Primary Vocal Cord Aspergillosis Can Involve the Trachea and Bronchus in Previously Healthy Patients: A Case Report.

Primary vocal cord aspergillosis is extremely rare in immunocompetent individuals, in whom lesions are mainly confined to the larynx, with the possibility of tracheal and bronchial infection largely ignored. In this article, we present a case of primary vocal cord aspergillosis involving the trachea and bronchus in a previously healthy 55-year-old woman. Our case highlights that vocal cord aspergillosis can involve the trachea and bronchus and that laryngoscopy alone may be insufficient to secure a comprehensive diagnosis in healthy patients presenting with hoarseness, pharyngalgia, and normal chest radiography. Furthermore, influenza B virus infection may be a risk factor for this rare disease.

[Correlation between conventional ultrasound features and BRAFV600E gene mutation and central lymph node metastasis in thyroid papillary carcinoma].

Objective:To investigate whether central lymph node metastasis（CLNM） in the central region of thyroid papillary carcinoma（PTC） is related to conventional ultrasound features of the primary lesion and BRAFV600E gene mutation. Methods:A total of 300 patients with PTC confirmed by surgical pathology and central lymph node dissection in the First Affiliated Hospital of Jinzhou Medical University from October 2019 to June 2021 were collected. The subjects were divided into the metastatic group and the non-metastatic group according to whether CLNM occurred. The correlation was determined by analyzing the conventional ultrasound characteristics and BRAFV600E gene test results of the two groups of patients. Results:Among 300 PTC patients, 120（40%） had CLNM. Univariate analysis showed that there were statistically significant differences between groups in gender, nodule maximum diameter line, number of lesions, boundaries, morphology, aspect ratio, proximity to the membrane, calcification and BRAFV600E gene mutation（P<0.05）. Logistic multivariate regression analysis showed that gender, maximum diameter line, aspect ratio, proximity to the membrane, microcalcification and BRAFV600E were the risk factors for CLNM in PTC patients（P<0.05）. ROC curve showed that when the maximum diameter was 8.5 mm, the Yooden index was the maximum. Conclusion:When the risk factors of male, maximum diameter ≥8.5 mm, aspect ratio ≥1, microcalcification, proximity to capsule and BRAFV600E（+） appear in PTC patients, high attention should be paid to preventive CLN dissection as soon as possible.