Cranial Rosai-Dorfman disease: a case report and literature review.

Rosai-Dorfman Disease (RDD) is a rare, benign, idiopathic histiocytic proliferative disorder, with its occurrence in the cranial bones being particularly uncommon and prone to misdiagnosis in preoperative radiological examinations. This article reports a case of RDD in the left temporal bone. The radiological presentation of intraosseous RDD includes osteolytic bone destruction, infrequent periosteal reaction, clearly defined tumor margins, and marked uniform enhancement on contrast-enhanced scans. However, these radiological features lack specificity, highlighting the necessity of histopathological examination for a definitive diagnosis, especially for the rarer extranodal subtypes of RDD. Surgical excision of the lesion can lead to favorable therapeutic outcomes.

Current landscape of primary small bowel leiomyosarcoma: cases report and a decade of insights.

The incidence of leiomyosarcoma (LMS) is about 4-5/100,000 individuals per year. LMSs occurring in the small bowel are even rarer, and their preoperative diagnosis is very difficult. We described two patients with pathologically confirmed small bowel LMS and analyzed their clinical and medical imaging features. Similar cases reported in English in Pubmed database over the past decade were reviewed and summarized. These tumors were categorized by the growth direction and relationship with the intestinal lumen into three types: intraluminal (n = 10), intermural (n = 3), and extraluminal (n = 7). Notably, among the three types of LMS, the intramural leiomyosarcoma stands out as a noteworthy subtype. Emerging evidence suggests that smaller tumor size (< 5 cm) and the intraluminal type may serve as favorable prognostic indicators, while the extraluminal type is associated with relatively poor prognosis. Furthermore, the integration of imaging features with CA125 and LDH biomarkers holds promise for potential diagnostic value in LMS.

Multi-faceted effects of NaCl on salt-tolerant microalgae Golenkinia sp. SDEC-16.

The salt-tolerant microalgae are extremely few and salt-tolerance mechanism is unclear, requiring urgent exploration of salt-tolerance mechanism of known microalgae. This study was first to reveal the salt-tolerance mechanism of Golenkinia sp. SDEC-16 by investigating the growth and metabolism under different salinities and high salinity long-term cultivation. SDEC-16 can survive under high salinity and resume normal growth after NaCl removal. Under long-term stress, SDEC-16 had higher lipid content and productivity than BG11. However, the suppressed Fv/Fm (58.4%) and Fv/F0 (84.0%) along with the increased reactive oxygen species (×6.6), and superoxide dismutase (×1.7) during the treatment revealed NaCl-induced photosynthetic inhibition and oxidative stress. RNA sequencing results showed inhibition of the photosynthetic system, and the enhancement of pathways such as nitrogen metabolism, energy metabolism, and lipid synthesis contributed to the good function of chloroplast, energy supply, and metabolic activity of SDEC-16. This study provides theoretical support for large-scale microalgal cultivation in seawater.

One case of myxoid glioneuronal tumour in the left frontal lobe.

Myxoid glioneuronal tumour (MGNT), previously described as dysembryoplastic neuroepithelial tumour of the septum pellucidum, was classified as a new tumour type in the fifth edition of the WHO Central Nervous System Tumor Classification of 2021. This classification was based on its anatomical location, imaging features, and genetic characteristics. MGNTs are clinically rare and prone to misdiagnosis. In this report, we present a case of MGNT in the left frontal lobe, which was confirmed through surgical pathology.

The imaging dynamic changes in the malignant transformation of an epidermoid cyst: a case report and literature review.

Malignant transformation of epidermoid cysts is a rare complication. Most of the previously reported cases have involved postoperative malignant transformations. We present a case of malignant transformation of a nonpostoperative epidermoid tumor into squamous cell carcinoma (SCC) that occurred in a 61-year-old Chinese woman. The patient's initial cranial MRI scan showed an epidermoid cyst with marginal enhancement in the pre-pontine cistern, and the lesion gradually enlarged after 10 months. A craniotomy was performed using to remove part of the tumor via the right retrosigmoid approach, and postoperative pathology confirmed that the transformation of the epidermoid cyst was malignant. Our case study suggests that the possibility of malignant transformation of epidermoid cyst should not be ignored on the basis of enhanced imaging features, regardless of whether they are nodular, annular, or patchy, as is the case for inflammation. Strict follow-up is required for early detection of malignant transformation to prompt correspondingly early clinical treatment.

