

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Angioarchitecture of twig-like MCA. (A) Two-dimensional DSA of the right ICA showing a right twig-like MCA and an aneurysm (arrow) at the origin of the AccMCA from the A1 segment. (B) Three-dimensional DSA showing that the ICA (arrowhead) did not give off the branch supplying the twig-like MCA; the arrow indicates the aneurysm. (C) Three-dimensional DSA showing the AccMCA (arrowhead) as a collateral artery from the A1 segment supplying the twig-like MCA; the arrow indicates the aneurysm. (D) Three-dimensional DSA showing that the AchA (arrowhead) supplies the twig-like MCA. A1, first segment; AccMCA, accessory middle cerebral artery; ACA, anterior cerebral artery; AchA, anterior choroidal artery; DSA, digital subtraction angiography; ICA, internal carotid artery; MCA, middle cerebral artery.

A1 segment of the ACA, and the AccMCA was a collateral artery for the MCA twig (Figure 2). After the three-dimensional reconstruction of the DSA data, the best projection degree showed the aneurysm sac and its neck. An Echemon-10 microcatheter (Medtronic, Irvine, CA, USA) was used to perform the coiling [Axium Prime coils: 3.5 mm x 10 cm, 2 mm x 6 cm, 1.5 mm x 3 cm (Medtronic, Irvine, CA, USA)], and the aneurysm was completely embolized (Figures 3A, B).

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Aneurysm coiling and follow-up CT. (A) DSA roadmap navigation of the right ICA showing that the microcatheter was positioned into the aneurysm sac (arrow); the arrowhead indicates the AccMCA. (B) Postoperative DSA of the right ICA showing that the aneurysm was completely coiled and that the AccMCA (arrowhead) was preserved. (C) Follow-up CT showing normal brain tissue. (D) CT reconstruction showing the coils (arrow). A1, first segment; AccMCA, accessory middle cerebral artery; CT, computed tomography; DSA, digital subtraction angiography; ICA, internal carotid artery; MCA, middle cerebral artery; R, right.

A1 segment of the ACA, and the AccMCA was a collateral artery for the MCA twig (Figure 2). After the three-dimensional reconstruction of the DSA data, the best projection degree showed the aneurysm sac and its neck. An Echemon-10 microcatheter (Medtronic, Irvine, CA, USA) was used to perform the coiling [Axium Prime coils: 3.5 mm x 10 cm, 2 mm x 6 cm, 1.5 mm x 3 cm (Medtronic, Irvine, CA, USA)], and the aneurysm was completely embolized (Figures 3A, B). A postoperative CT at the 3-month follow-up showed that the brain tissue was normal (Figures 3C, D).

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Zone of hair loss.

In 2006, the patient experienced partial hair loss over an area ~1 cm in diameter on the head (Figure 1).

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Ulceration of the oral mucosa.

In January 2014, the patient was admitted to the Stomatological Hospital, and physical examination showed that the oral lesions (Figure 2) resembled LP.

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A, The medial mucosal surfaces of the labia minora had bright red-colored, defect-like lesions, and the vaginal orifice was stenosed with a diameter of 1 cm. Blue arrow: narrow urethral orifice; Black arrow: defect of the mucosa. B, The medial mucosa of the labia minora was smooth and slightly reddened, and the vaginal opening was slightly narrowed. C, The mucosa of the medial labia minora was slightly reddened, smooth, and without defects.

A small speculum was unable to expose the cervix (Figure 3A). Physical examination revealed that the mucosa of the labia minora was smooth, the frenulum labiorum pudendi was lightly chapped and the vaginal elasticity had improved, although the upper vagina still had a ring-like narrowing and no folds (Figure 3B). Gynecological examination showed that the mucosa of the medial labia minora was slightly reddened, smooth, and without defects, the elasticity of the vaginal mucosa was good, and two fingers could be accommodated (see Figure 3C).

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Biopsy of right buccal mucosa (taken beside the ulcer) showing squamous epithelial mucosa and squamous epithelial dyskeratosis. A, Superficial zonular lymphocytes and plasma cells were distributed in the lamina propria, and there was small vessel hyperplasia. Scale bar: 100 mum. B, Lymphocytes were scattered within the epithelium (black arrows). Scale bar: 50 mum.

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Vaginal wall biopsy. A, Squamous epithelial mucosa, with simple and pseudoepithelioma-like hyperplasia (white arrow) in some epithelium, hyperkeratosis and incomplete keratosis, and hyperplasia of interstitial small vessels (black arrow) Scale bar: 100 mum. B, Squamous epithelial mucosa, atrophy of part of the squamous epithelium, scattered superficial dermis, infiltration of focal lymph and plasma cells, and formation of lymphoid follicles (yellow arrows). Scale bar: 100 mum.

The pathological sections were considered to have squamous epithelial mucosal tissue, partial epithelial atrophy, partial simple hyperplasia, hyperkeratosis and incomplete keratosis, scattered focal infiltration of lymphocytes and plasma cells in the superficial dermis with formation of lymphoid follicles, and small vessel hyperplasia (Figure 5A and B).

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Measurement of urine flow rate. A, A maximum urine flow rate of 5.2 mL/s was measured before treatment with urethral dilatation and oral cyclosporine A. B, A maximum urine flow rate of 11.5 mL/s was measured after treatment with urethral dilatation and oral cyclosporine A.

Since the patient had not tolerated the adverse side effects of corticosteroid therapy during previous treatment and had fertility requirements, she was treated with oral cyclosporine A (125 mg/day) combined with physical dilatation of the urethra, and this resulted in an increase in urine flow rate to 11.5 mL/s (Figure 6B).

