Isoporous Membrane Mediated Imprinting Mass Spectrometry Imaging for Spatially-Resolved Metabolomics and Rapid Histopathological Diagnosis.

Surface-assisted laser desorption/ionization (SALDI) mass spectrometry imaging (MSI) holds great value in spatial metabolomics and tumor diagnosis. Tissue imprinting on the SALDI target can avoid laser-induced tissue ablation and simplifies the sample preparation. However, the tissue imprinting process always causes lateral diffusion of biomolecules, thereby losing the fidelity of metabolite distribution on tissue. Herein, a membrane-mediated imprinting mass spectrometry imaging (MMI-MSI) strategy is proposed using isoporous nuclepore track-etched membrane as a mediating imprinting layer to selectively transport metabolites through uniform and vertical pores onto silicon nanowires (SiNWs) array. Compared with conventional direct imprinting technique, MMI-MSI can not only exclude the adsorption of large biomolecules but also avoid the lateral diffusion of metabolites. The whole time for MMI-based sample preparation can be reduced to 2 min, and the lipid peak number can increase from 46 to 113 in kidney tissue detection. Meanwhile, higher resolution of MSI can be achieved due to the confinement effect of the pore channel in the diffusion of metabolites. Based on MMI-MSI, the tumor margins of liver cancer can be clearly discriminated and their different subtypes can be precisely classified. This work demonstrates MMI-MSI is a rapid, highly sensitive, robust and high-resolution technique for spatially-resolved metabolomics and pathological diagnosis.

Decoding Early Mycosis Fungoides: Histopathologic and Immunohistochemical Clues.

INTRODUCTION: Primary cutaneous lymphomas, notably mycosis fungoides (MF), present diagnostic challenges in recognizing early mycosis fungoides (eMF) due to their diverse clinical and histopathologic manifestations. The aim of our study was to use adjunctive histopathologic and immunohistochemical methods in eMF cases to make an early diagnosis and to facilitate differentiation from other dermatoses. METHODS: This retrospective study analyzed 35 cases of eMF diagnosed at a single center. Demographic and clinicopathologic data were collected, and histopathologic features were assessed. Comparative analyses were conducted with conditions mimicking eMF, including large plaque parapsoriasis (LPP), psoriasis, and chronic dermatitis. Immunohistochemistry for T-cell markers (CD3, CD4, CD8, CD2, CD7) was performed. RESULTS: With the scoring we applied in our study, a sensitivity of 91.43% (95% CI; 76.94% to 98.20%) and specificity of 85.71% (95% CI; 69.74% to 95.19%) for distinguishing eMF from LPP. Epidermotropism emerged as a crucial histopathologic marker, with a notable absence in most cases of cutaneous dermatitis (81.6% and 80% for CD and psoriasis, respectively) (P < 0.001). Immunohistochemistry revealed a T-helper phenotype (CD4+/CD8-) in the majority of eMF cases (78.1%), while CD4+/CD8+ and CD8+/CD4- patterns were less common (28.5% and 8.5%, respectively). CONCLUSION: This study underscores the complexities in distinguishing eMF from inflammatory skin diseases, advocating for a comprehensive diagnostic approach.

Cystic meningiomas: A complex diagnostic challenge and clinicopathological insights from a unique case presentation.

Meningiomas present diverse clinical and radiological characteristics, with cystic formations constituting a lesser subset but posing significant diagnostic hurdles. We explore the complexities of cystic meningiomas through a distinctive case, highlighting the challenges in diagnosis and management due to their variable presentations. A 54-year-old female from Bengaluru, Karnataka, initially presented with transient memory disturbances. Brain MRI revealed a sizable left frontal cystic lesion exerting a mass effect and midline shift. However, rapid neurological decline led to an urgent surgical intervention via decompressive craniectomy unveiling unique intraoperative findings and with subsequent histopathological documentation of a Grade WHO 1 cystic meningioma. Cystic meningiomas present intricate diagnostic challenges resembling other intracranial lesions. Various classification systems attempt to categorize these tumors based on their imaging and histopathological characteristics. Despite this, atypical clinical manifestations often lead to misdiagnoses, necessitating a comprehensive approach to differential diagnosis. Further research is crucial to unravel the mechanisms underlying these tumors' cystic changes for improved diagnostic accuracy and tailored therapeutic interventions.

