Symptomatic Thyroglossal Duct Cyst Presenting With Synchronous and Localized Tongue Base Extranodal Mantle Cell Lymphoma. A Unique Case Report Demonstrating Lymphoma Colonization of Cyst Wall, Potentially Relating to a Persistent Embryological Foramen Cecum Remnant.

A 77-year-old male presented with a progressively enlarging midline neck mass. On further investigation he was found to have synchronous thyroglossal duct cyst and extranodal mantle cell lymphoma (MCL) localized to the base of tongue. Both pathologies were managed simultaneously with a surgical approach and the patient remained in clinical remission at the time of publication without indication for systemic oncological treatment. Histology revealed primary extranodal nonblastoid MCL forming a base of tongue mass, with colonization of the thyroglossal duct cyst. Lymphoma was also found in the epithelium of a crypt-like tract traversing one of the tongue base tumor sections. This tract was anatomically and histologically consistent with documented descriptions of the foramen cecum. This case report illustrates a previously undescribed temporal, clinical, and histological association between a base of tongue MCL and symptomatic thyroglossal duct cyst. We provide evidence for a potential causal relationship for the presentation of the thyroglossal duct cyst as a result of oropharyngeal MCL, in the absence of clinical and histological evidence of disseminated disease, directly infiltrating from its tongue base origin to the infrahyoid neck region, potentially via an embryologic foramen cecum remnant. We also highlight the crucial role of the histopathologist in multidisciplinary clinicopathological discussion in demonstrating how fundamental embryological and microanatomical relationships can unite apparently separate diseases.

Overview of transparent optical ceramics for high-energy lasers at NRL.

In this review, we present our recent research progress at the Naval Research Laboratory in the development of highly transparent and rugged ceramic window materials such as MgAl2O4 spinel and ß-SiC; high-power solid-state laser gain materials based on sesquioxide such as Yb(3+):Y2O3, Yb(3+):Lu2O3, and Ho(3+):Lu2O3; and composite ceramics in the application for high-energy lasers. Various powder synthesis/purification methods and powder post-process techniques necessary to create high-purity powders are described. Ceramic fabrication processes and chemical, morphological, and optical properties of the ceramics developed at the Naval Research Laboratory (NRL) are highlighted. We also report high-efficiency lasing from a hot-pressed rare-earth sesquioxide single layer and composite ceramics made from coprecipitated powder.

Overview of transparent optical ceramics for high-energy lasers at NRL: publisher's note.

This note amends the author list of a recent publication [Appl. Opt.54, F210 (2015)].

Visual expertise in detecting and diagnosing skeletal fractures.

OBJECTIVE: Failure to identify fractures is the most common error in accident and emergency departments. Therefore, the current research aimed to understand more about the processes underlying perceptual expertise when interpreting skeletal radiographs. MATERIALS AND METHODS: Thirty participants, consisting of ten novices, ten intermediates, and ten experts were presented with ten clinical cases of normal and abnormal skeletal radiographs of varying difficulty (obvious or subtle) while wearing eye tracking equipment. RESULTS: Experts were significantly more accurate, more confident, and faster in their diagnoses than intermediates or novices and this performance advantage was more pronounced for the subtle cases. Experts were also faster to fixate the site of the fracture and spent more relative time fixating the fracture than intermediates or novices and this was again most pronounced for subtle cases. Finally, a multiple linear regression analysis found that time to fixate the fracture was inversely related to diagnostic accuracy and explained 34 % of the variance in this variable. CONCLUSIONS: The results suggest that the performance advantage of expert radiologists is underpinned by superior pattern recognition skills, as evidenced by a quicker time to first fixate the pathology, and less time spent searching the image.