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(a) T1-weighted magnetic resonance imaging axial section demonstration multiple cysts generating a hypointense signal. Multiple septations can be appreciated significant mass effect can be appreciated. (b) T2-weighted magnetic resonance imaging axial section representing multiple cysts with a hyperintense signal and the cyst walls generating a hypointense signal. (c) T1-contrast enhanced magnetic resonance imaging axial cut showing contrast enhancement of the cyst wall in some regions. (d) Fluid attenuated inversion recovery sequence coronal section showing multiple cysts as hypointense signals and significant mass effect

A magnetic resonance imaging (MRI) brain was performed which showed multiple intracranial cysts predominantly in the right frontal region with significant mass effect [Figure 1].

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(a) Intraoperative photograph demonstrating the durotomy incision and the capsule of a huge hydatid cyst. (b and c) Photograph of daughter/secondary cysts in the brain parenchyma after the first cyst was removed. (d) The main cyst and two daughter cysts after excision with intact capsules

There was significant dural tension, and a c-shaped durotomy was done which revealed a huge hydatid cyst extending toward the lateral ventricle [Figure 2a]. A soft rubber catheter was inserted between the brain parenchyma and the cyst capsule (Dowling's technique); a cleavage plane was established using warm hypertonic saline and the cyst was delivered unruptured [Figure 2d]. Numerous daughter cysts were then identified which were carefully delivered unruptured using the same technique [Figure 2b and c].

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Chest computer tomography with the venous stent dangling in the tricuspid valve apparatus.

One hour postprocedural echocardiography and computed tomography scan ( Fig. 1 ) revealed stent migration into the subvalvular chordal structures of the right ventricle causing significant tricuspid regurgitation.

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Intraoperative finding: Removal of the stent from the tricuspid valve apparatus.

Despite the fact, that the stent was entrapped by subvalvular chordal structures of the tricuspid valve due to the stent design with wire brackets, it was possible to recover it without harming the tricuspid valve and adjacent structures ( Fig. 2 ).

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Raw sleep indices measured in sleep on a given night.

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Sleep stages chart on a given night.

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Rem Latency and BDI-II scores during 3 month follow-up.

As shown in Figures 3, 4, Rem Latency was gradually reduced over the following weeks, followed by a significant reduction to 53 min.

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Chest X-Ray: There is a giant soft tissue, well-demarcated, lobulated mass in the right hemithorax expanding and splaying the adjacent ribs.

A chest X-ray was performed showing a giant soft tissue, well-demarcated, well - demarked mass in the right hemithorax expanding and splaying the adjacent ribs, Fig. 1.

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Fine-needle aspiration cytology. First study: (A) Groups and microfollicles of clear balloon-shaped cells showing abundant fine vesicles in their cytoplasm. Second study: (B) A cluster and a microfollicle of clear balloon-shaped cells can be seen - nuclei are round with a visible nucleolus; (C) A microfollicle is displaying a central lumen - there is slight anisokaryosis. Papanicolaou (Pap) staining: (A-C) x400

There were groups of clear cells or microfollicular structures with a diffusely vacuolated cytoplasm (Figure 1A). Based on these findings the successive diagnoses in two samples were follicular neoplasia (Figure 1, B and C).

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Total thyroidectomy. The right lower lobe contains a 2 cm diameter, solid, pale tan, nodular lesion

The right lower lobe contained a 2 cm diameter encapsulated, solid, pale tan, fleshy, nodular lesion (Figure 2).

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Preoperative chest X-ray, preoperative coronary angiogram, and postoperative chest X-ray. Pseudoaneurysm (red arrow). Panels (A) and (C) Improvement in cardiac maximal dimensions between preoperative day 12 (A) and postoperative day 23 (C) with a reduction in cardiomegaly. Panel (B) Left heart coronary angiogram with dashed line delineating pseudoaneurysm neck.

TEE at our institution further characterized the dehisced mitral ring as well as the LVPA contained by the posterolateral pericardium ( Fig. 1 ). The patient subsequently underwent redo sternotomy for repair of the LVPA repair along with MVR ( Fig. 2 ).

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Intraoperative repair of the pseudoaneurysm. Panel (A) Pseudoaneurysm neck (yellow arrow) and pseudoaneurysm sack (red arrow). Panel (B) Cut anterior leaflet of mitral valve (dashed yellow line). Panel (C) Bovine pericardial patch (blue stars). Panel (D) Surgeon's view: anterior annulus (dashed yellow line), patch (blue star), and noneverting pledgeted annular sutures (red arrows).

The pseudoaneurysm wall was then carefully cleaned of all thrombi with high power suction with an open-ended tip ( Fig. 3A ). The neck of the pseudoaneurysm was patched on the posterior aspect of the heart using a bovine pericardium patch and sewn to the underside of the mitral annulus extending to the anterior and medial aspects of the ventricle ( Fig. 3C ). Pledgeted sutures in a noneverting manner were placed from the ventricular side to the atrial side at the level of the A3-P3 commissure ( Fig. 3D ).

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49-year-old woman with retinoic acid arthropathy. Anteroposterior radiograph of the right elbow shows hyperostosis, especially involving the lateral humeral epicondyle at the origin of the extensor tendons (white arrow). Hyperostosis is also seen involving the sublime tubercle (yellow arrow).