Detection of somatic and germline pathogenic variants in adult cohort of drug-resistant focal epilepsies.

OBJECTIVE: This study investigates the prevalence of pathogenic variants in the mechanistic target of rapamycin (mTOR) pathway in surgical specimens of malformations of cortical development (MCDs) and cases with negative histology. The study also aims to evaluate the predictive value of genotype-histotype findings on the surgical outcome. METHODS: The study included patients with drug-resistant focal epilepsy who underwent epilepsy surgery. Cases were selected based on histopathological diagnosis, focusing on MCDs and negative findings. We included brain tissues both as formalin-fixed, paraffin-embedded (FFPE) or fresh frozen (FF) samples. Single-molecule molecular inversion probes (smMIPs) analysis was conducted, targeting the MTOR gene in FFPE samples and 10 genes within the mTOR pathway in FF samples. Correlations between genotype-histotype and surgical outcome were examined. RESULTS: We included 78 patients for whom we obtained 28 FFPE samples and 50 FF tissues. Seventeen pathogenic variants (22 %) were identified and validated, with 13 being somatic within the MTOR gene and 4 germlines (2 DEPDC5, 1 TSC1, 1 TSC2). Pathogenic variants in mTOR pathway genes were exclusively found in FCDII and TSC cases, with a significant association between FCD type IIb and MTOR genotype (P = 0.003). Patients carrying mutations had a slightly better surgical outcome than the overall cohort, however it results not significant. The FCDII diagnosed cases more frequently had normal neuropsychological test, a higher incidence of auras, fewer multiple seizure types, lower occurrence of seizures with awareness impairment, less ictal automatisms, fewer Stereo-EEG investigations, and a longer period long-life of seizure freedom before surgery. SIGNIFICANCE: This study confirms that somatic MTOR variants represent the primary genetic alteration detected in brain specimens from FCDII/TSC cases, while germline DEPDC5, TSC1/TSC2 variants are relatively rare. Systematic screening for these mutations in surgically treated patients' brain specimens can aid histopathological diagnoses and serve as a biomarker for positive surgical outcomes. Certain clinical features associated with pathogenic variants in mTOR pathway genes may suggest a genetic etiology in FCDII patients.

Can Artificial Intelligence Replace Humans for Detecting Lung Tumors on Radiographs? An Examination of Resected Malignant Lung Tumors.

OBJECTIVE: Although lung cancer screening trials have showed the efficacy of computed tomography to decrease mortality compared with chest radiography, the two are widely taken as different kinds of clinical practices. Artificial intelligence can improve outcomes by detecting lung tumors in chest radiographs. Currently, artificial intelligence is used as an aid for physicians to interpret radiograms, but with the future evolution of artificial intelligence, it may become a modality that replaces physicians. Therefore, in this study, we investigated the current situation of lung cancer diagnosis by artificial intelligence. METHODS: In total, we recruited 174 consecutive patients with malignant pulmonary tumors who underwent surgery after chest radiography that was checked by artificial intelligence before surgery. Artificial intelligence diagnoses were performed using the medical image analysis software EIRL X-ray Lung Nodule version 1.12, (LPIXEL Inc., Tokyo, Japan). RESULTS: The artificial intelligence determined pulmonary tumors in 90 cases (51.7% for all patients and 57.7% excluding 18 patients with adenocarcinoma in situ). There was no significant difference in the detection rate by the artificial intelligence among histological types. All eighteen cases of adenocarcinoma in situ were not detected by either the artificial intelligence or the physicians. In a univariate analysis, the artificial intelligence could detect cases with larger histopathological tumor size (p < 0.0001), larger histopathological invasion size (p < 0.0001), and higher maximum standardized uptake values of positron emission tomography-computed tomography (p < 0.0001). In a multivariate analysis, detection by AI was significantly higher in cases with a large histopathological invasive size (p = 0.006). In 156 cases excluding adenocarcinoma in situ, we examined the rate of artificial intelligence detection based on the tumor site. Tumors in the lower lung field area were less frequently detected (p = 0.019) and tumors in the middle lung field area were more frequently detected (p = 0.014) compared with tumors in the upper lung field area. CONCLUSIONS: Our study showed that using artificial intelligence, the diagnosis of tumor-associated findings and the diagnosis of areas that overlap with anatomical structures is not satisfactory. While the current standing of artificial intelligence diagnostics is to assist physicians in making diagnoses, there is the possibility that artificial intelligence can substitute for humans in the future. However, artificial intelligence should be used in the future as an enhancement, to aid physicians in the role of a radiologist in the workflow.