Frontotemporal giant extradural dermoid cyst: illustrative case.

BACKGROUND: Dermoid cyst is a rare benign tumor exhibiting a typical radiological pattern and most commonly located along the midline. Laboratory examination was always normal. However, the features of some rare cases are atypical that can be easily misdiagnosed as other tumors. OBSERVATIONS: A 58-year-old patient presented with tinnitus, dizziness, blurred vision, and gait unsteadiness. Laboratory examination showed the serum levels of carbohydrate antigen 19-9 (CA19-9) were significantly increased (186 U/mL). A computed tomography (CT) scan revealed a predominant hypodense lesion in the left frontotemporal region with a hyperdense mural nodule. The lesion appeared as an intracranial extradural mass with a mural nodule on the sagittal image, displaying mixed signal on T1- and T2-weighted imaging. A left frontotemporal craniotomy was performed for cyst resection. Histological results confirmed a diagnosis of dermoid cyst. No tumor recurrences were observed at the 9-month follow-up. LESSONS: Extradural dermoid cyst with a mural nodule is extremely rare. When a hypodense lesion on CT shows mixed signal on T1- and T2-weighted imaging with a mural nodule, even if it is located in the extradural areas, it is important to consider a dermoid cyst. Serum CA19-9 combined with atypical imaging features may contribute to the diagnosis of dermoid cysts. Only recognition of atypical radiological features can avoid misdiagnosis.

Neoadjuvant Arterial Embolization Chemotherapy Combined PD-1 Inhibitor for Locally Advanced Rectal Cancer (NECI Study): a protocol for a phase II study.

INTRODUCTION: The NICHE trial showed remarkable results of neoadjuvant immunotherapy in colorectal cancer patients with mismatch repair (MMR) deficiency (dMMR). However, rectal cancer patients with dMMR accounted for only 10% of case. The therapeutic effect is unsatisfactory in MMR-proficient patients. Oxaliplatin has been demonstrated to induce immunogenic cell death (ICD), which may improve the therapeutic effect of programmed cell death 1 blockade; however, a maximum tolerated dose is required to induce ICD. Arterial embolisation chemotherapy provides drugs locally and can easily reach the maximum tolerated dose, which could be a significant method for delivering chemotherapeutic agents. Therefore, we designed a multicenter, prospective, single-arm, phase II study. METHODS AND ANALYSIS: First, recruited patients will receive neoadjuvant arterial embolisation chemotherapy (NAEC) with oxaliplatin 85 mg/m2 and 3 mg/m2. After 2 days, three cycles of immunotherapy with intravenous tislelizumab (200 mg/body, day 1) will be initiated at an interval of 3 weeks. From the second cycle of immunotherapy, the XELOX regimen will be added. 3 weeks after neoadjuvant therapy finished, the operation will be initiated. Neoadjuvant Arterial Embolization Chemotherapy Combined PD-1 Inhibitor for Locally Advanced Rectal Cancer (NECI) Study combined arterial embolisation chemotherapy, immunotherapy and systemic chemotherapy. Based on this combination therapy, the maximum tolerated dose could easily be reached, and ICD could be induced by oxaliplatin easily. To our knowledge, the NECI Study is the first multicenter, prospective, single-arm, phase II clinical trial to assess the efficacy and safety of NAEC combined with tislelizumab and systemic chemotherapy in locally advanced rectal cancer. This study is expected to provide a new neoadjuvant therapeutic regimen for locally advanced rectal cancer. ETHICS AND DISSEMINATION: The Human Research Ethics Committee of the Fourth Affiliated Hospital of Zhejiang University School of Medicine approved this study protocol. The results will be published in peer-reviewed journals and presented at appropriate conferences. TRIAL REGISTRATION NUMBER: NCT05420584.

Transformation of lymphoid interstitial pneumonia (LIP) into malignant lymphoma in patients with Sjogren's syndrome: a case report and literature review.