Bilateral elbow radiographs demonstrated hyperostosis, especially involving the proximal ulnas, bilateral triceps tendon insertions, and the right lateral humeral condyle (Figure 1, Figure 2, Figure 3).

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49-year-old woman with retinoic acid arthropathy. Anteroposterior radiograph of the asymptomatic left elbow shows hyperostosis at the sublime tubercle (arrow).

Bilateral elbow radiographs demonstrated hyperostosis, especially involving the proximal ulnas, bilateral triceps tendon insertions, and the right lateral humeral condyle (Figure 1, Figure 2, Figure 3).

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49-year-old woman with retinoic acid arthropathy. Lateral radiograph of the right elbow shows hyperostosis involving the olecranon process, but no soft-tissue swelling adjacent to this site, joint effusion, or fracture.

Bilateral elbow radiographs demonstrated hyperostosis, especially involving the proximal ulnas, bilateral triceps tendon insertions, and the right lateral humeral condyle (Figure 1, Figure 2, Figure 3). No fracture, dislocation, joint effusion, or radiographic evidence of triceps tendon tear was evident in the right elbow (Fig. 3).

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49-year-old woman with retinoic acid arthropathy. Lateral radiograph of the thoracic spine shows flowing ossification of the anterior longitudinal ligament of several thoracic vertebral bodies. The disc spaces and vertebral body heights are normal.

Although no prior elbow radiographs were available for comparison, radiographs of the thoracic spine from two years prior also showed flowing ossification of the anterior longitudinal ligament with relatively maintained disc spaces (Fig. 4).

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49-year-old woman with retinoic acid arthropathy. AP radiograph of the pelvis shows enthesopathy at the iliolumbar ligament insertions (black arrow), anterior superior iliac spines (white arrow), and hamstring tendon (yellow arrow) attachments bilaterally.

An AP radiograph of the pelvis from one year prior showed multiple sites of hyperostosis, including at the iliac crests (Fig. 5).

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MRI head revealing right frontal subgaleal abscess along with involvement of the right frontal bone.

MRI head confirmed the findings (Fig. 1).

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first day, hyperpigmentation macules accompanied by crusting, squama, and macular erythema in the posterior trunk area

Dermatological examination of the posterior trunk region found hyperpigmented macules accompanied by crust, squama and erythematous macules (Figure 1).

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examination of 10% KOH showing clustered spores and pseudo hyphae

Direct microscopic of the skin scrapings on the back using 10% KOH showed clustered spores and pseudohyphae (Figure 2).

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macroscopic culture in Sabouraud's Dextrose Agar (SDA) media showing mucoid brownish white colonies with a smooth surface

Culture in Sabouraud Dextrose Agar (SDA) media added with chloramphenicol incubated at 25 -30 C showed mucoid brownish white colonies with smooth surfaces on the third day (Figure 3), typical of the fungus Candida sp.

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A) gram staining showed purple-colored fungal colony, yeast cells and budding spores; B) LCB (lactofenol cotton blue) staining showed positive results for candida

One week later, gram staining was carried out and positive purple color mildews were obtained (Figure 4).

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carbohydrate fermentation test resulted in a change in colour from purple to orange in glucose, sucrose, and lactose, and gas formation

Further examination was carried out using carbohydrate fermentation to determine the type of candida which showed a change in color from purple to orange in glucose, sucrose, and lactose and gas formed in each of the reagents (Figure 5).

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dermatologic examination on the fifth day showed the lesions on the posterior trunk had dried out

On the fifth day of treatment the lesion showed marked improvement (Figure 6).

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Axial CT scans of patient #4. Left: Discovery CT scan showing a colloid cyst of 13 mm with dilatation of the lateral ventricles and slight asymmetry on the right. Right: CT scan at 6-year follow-up demonstrating absence of the colloid cyst

CT scan of the brain [Figure 4, Left] revealed that there was evidence of a hyperdense colloid cyst within the right third ventricle at the junction of the foramen of Monro with mild dilation of the right lateral ventricle. The most recent axial CT without contrast [Figure 4, Right] from October 2015 demonstrates that the previously noted hyperdense presumed colloid cyst is no longer present.

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Axial section of a contrast-enhanced computed tomography scan of the abdomen and pelvis showing the sigmoid tumor (marked with arrow)

A contrast-enhanced computed tomography of the abdomen and pelvis was performed which revealed a sigmoid tumor (Fig. 1).

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Intraoperative photograph showing the perianal scar at the site of excised fistula and the perianal abscess (marked with arrows)

A day before the surgery he developed another perianal abscess (Fig. 2).

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Photograph of the abdominoperineal resection specimen showing the perianal scar at site of the excised fistula, the perianal abscess and the sigmoid tumor (marked with arrows)

Surgery consisted of abdominoperineal resection (APR) with excision of the sigmoid mass, perianal mass and the scar site of excised fistula (Fig. 3).

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(A) Sections showing moderately differentiated adenocarcinoma of the sigmoid (H& E x 100x); (B) and anal fistula tract lined by inflammatory granulation tissue (H& E x 40x); (C) with tiny foci of adenocarcinoma in the fistulous tract along with pools of extracellular mucin (H& E: 40x); (D) and high magnification showing similar tumour in anal fistula tract as in the sigmoid (H& E: 100x)

Pathological results of the sigmoid tumor revealed moderately differentiated adenocarcinoma with focal signet ring cell morphology up to subserosal fat without lymph node involvement of 12 lymph nodes dissected (T3N0M0) with MSI-H histology (Fig. 4 A). The perianal fistula tract (Fig. 4 B,C) also revealed moderately differentiated adenocarcinoma with extracellular mucin amidst acute inflammation. The histologic appearances of the two malignancies were similar (Fig. 4 A,D).