Accuracy of Ultrasound in the Prediction of the FIGO Classification of Placenta Accreta Spectrum.

OBJECTIVES: To evaluate the accuracy of greyscale ultrasound (US) and colour Doppler detecting placenta accreta spectrum (PAS) based on the newly recommended International Federation of Obstetrics and Gynaecology (FIGO) grading system. METHODS: This prospective study was conducted on women diagnosed with placenta previa or low-lying placenta involving the anterior uterine wall and associated with PAS as identified by the US. Transabdominal and transvaginal greyscale US was performed on admission between 34 and 36 weeks of gestation and compared to clinical grading and histopathological examination after cesarean hysterectomy. RESULTS: In total, 36 pregnant females who underwent a cesarean hysterectomy due to placenta previa complicated by PAS were included in this study. All patients had a history of previous cesarean deliveries, ranging from 1 to 5 deliveries. The US has an overall sensitivity of 33%, 55%, and 84.62%, and specificity of 100%, 75%, and 60% in detecting the 3 degrees of PAS, respectively. US cannot differentiate between the different subtypes of PAS grade 3 (a, b, and c). CONCLUSION: The overall US evaluation was highly significant in predicting the FIGO diagnosis of PAS; however, all ultrasonographic signs were equally relevant in diagnosing grade 1 and/or 2 PAS and were inaccurate in differing the subtypes of PAS grade 3.

Vulvar Leiomyoma Masquerading as Bartholin Cyst: A Case Report of Unveiled Diagnosis and Surgical Management.

Vulvar leiomyomas are rare benign tumors originating from smooth muscle cells of the vulvar tissue. We present the case of a 44-year-old female patient complaining of a painless vulval mass for 12 years, gradually increasing from 1x1 cm to 5x4 cm. Clinical assessment initially suggested a Bartholin cyst because of its non-tender and non-fluctuant nature. However, surgical intervention revealed an unexpected diagnosis of vulvar leiomyoma, measuring 5x5x4 cm. The patient underwent successful excision and repair under spinal anesthesia. This case underscores the significance of meticulous clinical evaluation and accurate histopathological examination in distinguishing vulvar masses. Accurate diagnosis guides appropriate management, and long-term follow-up prevents complications and recurrence. This report highlights the diagnostic challenges of rare vulvar lesions and the importance of a comprehensive approach to their evaluation and treatment.

Case Report: Unveiling an Incidentally Diagnosed Extrapulmonary Small Cell Carcinoma of the Rectum.

Extrapulmonary small cell carcinoma (EPSCC) is a rare malignancy with distinct clinical and pathological characteristics. We present the case of a 72-year-old male diagnosed with EPSCC of the rectum during a routine screening colonoscopy. The patient was asymptomatic, and pathological examination revealed a rectal mass displaying features of small cell carcinoma (SCC) associated with tubular adenoma. The treatment comprised radiation therapy and cisplatin/etoposide chemotherapy. This case underscores the importance of considering EPSCC as a potential diagnosis in patients with rectal masses, necessitating further studies to optimize treatment strategies.

A study on the multidisciplinary diagnostic approach of leprosy: Can we prevent the recrudescence in the post-elimination Indian scenario?