BACKGROUND: Lymphoid interstitial pneumonia (LIP) is a very rare disease and its malignant transformation is even more rare. LIP is easily misdiagnosed by clinicians and radiologists. CASE PRESENTATION: The medical record of a 64-year-old female with Sjogren's syndrome was reviewed. The clinical and pathological data along with chest CT images were obtained. The literature related to the transformation was reviewed. There were no specific clinical manifestations of LIP and its transformation into malignant lymphoma in the patient. The chest CT mainly displayed multiple cystic foci, with multiple nodules and ground-glass shadows in both lungs. CONCLUSIONS: Malignant transformation to lymphoma is suspected with findings of large nodules (> 11 mm) or their sizes doubly increased, pleural effusion and alveolar consolidation.

Changes of [18F]FDG-PET/CT quantitative parameters in tumor lesions by the Bayesian penalized-likelihood PET reconstruction algorithm and its influencing factors.

BACKGROUND: To compare the changes in quantitative parameters and the size and degree of 18F-fluorodeoxyglucose ([18F]FDG) uptake of malignant tumor lesions between Bayesian penalized-likelihood (BPL) and non-BPL reconstruction algorithms. METHODS: Positron emission tomography/computed tomography images of 86 malignant tumor lesions were reconstructed using the algorithms of ordered subset expectation maximization (OSEM), OSEM + time of flight (TOF), OSEM + TOF + point spread function (PSF), and BPL. [18F]FDG parameters of maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and signal-to-background ratio (SBR) of these lesions were measured. Quantitative parameters between the different reconstruction algorithms were compared, and correlations between parameter variation and lesion size or the degree of [18F]FDG uptake were analyzed. RESULTS: After BPL reconstruction, SUVmax, SUVmean, and SBR were significantly increased, MTV was significantly decreased. The difference values of %ΔSUVmax, %ΔSUVmean, %ΔSBR, and the absolute value of %ΔMTV between BPL and OSEM + TOF were 40.00%, 38.50%, 33.60%, and 33.20%, respectively, which were significantly higher than those between BPL and OSEM + TOF + PSF. Similar results were observed in the comparison of OSEM and OSEM + TOF + PSF with BPL. The %ΔSUVmax, %ΔSUVmean, and %ΔSBR were all significantly negatively correlated with the size and degree of [18F]FDG uptake in the lesions, whereas significant positive correlations were observed for %ΔMTV and %ΔTLG. CONCLUSION: The BPL reconstruction algorithm significantly increased SUVmax, SUVmean, and SBR and decreased MTV of tumor lesions, especially in small or relatively hypometabolic lesions.

The Risk Assessment and Clinical Research of Bile Duct Injury After Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma.

PURPOSE: To retrospectively evaluate the risk factors and the clinical outcomes of bile duct injury after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) and to evaluate factors that aid clinical detection and subsequent treatment of the injured bile duct. MATERIALS AND METHODS: All patients undergoing TACE for HCC were retrospectively reviewed for identification of bile duct injury. The clinical spectrum of all the patients analyzed including patients' demographics, laboratory data, radiologic imaging and mode of treatment. RESULTS: From January 2015 to December 2017, a total of 21 patients (4.3%) out of 483 patients with 693 TACE procedures were identified to have bile duct injury at our single institution. There were 17 males and 4 females, with a mean age of 59.8±11.6 years (range 34-84). About 14.3% (3/21) patients show the high-density shadow around the bile duct wall in one week non-enhanced CT, and 76.2% (16/21) cases ALP>200 U/L, all these patients showed bile duct injury on the subsequent follow-up CT. Post-TACE follow-up blood biochemistry showed that alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (GGT) increased significantly compared with pre-TACE level. The incidence of various types of bile duct injuries on CT was intrahepatic bile duct dilatation (57.1%), biloma (25.7%) and hepatic hilar biliary strictures (17.1%), respectively. Patients with prior hepatectomy as well as proximal arterial chemoembolization carried a higher risk of post-TACE bile duct injury in terms of microvascular damage to the peribiliary capillary plexus. CONCLUSION: Bile duct injury complicating TACE is not caused by a single factor, but by a variety of factors, and is closely related to the microvascular compromise of the bile ducts and subsequent chronic biliary infection. Lipiodol deposited along the bile duct wall and the sharp rise of ALP>200 U/L in one week after TACE can predict bile duct injury and early intervention may prevent the occurrence of serious complications. The probability of bile duct injury in patients with prior hepatectomy and proximal arterial chemoembolization increases significantly.