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(A) Sections showing sigmoid adenocarcinoma immunopositive for cytokeratin 20; (B) while immunonegative for cytokeratin 7; (C) and perianal adenocarcinoma immunopositive for cytokeratin 20; (D) while immunonegative for cytokeratin 7

Both the sigmoid cancer and the perianal tumor were CK7- and CK20+ and showed a similar pattern (Fig. 5A-D).

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Pelvic computed tomography (CT) shows a hydroaeric level and a pneumo bladder with air bubbles at the level of the vesical wall

An abdominal pelvic computed tomography (CT) without injection of intravenous contrast showed a vesical globe containing air (Figure 2, Figure 3) and the presence of the sight at the level of the left pyelon (Figure 4) confirming the diagnosis of cystitis and pyelonephritis emphysematous.

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Computed tomography scan of the pelvic shows air bubbles at the level of the vesical wall

An abdominal pelvic computed tomography (CT) without injection of intravenous contrast showed a vesical globe containing air (Figure 2, Figure 3) and the presence of the sight at the level of the left pyelon (Figure 4) confirming the diagnosis of cystitis and pyelonephritis emphysematous.

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The computed tomography scan with the arrow pointing to the emphysematous pyelitis

An abdominal pelvic computed tomography (CT) without injection of intravenous contrast showed a vesical globe containing air (Figure 2, Figure 3) and the presence of the sight at the level of the left pyelon (Figure 4) confirming the diagnosis of cystitis and pyelonephritis emphysematous.

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A) OCT of the left eye at presentation reveals subretinal fluid overlying the macular lesion. B) OCT image three weeks after presentation and before treatment demonstrates complete anatomical resolution.

Indocyanine green angiography (ICGA) revealed persistent leakage of the choriocapillaris and hypofluorescence areas in the early and late phases (Figure 4 (Fig. 4)).

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(A) Cervical plexus MRI: fluid attenuation inversion recovery (FLAIR) shows slightly thickened bilateral nerve roots at C4/C5-C6/C7. (B) Lumbosacral plexus MRI: fluid attenuation inversion recovery (FLAIR) shows bilateral nerve root thickening at the L1/L2-L4/L5 intervertebral space, with slightly higher signal intensity, especially at L2/L3-L4/L5.

An MRI of the cervical plexus is shown in Figure 1A, an MRI of the lumbosacral plexus in Figure 1B, and musculoskeletal ultrasounds are shown in Figure 2.

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The main clinical manifestation of the patient before surgery. (A) shows the obvious cataract in the right eye of the patient. (B) shows the exudative retinal detachment in the inferior part of the retina, accompanied by naevus-like multifocal reddish patches in the superior part of the fundus. Total retinal detachment was observed in the posterior pole of the retina when the patient was in the supine position (C). (D-F) show the similar clinical manifestation of the left eye.

A slit-lamp examination of the anterior segment of the eyes showed obviously tortuous and dilated episcleral vessels (Supplementary Figure 1), significantly decreased depth of anterior chamber, iris bombe, slight eversion of iris pigment at the pupillary margin and prominent cortical opacity of the lens (Figure 1). There were no signs of synechia, neovascular membranes in the iris, or active inflammation (Figure 1). Color fundus retinal photography revealed typical exudative retinal detachment in both eyes (Figure 1), accompanied by naevus-like multifocal reddish patches under RPE in the superior part of the fundus.

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Pathological examination of biopsies collected from the choroid during surgery. (A) shows hematoxylin-eosin (HE) staining of the biopsies, which revealed a predominant spindle-shaped melanocytic cell mass. Immunohistochemical staining showed that the tissue was positive for antibodies against S-100 (B) and negative for antibodies against Ki67 (C).

Haematoxylin-eosin (HE) staining for biopsies from the choroid suggested predominantly spindle-shaped melanocytic cell masses, while immunohistochemistry showed that the samples were positive for antibodies against S-100, and negative for antibodies against Ki67, LCA, PAX-5, and SOX-10 (Figure 2).

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PET-CT: Increased metabolic activity of FDG at the level of a tumor of the right adrenal gland (36 x 29 mm), possibly pheochromocytoma.

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USG of the thyroid gland: right lobe with one heterogeneous node 7 mm and multiple calcinates, intronodular vascularity.

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Macroscopic view of the thyroid gland, 8 x 3 cm.

Total thyroidectomy was performed, macroscopic examination revealed multinodular thyroid gland with dimensions 8 x 3 cm (Fig. 4).

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EGD showing a large, benign-appearing mass in the duodenum.

Further evaluation with esophagogastroduodenoscopy (EGD) and colonoscopy revealed a large, benign-appearing mass in the duodenum (Figure 1).

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EUS revealing 3 x 4-cm subepithelial mass (arrows) arising from the submucosa with numerous cystic spaces and mixed echogenicity.

Subsequent endoscopic ultrasound (EUS) revealed a 3 x 4-cm subepithelial mass arising from the submucosa with numerous cystic spaces and mixed echogenicity (Figure 2).

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Resected 3 x 12-cm polyp.

Transduodenal resection per hepatobiliary surgery revealed a 3 x 12-cm polyp (Figure 3).

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Brunner's gland hyperplasia with secondary polyp formation that extends to the margin.

The transition from small nests of Brunner's glands and other submucosal elements to a multinodular proliferation composed entirely of closely spaced Brunner's glands was also noted (Figure 4).