Introduction: Leprosy also widely known by the name Hansen's disease is a chronic disease caused by Mycobacterium leprae affecting mankind with various clinico-pathological forms. It remained a major public health issue due to associated case load, morbidity and stigma attached to it. India declared elimination of leprosy in the year 2005. However, it is surprising to see that in some parts of the country, the prevalence is still significant. The objective of the study is to describe the spectrum of histopathological profile of leprosy and compare its correlation with clinical diagnosis in this post elimination era. Methods: A 24-months prospective study was conducted with clinically diagnosed leprosy cases in a tertiary care hospital in eastern India. Lesions were graded and the histopathological slides along with its bacteriological index (BI) on slit skin smears where possible was reviewed and analyzed. Agreement of histopathological finding with clinical finding was established. Results: A total of 220 cases were included in the study. On histopathology, borderline category was the most frequently reported with borderline tuberculoid the most common subtype. Most common clinical feature was hypopigmented plaque, followed by erythematous skin lesions, nodules, macules etc. Bacteriological index was studied in 192 slit skin smears. Moderate agreement between clinical and histopathological diagnosis with kappa measure of inter-rater agreement as 0.457 was noted. Conclusion: Clinico-histopathological correlation is pivotal in the accurate diagnosis of leprosy to prevent, treat, and control the resurgence of the disease in the post-elimination era.

Clinical Accuracy Of Dermatologists And Nondermatologists In The Diagnosis Of Dermatological Diseases.

OBJECTIVE: To compare the clinical diagnostic accuracy of dermatologists and non- dermatologists in the diagnosis of dermatological diseases. Method: The descriptive, cross-sectional study was conducted at the Dermatopathology department of a tertiary healthcare hospital in the Punjab province of Pakistan from January 1 to December 31, 2019, and comprised biopsy specimens of patients with diseases of the skin and subcutaneous tissue. The clinical diagnoses of general surgeons, otolaryngologists, dental/maxillofacial surgeons, plastic surgeons and gynaecologists were noted and compared with those of dermatologists in the light of histopathological findings. Data was analysed using SPSS 16. RESULTS: Of the 386 specimens submitted, 113(29.3%) were sent by dermatologists and 273(70.7%) by non-dermatologists. Clinical diagnostic accuracy of dermatologists 92(81.4%) compared to non-dermatologists 137(50.2%) (p<0.005). The dermatologists diagnosed significantly more cases belonging to inflammatory and miscellaneous cutaneous diseases category accurately than non-dermatologists (p<0.005). Similarly, the dermatologists diagnosed significantly more cases of neoplastic disorders accurately than the non-dermatologists (p= 0.018). There was no significant difference in the clinical diagnostic accuracy of dermatologists and non-dermatologists in cases of cystic lesions (p>0.05). In the neoplastic category, no significant difference was found in the clinical accuracy of dermatologists and plastic surgeons (p=0.347). CONCLUSIONS: The specialised skills of dermatologists could not be matched by any other group of physicians.

Immunohistochemical Expression of Alpha-Methyl-Coa (AMACR) and ERG in Prostatic Adenocarcinoma and Prostatic Hyperplasia: A Comparative Study.

OBJECTIVE: This observational comparative study aimed at investigating the diagnostic accuracy of ERG in differentiating benign and malignant prostatic lesions and comparing it to the diagnostic accuracy of AMACR. We also aimed at comparing AMACR and ERG expression to Gleason grade of the carcinoma cases. METHODS: Seventy- two cases (22 prostatic hyperplasia and 50 prostatic carcinoma) were collected from the pathology department at Cairo university. The cases were immunostained by antibodies against AMACR and ERG. Immunohistochemical expressions of both markers were differentially examined in benign and malignant cases, compared to each other's, as well as, to the grade group of the malignant cases. RESULTS: AMACR showed 62% sensitivity and 86.4% specificity for the diagnosis of PC, with a statistically significant differential expression in benign and malignant lesions (P=0.001). Its expression also correlated significantly with the age (p=0.007), Gleason grade (P=0.006) and perineural invasion (P=0.011). Although ERG showed 100% specificity to PC with no expression in hyperplasia cases, it showed only 22% sensitivity for PC cases. ERG expression also showed statistically significant correlation with the Gleason grade. No association between ERG and AMACR expression was detected in our study (P=0.151). Regarding the diagnostic accuracy, although ERG accuracy was much lower than that of AMACR, combining both markers yielded a higher diagnostic accuracy. CONCLUSION: Although ERG proved no superior value than AMACR in diagnosing prostatic lesions, combining both markers may lead to higher diagnostic accuracy owing to higher ERG specificity for PC.