Direct synthesis of the organic and Ge free Al containing BOG zeolite (ITQ-47) and its application for transformation of biomass derived molecules.

Aluminosilicate boggsite (Si/Al-BOG) has been hydrothermally synthesized without adding organic structure-directing agents (OSDAs) in the synthesis gel using the borosilicogermanium ITQ-47 (Si/B-ITQ-47) zeolite as seeds. The introduction of the costly and environmentally less benign phosphazene organic structure-directing agent is not required to grow the zeolite. Physicochemical characterization experiments show that Si/Al-BOG has good crystallinity, high surface area, tetrahedral Al3+ species, and acid sites. In order to test the catalytic performance of the zeolite, the synthesis of l,l-lactide from l-lactic acid was performed. Si/Al-BOG exhibits 88.2% conversion of l-lactic acid and 83.8% l,l-lactide selectivity, which are better than those of other zeolites studied up to now.

Correction: Direct synthesis of the organic and Ge free Al containing BOG zeolite (ITQ-47) and its application for transformation of biomass derived molecules.

[This corrects the article DOI: 10.1039/D0SC04044D.].

A simple matrine derivative for the facile syntheses of mesoporous zeolites ITQ-37 and ITQ-43.

ITQ-37 and ITQ-43 possessing mesoporous structures have aroused great interest because of their promising applications involving large molecules. However, it is challenging to synthesize these zeolites. Herein, MAS-ITQ-37 and MAS-ITQ-43 with enhanced Si/Ge ratios of 1.7 and 3.0 have been synthesized by using a simple matrine-derived organic structure-directing agent.

Characterization of single lesion nonfunctioning pancreatic neuroendocrine carcinoma via computed tomography.

Nonfunctioning pancreatic neuroendocrine carcinoma (NPNEC) is a poorly differentiated neuroendocrine carcinoma and a rare type of pancreatic cancer. Computed tomography (CT)-based imaging is currently the most effective method for diagnosing and classifying NPNEC. The present study investigated the clinical features and CT manifestations of this disease. The CT manifestations and clinical data of 13 patients with NPNEC, confirmed by surgery or needle biopsy, were retrospectively analyzed. None of the 13 patients exhibited endocrine-related symptoms and a single lesion with a variable position in the pancreatic was observed in all patients. The tumors were generally round or irregular, with inhomogeneous density and an average diameter of 7.45±3.92 cm (range, 4.0-16.0 cm). Cystic necrosis zones were observed in 5 patients and calcification was observed in 2. A total of 4 patients exhibited intrahepatic metastases, and 2 patients demonstrated spleen and colon invasion. Enhanced scanning indicated that tumors were markedly enhanced. There were 11 cases of middle or high-grade enhancement (84.6%) and 2 cases of mild enhancement (15.4%). Marked envelope enhancement was observed in 3/11 patients with high-grade enhancement. In conclusion, the majority of patients with NPNEC lacked characteristic manifestations. While the CT examination revealed certain characteristics, histological analysis was necessary to confirm diagnoses.

Clinicopathological characteristics of mediastinal follicular dendritic cell sarcoma: report of three cases.

BACKGROUND: Follicular dendritic cell sarcoma (FDCS) is a rare malignant neoplasm of follicular dendritic cells that form a tight meshwork within lymphoid follicles. It occurs most commonly in the lymph nodes and occasionally at extranodal sites, but rarely in the mediastinum. It is an under-recognized clinical entity without clear diagnosis. Due to its rarity, FDCS is easily misdiagnosed by clinicians or pathologists. CASE PRESENTATION: Herein, we report three unusual cases of mediastinal FDCS, including one with hyaline vascular Castleman's disease in woman. The clinicopathological characteristics and CT imagings were described. Their diagnosis was confirmed by immunohistochemical stainings of specific markers. Their therapeutic intervention, follow-up and outcomes were presented with brief literature review. CONCLUSIONS: A huge mediastinal shallowly-lobulated, demarcated soft tissue mass, with speckled, strip-like, coarse or arborizing calcification inside, and mild to moderate enhancement after contrast material administration on CT image, should consider FDCS as a possible diagnosis.

[Optimization of scan protocol in pulmonary angiography of second generation dual source computed tomography].