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No abnormalities are detectable on the T1-weighted (A) and T2-weighted (B) magnetic resonance imaging (MRI) sequences. The diffusion-weighted imaging (DWI; C) shows the typical features of "cortical ribboning" in the cortex and subcortex of bilateral frontal, temporal, and occipital lobes on DWI (C). On the apparent diffusion coefficient map (ABC; D), there is low signal intensity in the cortex and subcortex of the bilateral frontal, temporal, and occipital lobes.

However, abnormal high signal in two or more cerebral cortex regions, referred to as "cortical ribboning" (Figure 1), and/or the basal ganglia, was incidentally found in the DWI of all four patients, which alerted physicians to suspect a diagnosis of CJD.

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The typical presence of periodic sharp wave complexes (PSWCs) on the electrocephalogram of patient 1.

Patients 1 and 3 had characteristic period sharp wave complexes (PSWCs; Figure 2) recorded by EEG.

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Brain CT scan without contrast (left) on first day showing dim hypodensity in the left cerebellar hemisphere and sagittal plane of brain MRI (right) on second day

The first EEG report was mildly abnormal due to some spike and wave discharges (Figure 2 Left) and in the last EEG report, there were some background attenuations without epileptiform activity (Figure 2 Right).

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First EEG; Taken while the patient is sleep (left), Second EEG; Taken while the patient is awake (right).

Findings on the first brain CT scan were a dim hypodensity in the left cerebellar hemisphere accompanied by a mild generalized ventriculomegaly (Figure 3 Left). In the MRI report, there were abnormal low T1 and high T2 signal intensity in left cerebellar hemisphere involving superior and middle cerebellar peduncles in the same side as well (Figure 3 Right , Figure 4 Middle), restriction was noted in this region.

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Cerebellar diffusion-weighted image (ADC map) (left) and axial T2 image (middle) showing infarcts at left cerebellar hemisphere on the second day and normal brain MRV (right).

The MRV's result was also normal (Figure 4 Right). In the MRI report, there were abnormal low T1 and high T2 signal intensity in left cerebellar hemisphere involving superior and middle cerebellar peduncles in the same side as well (Figure 3 Right , Figure 4 Middle), restriction was noted in this region. DWI findings were consistent with cerebellar infarction in this region (Figure 4 Left).

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Brain CT scan on fourth day showing infarction on the same area along with obstructive hydrocephaly (left), Brain CT scan after inserting the drain in left lateral ventricle (middle), Brain CT scan after hemispherectomy of the left hemisphere of the cerebellum and extracting the drain (right).

On the second brain CT scan that was 48 h after the MRI, there was an intense hypodensity arising from cytotoxic edema in the left cerebellar hemisphere with concomitant cortical entanglement exerted pressure on fourth ventricle and had resulted in hydrocephaly, severe ventriculomegaly was also seen in the CT scan (Figure 5 Left) . On the third brain CT which was after the patient's surgery, there were evidence of craniotomy in occipital bone on the left side and hemispherectomy of the left hemisphere of the cerebellum, the drain in the left lateral ventricle was in its appropriate position (Figure 5 Middle). The last brain CT scan had no new findings and the drain was extracted from the brain (Figure 5 Right).

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Small bowel videocapsule endoscopy (PillCam SB 2, Given Imaging, Israel, magnification x8) showing linear whitish lesions surrounded by reddish mucosa

A small bowel videocapsule endoscopy (SBVCE) study showed mucosal areas of denuded villi and prominent small bowel submucosal vessels in the jejunum, multiple linear whitish lesions surrounded by reddish mucosa (Fig. 1), and parasites within the ileal fluid, entering the ileal mucosa (Fig. 2).

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Flexible sigmoidoscopy three months after a stapled TAMIS.

On follow-up rigid proctosigmoidoscopy, the residual stellate scar, which was less than 1 cm, was confirmed to be at 14 cm from the anal verge in the left lateral position (Fig. 5).

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Supine shows distended bowel loops.

Abdominal radiographs revealed features of intestinal obstruction, with gaseous distension of the bowel especially of the small bowel with multiple air fluid levels and paucity of gas in the pelvis (see Figures 1 and 2).

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Erect film shows multiple air-fluid levels.

Abdominal radiographs revealed features of intestinal obstruction, with gaseous distension of the bowel especially of the small bowel with multiple air fluid levels and paucity of gas in the pelvis (see Figures 1 and 2).

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Microscopic finding of kidney biopsy with hematoxylin and eosin stain Periodic acid Schiff (PAS) stain, and Jones methionine silver (JMS) stain.. Notes: (A) Nodular sclerosis (big arrow) and thickened basement membrane (small arrow) - JMS. (B) Mesangial proliferation - PAS. (C) Neutrophil infiltration - PAS. (D) Cellular crescent. (E) RBC cast (arrow). (F) Focal acute tubular injury - JMS (arrow). (G) IF: C3 glomerulus. (H) IF: IgA glomerulus. G and H show the "starry sky" appearance.. Abbreviations: RBC, red blood cell; IF, Immunofluorescence; PIGN, post infectious glomerulonephritis.