A Commoner at an Extremely Rare Site: A Case of Dorsal Intramedullary Spinal Dermoid Cyst.

Intramedullary dorsal dermoid cysts are rare benign tumors, arising from the nests of embryonic ectoderm, which get buried or trapped under the lines of fusion of the ectodermal folds in the developing embryo. We present a rare case of intramedullary dermoid cyst in a 30-year-old asymptomatic female, who presented with paraplegia and ataxia. Magnetic resonance imaging was suggestive of neoplastic intramedullary mass. Intraoperatively, findings were suspicious of tuberculosis, but on final histopathological evaluation, the final and definitive diagnosis of intramedullary dermoid cyst was rendered. The postoperative phase was uneventful.

Procedimiento anestésico-quirúrgico en un adulto con esplenomegalia por linfoma primario de bazo / Anesthetic-surgical procedure in an adult with splenomegaly due to primary spleenic lymphoma: en

Se describe el caso clínico de un adulto joven de 30 años de edad, con antecedente de buena salud, quien fue asistido en el Servicio de Cirugía del Hospital Universitario Manuel Ascunce Domenech en Camagüey por presentar aumento de volumen en la región abdominal de dos meses de evolución, concomitante con astenia, anorexia, vómitos y pérdida de peso. En el examen físico resultaron notables el abdomen globuloso (bazo palpable) sin dolor, un hematoma periumbilical y múltiples adenopatías supraclaviculares; en tanto, en los estudios imagenológicos se evidenció la presencia de esplenomegalia. Se realizó esplenectomía con administración de anestesia general endotraqueal y en el estudio histopatológico de la muestra resecada se confirmó el diagnóstico de linfoma primario del bazo.

The case report of a 30-year-old young adult with a history of good health is described, who was assisted at the Surgery Service of Manuel Ascunce Domenech University Hospital in Camagüey due to volume increase in the abdominal region with a course of two months, concomitant with asthenia, anorexia, vomits and weight loss. Physical examination revealed a globular abdomen (palpable spleen) with no pain, a periumbilical hematoma, and multiple supraclavicular adenopathies; meanwhile, in the imaging studies splenomegaly was evidenced. Splenectomy was performed with administration of general endotracheal anesthesia and the histopathological study of the resected sample confirmed the diagnosis of primary spleenic lymphoma.

Endocervical sampling using brush versus curette: a single centre experience and literature review.

Endocervical sampling is performed traditionally with an endocervical curette (ECC). The current study objective is to compare the histopathological performance of endocervical brush (ECB) and endocervical curette (ECC). A retrospective review was performed including patients included that underwent colposcopy with endocervical sampling using either method. A total of 127 samples were obtained with ECC and 98 with ECB. Histopathological diagnosis was obtained in 124 (97.6%) ECC samples and in 94 (95.9%) ECB samples (p = 0.46). The incidence of benign results was similar between ECC and ECB (117 (92.1%) versus 88 (89.8%) respectively (p = 0.28)). When combining information from endocervical sampling with cervical biopsies, the detection rate of high-grade pathologies was similar between the groups with 14 cases (17.7%) for ECC and 8 cases (17.0%) for ECB (p = 0.43). A scope review of the topic was performed, illustrating that studies favour either method. In conclusion, ECB and ECC perform similarly for providing a histopathological diagnosis on endocervical samples.IMPACT STATEMENTWhat is already known on this subject? Endocervical samples in colposcopy were traditionally obtained using an endocervical curette. Similarly, a brush can be used for histological sampling of the endocervical canal. However, it is unclear how the ability to obtain a histopathological diagnosis compares between the two techniques.What do the results of this study add? This single-institution experience with using endocervical brush and curette for endocervical sampling finds that both methods are acceptable and have a high ability to provide a histopathological diagnosis. Precisely, 4.1% of brush and 2.4% of curette samples had insufficient tissue.What are the implications of these findings for clinical practice and further research? The endocervical brush is an adequate sampling method for colposcopy, and can be safely used instead of the curette, based on clinician preference. Further studies could investigate how these methods compare from a patient perspective.