OBJECTIVE: To explore the scan protocol of second generation dual source computed tomography (CT) for CT pulmonary angiogram (CTPA) in patients with suspected pulmonary embolism and determine the proper volume of contrast medium. METHODS: A total of 120 patients undergoing CTPA were recruited. All examinations were performed on a second generation dual source CT. The scan delay was determined with the test bolus technique. Four contrast volume protocols were designed, namely groups A, B, C and D respectively (n = 30 each). For CTPA scan of groups A, B, C and D, 35, 40, 45 and 50 ml contrast medium were injected at an injection rate of 4 ml/s, followed by a saline chaser of 55, 50, 45 and 40 ml respectively. Attenuation profiles of different vascular segments (subclavian vein, vena cava, left atrium, pulmonary trunk, S1 artery, S10 artery) were measured to evaluate the timing techniques. The image quality and artifact of iodine map were analyzed by two radiologists for comparisons. RESULTS: The percentage of pulmonary arteries exceeding optimal attenuation (> 200 HU) showed that groups of B, C and D were higher than group A (93% - 100% vs 80% - 90%). The image quality of group A was lower than the others (P < 0.05) while the other groups showed no significant difference. The artifacts of iodine map of group A were much fewer than the others (P < 0.05) and group D was much more than the other groups (P < 0.05). Groups B and C had a score of 4.13 and 3.67 respectively without significant difference (P = 0.091). CONCLUSION: With the aids of test bolus technique and proper injection protocol (40 ml contrast medium followed by 50 ml saline), the high quality image and low volume of iodine can be realized with second generation dual source CT for CTPA.

[Localization of upper airway stricture by CT scan in patients with obstructive sleep apnea syndrome during drug-induced sleeping].

OBJECTIVE: To evaluate the feasibility of multi-slice spiral CT scan to localize upper airway stricture in patients with obstructive sleep apnea syndrome (OSAS) during drug-induced sleeping. METHODS: One hundred and fourteen patients diagnosed as OSAS by polysomnography were included in the study. Multi-slice spiral CT scan covering upper airway was performed at the end of inspiration and clear upper airway images were obtained in waking. After injecting 5 mg of midazolam intravenously slowly in 109 patients, CT scan was performed at apnea and clear upper airway images were obtained in sleeping. Cross-section area and minimal diameter of airway were measured and the parameters were compared under those two states. Upper airway was displayed intuitionisticly by using post-processing techniques. RESULTS: One hundred and nine patients with OSAS finished the examination with a success rate of 100 %. Airway obstruction at retropalatal level was observed in 62 patients, among whom 26 were associated with airway obstruction at retroglossal level, 27 with narrower airway at retroglossal level in sleeping compared with that in waking, and 9 with no significant change of the airway at retroglossal level after sleeping. Narrower airway at retropalatal level in sleeping compared with that in waking was observed in 40 patients, among whom 20 were associated with narrower airway at retroglossal level in sleeping compared with that in waking, 10 with complete airway obstruction at retroglossal level in sleeping, and 7 with no significant change of the airway at both retropalatal and retroglossal levels before and after sleeping. Minimal mean cross-section area of airway at retropalatal level was (72.60 +/-45.15)mm(2) in waking and (8.26 +/-18.16)mm(2) in sleeping; and minimal mean cross-section area of airway at retroglossal level was (133.21 +/-120.36)mm(2)in waking and (16.73 +/-30.21)mm(2) in sleeping (P <0.01). Minimal mean diameter of airway at retropalatal level was (6.91 +/-2.23) mm in waking and (1.18 +/-2.14) mm in sleeping; and minimal mean diameter of airway at retroglossal level was (8.68 +/-4.32) mm in waking and (1.68 +/-2.22) mm in sleeping (P <0.01). CONCLUSION: Multi-slice spiral CT with post-processing techniques can display the shape of the upper airway in patients with OSAS in sleeping, and can localize the upper airway stricture and assess its range accurately.

Perivascular epithelioid cell tumor of the liver: a report of two cases and review of the literature.

Perivascular epithelioid cell tumor (PEComa) is a rare tumor which arises from mesenchymal tissues. It is predominant in the uterus, but very rare in the liver. To the best of our knowledge, less than 5 cases of PEComa of the liver have been reported. Herein we present two pathologically proven cases of PEComa of the liver, retrospectively analyze their clinical and imaging features, and review the literature.