The glomerular basement membranes appear diffusely thickened with focal duplications. (Figure 1A) Superimposed on this nodular sclerosis, there is mild to moderate mesangial hypercellularity and segmental to global endocapillary proliferation (Figure 1B) including infiltrating neutrophils. (Figure 1C) There is endocapillary and focal extracapillary proliferative and exudative features: cellular/fibrocellular crescents; arteries and arterioles are narrowed by moderately severe intimal sclerosis; (Figure 1D) RBC casts (Figure 1E) and focal acute tubular injury. Figure 1F; the immunofluorescence (IF) findings of granular global mesangial and "starry-sky" pattern of glomerular capillary wall positivity for IgA and C3 (Figure 1G and H) support IgA-dominant post-infectious glomerulonephritis (IgA-PIGN) with endocapillary and focal extracapillary proliferative and exudative features associated with staphylococcal infection.

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(A) Marginal facial asymmetry was observed on the left side of the patient's face. (B and C) Intraoral images were captured showing a large mass located in the buccal and palatal aspect of the edentulous alveolus of the left maxilla, in the area between the second premolar and the first molar. The mucosal surface was covered with rough hemorrhagic papules, which were pink-red in color.

Extraoral examination revealed marginal left-sided facial asymmetry and tenderness (Fig. 1A); however, the patient experienced no abnormal sensation in the left buccal area. The intraoral examination revealed a mass, 25x35-mm in diameter, located in the buccal and palatal aspect of the edentulous alveolus of the left maxilla, in the area between the second premolar and the first molar (Fig. 1B and C).

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A panoramic radiograph revealed a dome-shaped radiopaque mass with well-defined margins extending from the left maxilla to the maxillary sinus.

The lesion caused the floor of the antrum to be elevated (Fig. 2).

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(A) Axial 18F-fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography revealed FDG accumulation in the lesion in the left maxilla (maximum standardized uptake value, 12.2). (B) No other abnormal FDG accumulation was detected elsewhere by FDG-PET.

A section of the elevated sinus floor had been destroyed (Fig. 3C). 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) detected FDG uptake in the left maxilla [maximum standardized uptake value, (SUVmax), 12.4; Fig. 4A] and in two submandibular lymph nodes (SUVmax, 2.2). No abnormal FDG uptake that would have been indicative of another primary tumor or distant metastasis was detected on the FDG-PET images (Fig. 4B).

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Histopathological observations. (A) The tumor mass was located in the center of the maxilla and extended to the surface epithelium. The epithelium of the maxillary sinus was not involved. (B) The tumor cells formed atypical squamous epithelium, exhibiting features of squamous cell carcinoma (magnification, x2). (C) The surface of the mass was covered by non-cancerous oral mucosa with ulcers, indicating an intraosseous origin (magnification, x2).

The histopathological examination of the excised specimen revealed tumor cells consisting of atypical squamous epithelial cells with enlarged nuclei, which had invaded the submucosal connective tissue and bone (Fig. 5A-C).

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Postcontrast sagittal magnetic resonance image showing a heterogeneously enhancing tumor involving the lateral, third and fourth ventricles. Tumor is noted to extend into the cistrna magna (arrow)

Magnetic resonance imaging demonstrated a well-defined lobulated intraventricular mass lesion occupying lateral ventricles, third ventricle, fourth ventricle and extending into cisterna magna through foramen of magendi [Figure 1 and 2].

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Postcontrast coronal magnetic resonance image demonstrates tumor extension into both lateral ventricles. It extends through the third ventricle into the fourth ventricle

Magnetic resonance imaging demonstrated a well-defined lobulated intraventricular mass lesion occupying lateral ventricles, third ventricle, fourth ventricle and extending into cisterna magna through foramen of magendi [Figure 1 and 2].

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Echocardiogram with transthoracic Doppler showing a mass in the region. Source: Image provided by the patient.

She underwent transthoracic echocardiography (Figure 1), which showed cavitary enlargement of the left atrium, moderate to important mitral stenosis with mass adhered to the anterior leaflet, a systolic function of the left ventricle preserved at rest and mild aortic and tricuspid insufficiencies.

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Immune-histochemistry. Source: Image provided by the patient.

The morphology described was myxoid fusocellular tumour with cellular anaplasia, and the immunohistochemical study with desmin (Figure 2) showed that the neoplastic cells were positive for D33 and smooth muscle actin 1-4; and negative for CD34, AE1/AE3, FSD and protein S100; findings compatible with undifferentiated high-grade LMS in the left atrium.

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histologic and immunohistochemical findings in the left ovary; (A) a hematoxylin-eosin stained image of an ectopic adrenal tissue in the left ovary; microscopic examination shows pale cells with spongy-appearing cytoplasm and polygonal cells with acidophilic granular cytoplasm, which is reminiscent of zona fasciculata and zona reticularis of the adrenal cortex ((A) x20, (B) x100); (C, D) immunohistochemical stains are positive for inhibin-A ((C) x200) and Melan-A ((D) x200)

The tissue consisted of pale cells with spongy-appearing cytoplasm and polygonal cells with acidophilic granular cytoplasm, which is reminiscent of zona fasciculata and zona reticularis of the adrenal cortex (Figure 1A, Figure 1B). The ectopic tissue was reactive for inhibin-A and Melan-A, which favored the diagnosis of ectopic adrenal tissue (Figure 1C, Figure 1D).

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(a) Postoperative midsagittal computed tomography showing adequate reduction. (b) Coronal computed tomography showing correction of vertical dislocation with C1-C2 joints drilled flat with spacers along with screws in C2 body and C1 lateral masses. (c) Parasagittal showing the spacers and screws. (d) Posterior view of reconstructed computed tomography showing bone grafts form occiput to C4

Immediate postoperative scan revealed good reduction of the dislocation and was discharged after a week [Figure 2].