Bone metaplasia of the appendix presented with clinical and computed tomography signs of acute appendicitis managed with laparoscopic appendectomy.

Bone metaplasia or heterotopic ossification of the appendix is an extremely rare condition, which is usually associated with mucinous appendiceal neoplasms. This case describes a young male patient, who presented to the surgical emergency department with clinical and computed tomography signs of acute appendicitis. Laparoscopic appendectomy was performed. The final histopathological examination revealed a bone metaplasia of the distal appendix, without any other associated appendiceal pathology. According to our knowledge and literature review, this is the first such case described in the English literature yet.

Role of muscle biopsy in diagnosis of extraocular muscles enlargement.

PURPOSE: To study the role of muscle biopsy in patients with enlarged extraocular muscles. METHODS: A retrospective review of 31 patients who underwent biopsy for extraocular muscle enlargement. Characteristics, including signs, symptoms, imaging findings, and histopathological assessment were examined. RESULTS: Chronic inflammatory disorders represented the most common cause of the muscle enlargement followed by malignancy/metastasis. Multiple muscle involvement was more consistent with benign diseases, whereas single muscle involvement was more consistent with malignant causes. Positive predictive value of muscle biopsy was 0.52 for determining a specific cause of the muscle enlargement. CONCLUSIONS: Muscle biopsy is the standard for diagnosis in patients with extraocular muscle enlargement. This diagnostic test should be performed in every case of non-resolving muscle enlargement, with a specific diagnosis being made in over half of cases.

Diagnosing chronic pancreatitis by endoscopic ultrasound assessing the association between ultrasound and pathological findings: A narrative review.

Endoscopic ultrasound (EUS) is widely recognized for its non-invasiveness and for its usefulness in chronic pancreatitis (CP) diagnosis, including early CP. Although it is desirable to obtain a definitive diagnosis of CP by tissue sampling with EUS-guided fine needle aspiration, histopathological changes in CP are heterogeneous in terms of the extent and the distribution of lesions. Therefore, histopathological diagnosis of appropriate tissue sampling by EUS-fine needle aspiration is expected to be difficult. Furthermore, it is virtually impossible to match EUS images with pathological sections, making direct contrast between EUS findings and pathology difficult. This narrative review presents a discussion of the diagnosis of CP/early CP by EUS, particularly assessing the association between ultrasound and pathological findings. Recently, the histological corroboration and correlation of EUS findings related to CP have been clarified by surgical specimens, including those obtained from animal studies. Furthermore, remarkable advances have occurred in the objective and quantitative diagnosis of pancreatic fibrosis by EUS-elastography. Future technological advances in EUS are expected to improve the accuracy of diagnosis of pancreatic fibrosis at earlier stages.

Comparative Role of MDCT and FDG-PET/CT in the Diagnostic Evaluation of Mediastinal Mass Lesions: An Institutional Experience.

