Enhancements in Radiological Detection of Metastatic Lymph Nodes Utilizing AI-Assisted Ultrasound Imaging Data and the Lymph Node Reporting and Data System Scale.

The paper presents a novel approach for the automatic detection of neoplastic lesions in lymph nodes (LNs). It leverages the latest advances in machine learning (ML) with the LN Reporting and Data System (LN-RADS) scale. By integrating diverse datasets and network structures, the research investigates the effectiveness of ML algorithms in improving diagnostic accuracy and automation potential. Both Multinominal Logistic Regression (MLR)-integrated and fully connected neuron layers are included in the analysis. The methods were trained using three variants of combinations of histopathological data and LN-RADS scale labels to assess their utility. The findings demonstrate that the LN-RADS scale improves prediction accuracy. MLR integration is shown to achieve higher accuracy, while the fully connected neuron approach excels in AUC performance. All of the above suggests a possibility for significant improvement in the early detection and prognosis of cancer using AI techniques. The study underlines the importance of further exploration into combined datasets and network architectures, which could potentially lead to even greater improvements in the diagnostic process.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) in Poland: analysis of patient series and practical guidelines for breast surgeons.

Introduction: Although breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is infrequent, with less than 1000 noted cases worldwide, patients consenting for breast implant surgery should be aware of its risk. We describe the first Polish multicenter case-series data on BIA-ALCL patients and present diagnostic and treatment recommendation for breast surgeons. Material and methods: In cooperation with the Polish Society of Surgical Oncology and Polish Lymphoma Research Group, we collected BIA-ALCL cases in Poland. Results: We retrospectively reviewed clinical data of seven BIA-ALCL patients, diagnosed between July 2013 and November 2019. The median time from implant placement to the first BIA-ALCL symptoms was 65 months (range: 33-96 months). All the patients were exposed to textured implants at presentation. Capsulectomy with implant removal was performed in all the patients with immediate reimplantation in 2 cases. In a median follow-up of 19 months (range 5-81 months), there was no recurrence and all the patients stayed alive. Between 2013 and 2019, the incidence of BIA-ALCL in Polish female population age 30 and above ranged from 0 to 0.021/100 000/year. Conclusions: BIA-ALCL is scarce in the Polish population. In a short-term follow-up, patients' prognosis remains excellent. Due to the withdrawal of roughly textured implants from the market and the exclusion of likely the most potent etiologic factor, it might be expected that the incidence of BIA-ALCL will become even rarer.

Cardiac Involvement in Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma.

Cardiac involvement of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is recognized extremely rarely. In addition, most CLL/SLL patients with heart infiltration are asymptomatic. In this review, we present the results of a literature search for English language articles concerning CLL/SLL or Richter transformation with symptomatic cardiac involvement. In total, 18 well-described cases with CLL/SLL and heart infiltration were identified. Only three patients were not diagnosed with CLL/SLL before the cardiac manifestation. In other patients, cardiac CLL/SLL was diagnosed between 5 months and 20 years from CLL/SLL diagnosis. All patients in these series had a diagnosis of secondary cardiac CLL/SLL. In addition, we identified four reported cases with Richter transformation in the heart. The treatment of patients with CLL/SLL and cardiac infiltration is variable and depends on the previous history and clinical characteristics of heart infiltration. In addition, no recommendations exist on how to treat patients with CLL/SLL and cardiac involvement.

[Diagnostic problems in a case of the pyriform sinus carcinoma in a man]. / Trudnosci diagnostyczne w przypadku raka zachylka gruszkowatego u mezczyzny.

Despite a use of many diagnostic tools to assess the stage of the carcinoma of hypopharynx and larynx various problems can still arise. A 45 years old man was admitted with an initial diagnosis of carcinoma of the hypopharynx with metastases to neck lymphnodes (Tin situ N1). Computed tomography of the neck revealed pathologic remodeling of the thyroid cartilage. An oncologist decided to commence a chemotherapy. After 4 cycles of chemotherapy a second CT scan revealed a suspected neoplastic infiltration of the cricoid and thyroid cartilages. After that the patients was disqualified from both radio- and chemotherapy. The consulting laryngologist did not find any pathologies in the larynx and hypopharynx. On palpation there were no enlarged neck lymph nodes. The second specimen taken from the right pyriform sinus was a loosen fragment of the epithelium with the Ca male differentiatum G3. The positron emission tomography imaging found a suspected site 11 mm in diameter situated in front of the carotid vessels. The neoplastic infiltration of the larynx was not confirmed. The patient started the radiotherapy. We are of the opinion that in the presented case the erroneous interpretation of the CT scan was a likely consequence of the improper setting of a window of brightness and contrast. Strong artifacts are also observed in 3D imaging. Another cause of the diagnostic problems could stem form an unfinished calcification of the cartilages which produced an image of irregular areas of calcification and rarely diagnosed T in situ in a pyriform sinus.

Primary osseous rhabdomyosarcoma with focal matrix formation mimicking osteosarcoma.

We present an unusual case of primary osseous pleomorphic rhabdomyosarcoma with focal matrix formation mimicking osteosarcoma. The patient was a 21-year-old man who had suffered from pain and slight enlargement of his left calf for 2 months. A plain radiograph demonstrated a large, predominantly osteolytic mass in the region of the proximal fibula with features typical of malignant primary bone tumor. On open surgical biopsy, the tumor consisted of atypical cells, some of them presenting spindle morphology. Between them, there were bands of densely hyalinized matrix with osteoid appearance, but without definite lacunae or calcifications, and an osteosarcoma was diagnosed. Consequently, the tumor was removed. The postoperative tissue presented more pleomorphic cells with some definite rhabdomyoblasts. Desmin, actin, Myf4, and MyoD1 were positive in tumor cells, and a diagnosis of rhabdomyosarcoma was eventually made. Only few cases of primary pure bone rhabdomyosarcoma have been reported. Other bone tumors with rhabdomyosarcomatous differentiation have been described: dedifferentiated chondrosarcoma, fibrosarcoma, and osteosarcoma. Our case does not meet the criteria for sclerosing rhabdomyosarcoma, as matrix formation is focal and cells are spindle-shaped and pleomorphic. However, it is a further example of a diagnostic error in connection with primary osseous tumor.

[Comparison of power Doppler technique, microscopic examination and VEGF levels for the assessment of adrenal tumors vascularization]. / Przydatnosc metody power Doppler w ocenie unaczynienia guzów nadnerczy w porównaniu z badaniem mikroskopowym tkanki guza i stezeniem vegf we krwi chorych.

The purpose of this study was to investigate the clinical usefulness of the color Doppler vascularity index (CDVI) in patients with adrenal masses before surgery. Twenty-four patients with adrenal masses were examined. The correlation between CDVI and microvessel density (MVD), vascular endothelial growth factor (VEGF) level and clinico-pathological factors was studied. There was a significant correlation between CDVI and VEGF level. The CDVI did not correlate with MVD. The CDVI was significantly higher in the patients with malignant or hormonally active tumors than in patients with benign non-hyperfunctioning lesions. Thus, the CDVI may be helpful in qualifying patients for adrenalectomy.