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X-ray in the 2nd postoperative week showing right lower lobe pneumonia

Although his improved neurological status was maintained, the chest X-ray showed right lower lung showing pneumatic patch [Figure 3].

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Ascitic fluid protein electrophoresis showing M spike in the beta-globulin region.

Protein electrophoresis of the ascitic fluid showed an M spike in the beta-globulin region (Fig. 1).

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MRI revealed right basilar meningeal enhancement concerning for meningitis and acute infarction of the right basil ganglia.

MRI of the brain and Neurologic consult where obtained. MRI with and without contrast revealed right basilar meningeal enhancement with an acute right basil ganglia infarction (Figures 1,2).

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CT Thorax findings consist of right upper lobe cluster of nodules with central cavitations.

CSF where negative for acid fast bacilli, and PCR of the CSF was negative for TB on two different occasions. CT of the chest was obtained to look for possible source of infection and revealed right upper lobe nodules with central cavitations (Figures 3,4).

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CT guided biopsy right lung nodule reveals acid fast bacilli (arrows).

Biopsy of the lung was performed and pathology revealed necrotizing granulomatous inflammation with acid fast bacilli (Figures 5,6).

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CTA imaging of below knee vessels.

An arterial duplex ultrasound and CT Angiogram (Fig. 1) found that the anterior tibial artery (ATA), which was the target angiosome vessel, was occluded.

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(a) Angiogram of left distal PTA. (b) Unsuccessful attempt at passage of wire towards distal PTA. (c) Crossing the PTA beyond the retrograde puncture point. (d) Post angioplasty of PTA.

However, the guide wire was not able to re-enter the true lumen of the distal PTA, despite using a supporting catheter and a multitude of wires (Fig. 6a and b). There was good flow into the medial plantar artery on completion (Fig. 6c and d).

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( A ) This is the surgeon's view of posterolateral incision of right thoracotomy. Yellow loop encircles the esophagus. The esophageal anastomosis was intact. Red vessel loop encircles the anomalous vessels supplying to right lower lobe. Blue loop encircles esophageal connection that enters into the right lower lobe which is being retracted by retractors. ( B ) Postoperative upper gastrointestinal contrast image after definitive surgery.

The right lower lobe was separated from the esophagus, by ligating and dividing these two fistulous connections, which bore more resemblance to bronchial type tissue, followed by a partial lobectomy ( Fig. 2A ). A postoperative upper GI contrast series identified a patent esophageal anastomosis, no leakage, and no fistulous connections ( Fig. 2B ).

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Computed tomography sinus. It shows frontal ethmoid mucocele destroying the left lamina papyracea. Note intact frontal sinus.

A computed tomography sinus was then done in the office that revealed an expansile mass destroying the left lamina papyracea and fiberoptic laryngoscopy demonstrated a mass in the posterior nasopharynx adjacent to the left orbit and posterior to the left middle turbinate (Figure 1).

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Fiberoptic photo. It displays a "knife" like object penetrating the left orbital tissue. The open frontal sinus can be seen above.

A video endoscopy in the office revealed a sharp object penetrating the left orbital tissue (Figure 2).

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A. (left), Histopathological examination shows moderately differentiated adenocarcinoma (Gleason score 3 + 4 = 7) (H & E staining, x200). B. (right), The biopsy of the swollen inguinal lymph node shows adenocarcinoma. The tumor cell cytoplasm shows vacuolar degeneration (H & E staining, x200).

The pathological finding was a moderately differentiated adenocarcinoma (Gleason score 3 + 4 = 7) (Fig. 1A). Pathological findings revealed metastatic prostate cancer (Fig. 1B).

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A. (top), A CT scan shows the swollen left inguinal lymph nodes with maximum size of 2cm in diameter. B. (bottom), The maximum size of the lymph nodes decreased to 8 mm in diameter due to secondary hormonal therapy.

Twenty-one months after the biochemical recurrence, the PSA level increased to 10.4 ng/mL and a CT scan showed left inguinal lymphadenopathy (Fig. 2A). The size of the lymph node decreased to 8 mm in diameter, and no other metastatic lesions were found (Fig. 2B).

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Pre-operative Digital subtraction arteriography showing the popliteal artery occlusion

An arteriography was performed and clearly showed a popliteal artery occlusion opposite the incision (Figure 2).

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Intraoperative image: popliteal artery repaired with a reversed saphenous vein interposition graft

The popliteal artery wall was repaired by veinous graft after vascular clamps were applied (Figure 3).

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Gross examination and histologic finding of the cutaneous melanoma. The pigmented skin is located on the lower right leg (black arrow) (a). The resected specimen contained granular, brown, cytoplasmic pigmented cells (white arrow) (hematoxylin-eosin stain, x400) (b)

In August 2008, a 44-year-old female had undergone surgery for resection of a malignant melanoma in the right lower leg and a right inguinal metastatic lymph node (Fig. 1), followed by chemotherapy with doxorubicin, adriamycin, vincristine, and interferon beta (DAV-feron).

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Sequential images of abdominal computed tomography (CT). These images are from September 2012 (a), November 2012 (b), and December 2012 (c). There is a metastatic tumor in the right lobe of the liver (a). Initially, the hepatic metastases considerably respond to vemurafenib treatment, and they become almost invisible (b). Later, they grow rapidly and rupture, resulting in a large amount of free fluid within the peritoneal cavity surrounding the liver (c). The yellow arrow demonstrates the same tumor in each image

A retrospective and sequential analysis of the CT images suggested that a part of the liver metastases had enlarged rapidly and then ruptured with intratumoral hemorrhage during vemurafenib treatment (Fig. 2).