Background Mediastinal mass lesions span a wide histopathological and radiological spectrum. Partition of the mediastinum into specific compartments aids in differential diagnosis of mass lesions, assistance in biopsies, and other surgical procedures. Multidetector row computed tomography (MDCT) is a promising three-dimensional imaging tool allowing substantial anatomical volumes to be routinely covered with isotropic submillimeter spatial resolution to precisely localize lesions and biopsy needles for both benign and malignant disease lesions of the mediastinum. Objective The aim of this study was to categorize mass lesions according to the mediastinal compartments to study their MDCT characteristics and to provide a comparative role of fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the diagnostic evaluation of mediastinal mass lesions. Materials and Methods Patients with clinical or radiological suspicion of mediastinal lesions on the basis of an abnormal chest radiograph were referred to the department of radiodiagnosis at a tertiary care center between April 2015 and December 2019 for MDCT evaluation. A total of 80 cases were correlated with the histopathological diagnosis excluding aneurysms. Size, CT density (Hounsfield unit [HU] mean), and maximum standardized uptake value (SUV max ) of mediastinal and chest wall lesions were determined on FDG-PET/CT. Results This study included a total of 102 cases, 72 males and 29 females. Mediastinal mass lesions were most common in the age group 46 to 60 years. Anterior mediastinum ( n = 43, 42.2%) is the most commonly involved compartment followed by posterior mediastinum ( n = 37, 35.9%) and middle mediastinum ( n = 22, 21.8%). Transcompartmental involvement is more commonly seen involving the anterior and middle mediastinum. The SUV max , HU mean, and size were higher in malignant cases ( p = 0.001, p = 0.003, and p = 0.004, respectively). The current study found a cutoff value of 4.61 for SUV max to discriminate benign lesions from malignant ones with a sensitivity and specificity of 73.7 and 75.9%, respectively (area under the curve: 0.841, 95% confidence interval: 0.793-0.965, p = 0.0001). The values of SUV max and HU mean were higher in solid benign lesions than those of cystic benign lesions ( p = 0.007 and p = 0.003, respectively). Conclusion In the current study, MDCT has high diagnostic accuracy of ∼94% overall as compared with histopathology, and 97 and 92% for benign and malignant lesions, respectively, in the evaluation of mediastinal mass lesions. FDG-PET/CT may be complementary to conventional imaging methods for the evaluation of mediastinal and chest wall mass lesions. However, confirmatory tissue sampling is required to confirm PET positive findings for the definite diagnosis.

The effect of the number of biopsies on the delay in the time from the delivery of mammography results to breast cancer histopathological diagnosis.

PURPOSE: The delay in the time (in calendar days) from the delivery of mammography results to histopathological breast cancer (BC) diagnosis could be associated with more advanced clinical stages, a worse prognosis and higher mortality. Therefore, we assessed the association between the number of biopsies and the delay in the time (in calendar days) from the delivery of mammography results to histopathological BC. METHODS: A survey was performed on 563 women aged between 35 and 69 years with histopathologically confirmed BC who attended 11 Mexican hospitals. RESULTS: After adjusting for potential confounders, the odds of having a delay in the time (in calendar days) from the delivery of mammography results to histopathological BC diagnosis (≥ 60 days) among women with ≥ 3 biopsies were 2.99 times the odds of those who had only one biopsy (95% CI 1.35, 6.63). CONCLUSION: The number of biopsies should be considered as a predictor of the time delay between the delivery of the mammography result and the diagnostic result.

What has changed in malignant mesothelioma between 1990 and 2019? A time- series analyses in Turkey.

OBJECTIVES: To investigate the changes in epidemiological and survival characteristics of malignant mesothelioma (MM) cases diagnosed in a 30-year period between 1990 and 2019. METHODS: Data were analyzed considering three time periods (1990-1999, 2000-2009, 2010-2019) when treatment practices changed. The Join point Regression Program was used to analyze the change in clinical and epidemiological characteristics of the cases. Kaplan-Meier analysis was used to calculate the overall survival of the patients. Cox regression analysis was used to determine the effect of variables on survival. RESULTS: The study group consisted of 928 MM patients. During the study period, the mean age of the patients and the percentage of epithelioid subtype increased, while the percentage of female and histopathologically unidentified cases decreased. The median survival (95%CI) of patients according to the study periods was 9.0 (7.2-10.9), 9.0 (7.6-10.4) and 12.0 (10.5-13.5) months, respectively. A significant increase in overall survival was observed in the time trend (p = 0.013). There was no significant change in overall survival in patients receiving best supportive care over the 30-year period (p = 0.060), but an improvement of 1.4 (95%CI 0.2 to 2.7) months (p = 0.027) was observed in patient receiving chemotherapy. An improvement in overall survival of 4.8 (1.2 to 8.4) months was also observed in patients receiving multimodality treatment during 2000-2019 (p = 0.014). MM patients who were younger, female, diagnosed after 2000, epithelioid subtype, early stage, and received chemotherapy or multimodal treatment had longer survival. CONCLUSIONS: It was found that histopathological diagnosis and treatment success in MM have improved over the years.