A very rare case of mycobacterium gordonae infection of the breast.

Mastitis is a common disease in women with both infectious and noninfectious causes. Most cases occur during lactation and are caused by Staphylococcus aureus and Streptococcus species; parasites and Mycobacteria have rarely been reported to cause breast infections (Mandell, Douglas, and Bennett's principles and practice of infectious diseases (9th edn);2019, Am J Respir Crit Care Med. 2007;175:367). Nontuberculous mycobacteria (NTM) which are also referred to as atypical mycobacteria, mycobacteria other than tuberculosis (MOTT), or environmental mycobacteria are a large group of Mycobacteria which are becoming increasingly common cause of infection all over the world (Arch Dermatol. 2006;142:1287). NTM can cause infection diseases especially in immunocompromised patients, such as HIV-positive hosts, most commonly in the lungs, skin and soft tissue, lymph nodes or rarely spread with multiorgan dissemination (Arch Plast Surg. 2014;41:759). Mycobacterium gordonae (M. gordonae) is a slow-growing atypical mycobacterium that is considered the least pathogenic NTM. The organism is ubiquitous, and mostly isolated from soil and water. Despite its nonvirulent nature, clinically significant infections have been reported also in some immunocompetent patients (J Formosan Med Assoc. 2020, Clin Infect Dis. 1992;1229). We report the first documented case of breast infection in a young immunocompetent woman sustained by Mycobacterium Gordonae.

Horseshoe adrenal gland associated with spinal and vascular anomalies.

Horseshoe (or butterfly) adrenal gland (HAG) is an exceedingly rare congenital abnormality compared to horseshoe kidney. Here we present computed tomography findings of HAG in a 70-year-old man, associated with some spinal and vascular abnormalities; in addition, a brief review of HAG in adult people is presented. In our case, spinal anomalies included a severe scoliosis, a "butterfly" deformation of Th9 vertebra and the presence of a "split lumbosacral thecal sac" at L5 level. As regards, vascular anomalies, they were noted: the origin of the left common carotid artery from the innominate artery and the absence of celiac trunk with separate origin of three branches directly off the aorta (a splenic artery, a left gastrohepatic trunk and a right hepatic-pancreaticoduodenal artery).

Exploring Response to Immunotherapy in Non-Small Cell Lung Cancer Using Delta-Radiomics.

Delta-radiomics is a branch of radiomics in which features are confronted after time or after introducing an external factor (such as treatment with chemotherapy or radiotherapy) to extrapolate prognostic data or to monitor a certain condition. Immune checkpoint inhibitors (ICIs) are currently revolutionizing the treatment of non-small cell lung cancer (NSCLC); however, there are still many issues in defining the response to therapy. Contrast-enhanced CT scans of 33 NSCLC patients treated with ICIs were analyzed; altogether, 43 lung lesions were considered. The radiomic features of the lung lesions were extracted from CT scans at baseline and at first reassessment, and their variation (delta, Δ) was calculated by means of the absolute difference and relative reduction. This variation was related to the final response of each lesion to evaluate the predictive ability of the variation itself. Twenty-seven delta features have been identified that are able to discriminate radiologic response to ICIs with statistically significant accuracy. Furthermore, the variation of nine features significantly correlates with pseudo-progression.