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Cross-sectional and histologic findings of the liver at autopsy. The ruptured region (white asterisk) and subcapsular hematoma surrounding the liver (white arrow) (a). The metastatic tumor is well demarcated by a fibrous capsule (yellow arrow) (hematoxylin-eosin stain, x40) (b)

The background liver was completely normal, whereas exposed necrotic tissue and intratumoral hemorrhage were observed at the site of tumor rupture (Fig. 3).

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Representative results of sample culture and antibiotic susceptibility testing in patients. (A) On day 14, P. aeruginosa was positive in the blood culture and bacterial culture of wound tissues. (B) On day 28, tiny, nonhemolytic, and transparent colonies were observed on the Columbia blood agar plate. (C) Fried-egg-type colonies were observed on mycoplasma medium after 5 days of incubation. (D) The results of antibiotic susceptibility testing showed that M. hominis was susceptible to doxycycline, minocycline, and josamycin but resistant to azithromycin, clarithromycin, norfloxacin, ciprofloxacin, roxithromycin, sparfloxacin, spectinomycin, and levofloxacin.

On day 14, P. aeruginosa was positive in the bacterial culture of wound tissues ( Figure 1A ) and was identified as a multiple-resistant strain with antibiotic susceptibility testing (AST; Kirby-Bauer method), thus amikacin (0.4 g/day) was added to the anti-infective regimen. On day 26, tiny, nonhemolytic, and transparent colonies grew on the Columbia blood agar plate of four blood sample cultures ( Figure 1B ), possibly representing M. hominis. A subculture of blood and wound tissue samples on mycoplasma medium presents as fried-egg-type colonies after 5 days of incubation ( Figure 1C ). The AST with a commercial kit (broth dilution method, Zhongaisheng, Hebei, China) showed that M. hominis was susceptible to doxycycline, minocycline, and josamycin but resistant to azithromycin, clarithromycin, norfloxacin, ciprofloxacin, roxithromycin, sparfloxacin, spectinomycin, and levofloxacin ( Figure 1D ).

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Phylogenetic analyses of M. hominis isolated from wound tissue and blood samples.

Colonies were then identified to be M. hominis by the matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and further confirmed by 16S rRNA sequencing (primers: 27F, AGAGTTTGATCMTGGCTCAG; 1492R, GGTTACCTTGTTACGACTT) and phylogenetic tree analysis ( Figure 2 ; GenBank Accession No.

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Timelines of patient's diagnosis and treatment. Red, the anti-infective drugs for P. aeruginosa. Blue, the anti-infective drugs for M. hominis. Abbreviations: CXM, cefuroxime; CSL, cefoperazone-sulbactam; LVX, levofloxacin; MEM, meropenem; TEC, teicoplanin; AMK, amikacin; MFX, moxifloxacin; CAZ-AVI, ceftazidime-avibactam; POL, polymyxin B; MNO, minocycline.

Details regarding the diagnosis and treatment are shown in Figure 3 .

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(a) Noncontrast head CT (axial cut) at time of presentation, showing large bifrontal mass (light blue lines) surrounded by brain edema (red lines), causing significant mass effect. (b) Sagittal cut. The tumor has destroyed the frontal bone, extending into the paranasal sinuses (arrow) and intracranially, involving the anterior skull base.

Extended peritumoral brain edema with significant mass effect was also noted [Figure 1].

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(a) Histological examination for hematoxylin and eosin (H&E) stain showing a tumor comprised small to medium size cells, some of them with clear cytoplasm. Rhabdoid cells were not noted. The tumor shows areas of necrosis. (b) H&E, x20. (c) The stain for INI1 was negative (loss of expression). Immunohistochemical stains were diffusely and strong positive for EMA (d) and partially positive for SMA (e) and GFAP (f).

The tumor shows areas of necrosis and high levels of mitotic and apoptotic activity [Figure 2a and b]. INI1 was negative (loss of expression) [Figure 2c]. Immunohistochemical stains were diffusely and strong positive for epithelial membrane antigen (EMA) [Figure 2d] and P63, partially positive for smooth muscle antigen (SMA) [Figure 2e], glial fibrillary acidic protein (GFAP) [Figure 2f], B-cell lymphoma 2, and vimentin (VIM), focally positive for pan-KER and KER 8, and negative for OLIG2, S100, desmin, synaptophysin, NEU-N, and chromogranin.

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Pathologic findings in a patient with rifampin-associated acute tubulointerstitial nephritis and Fanconi syndrome. Light microscopy revealed the extensive mononuclear cell infiltrates including epithelioid histiocytes and eosinophils, mild interstitial fibrosis and tubular atrophy (A: original magnification X 100; B: original magnification x 400). Immunofluorescent stains showed focal granular deposits of immunoglobulin A (C) and complement 3 (D) in mesangial spaces and tubules. Subendothelial electron-dense deposits (E) and expanded mesangial spaces with electron dense deposits (F) were visible using electron microscopy.

A renal biopsy showed extensive mononuclear cell infiltrates, including epithelioid histiocytes and eosinophils, mild interstitial fibrosis, and tubular atrophy (Figure 1A and B). Focal granular deposits of immunoglobulin A (IgA) and complement 3 (C3) were demonstrated in the tubules (Figure 1C and D). The same immunofluorescent positivity was also shown in glomerular mesangium, and electron microscopy showed electron-dense deposits in the subendothelial and mesangial spaces (Figure 1E and F).

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