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We report the discovery of TOI-2180 b, a 2.8 $M_{\rm J}$ giant planet orbiting a slightly evolved G5 host star. This planet transited only once in Cycle 2 of the primary Transiting Exoplanet Survey Satellite (TESS) mission. Citizen scientists identified the 24 hr single-transit event shortly after the data were released, allowing a Doppler monitoring campaign with the Automated Planet Finder telescope at Lick Observatory to begin promptly. The radial velocity observations refined the orbital period of TOI-2180 b to be 260.8$\pm$0.6 days, revealed an orbital eccentricity of 0.368$\pm$0.007, and discovered long-term acceleration from a more distant massive companion. We conducted ground-based photometry from 14 sites spread around the globe in an attempt to detect another transit. Although we did not make a clear transit detection, the nondetections improved the precision of the orbital period. We predict that TESS will likely detect another transit of TOI-2180 b in Sector 48 of its extended mission. We use giant planet structure models to retrieve the bulk heavy-element content of TOI-2180 b. When considered alongside other giant planets with orbital periods over 100 days, we find tentative evidence that the correlation between planet mass and metal enrichment relative to stellar is dependent on orbital properties. Single-transit discoveries like TOI-2180 b highlight the exciting potential of the TESS mission to find planets with long orbital periods and low irradiation fluxes despite the selection biases associated with the transit method., Comment: Published in AJ

We report the discovery of an eccentric hot Neptune and a non-transiting outer planet around TOI-1272. We identified the eccentricity of the inner planet, with an orbital period of 3.3 d and $R_{\rm p,b} = 4.1 \pm 0.2$ $R_\oplus$, based on a mismatch between the observed transit duration and the expected duration for a circular orbit. Using ground-based radial velocity measurements from the HIRES instrument at the Keck Observatory, we measured the mass of TOI-1272b to be $M_{\rm p,b} = 25 \pm 2$ $M_\oplus$. We also confirmed a high eccentricity of $e_b = 0.34 \pm 0.06$, placing TOI-1272b among the most eccentric well-characterized sub-Jovians. We used these RV measurements to also identify a non-transiting outer companion on an 8.7-d orbit with a similar mass of $M_{\rm p,c}$ sin$i= 27 \pm 3$ $M_\oplus$ and $e_c \lesssim 0.35$. Dynamically stable planet-planet interactions have likely allowed TOI-1272b to avoid tidal eccentricity decay despite the short circularization timescale expected for a close-in eccentric Neptune. TOI-1272b also maintains an envelope mass fraction of $f_{\rm env} \approx 11\%$ despite its high equilibrium temperature, implying that it may currently be undergoing photoevaporation. This planet joins a small population of short-period Neptune-like planets within the "Hot Neptune Desert" with a poorly understood formation pathway., Comment: Accepted at The Astronomical Journal; 17 pages, 11 figures

Convergent disk migration has long been suspected to be responsible for forming planetary systems with a chain of mean-motion resonances (MMR). Dynamical evolution over time could disrupt the delicate resonant configuration. We present TOI-1136, a 700-Myr-old G star hosting at least 6 transiting planets between $\sim$2 and 5 $R_\oplus$. The orbital period ratios deviate from exact commensurability by only $10^{-4}$, smaller than the $\sim$\,$10^{-2}$ deviations seen in typical Kepler near-resonant systems. A transit-timing analysis measured the masses of the planets (3-8$M_\oplus$) and demonstrated that the planets in TOI-1136 are in true resonances with librating resonant angles. Based on a Rossiter-McLaughlin measurement of planet d, the star's rotation appears to be aligned with the planetary orbital planes. The well-aligned planetary system and the lack of detected binary companion together suggest that TOI-1136's resonant chain formed in an isolated, quiescent disk with no stellar fly-by, disk warp, or significant axial asymmetry. With period ratios near 3:2, 2:1, 3:2, 7:5, and 3:2, TOI-1136 is the first known resonant chain involving a second-order MMR (7:5) between two first-order MMR. The formation of the delicate 7:5 resonance places strong constraints on the system's migration history. Short-scale (starting from $\sim$0.1 AU) Type-I migration with an inner disk edge is most consistent with the formation of TOI-1136. A low disk surface density ($\Sigma_{\rm 1AU}\lesssim10^3$g~cm$^{-2}$; lower than the minimum-mass solar nebula) and the resultant slower migration rate likely facilitated the formation of the 7:5 second-order MMR. TOI-1136's deep resonance suggests that it has not undergone much resonant repulsion during its 700-Myr lifetime. One can rule out rapid tidal dissipation within a rocky planet b or obliquity tides within the largest planets d and f., Comment: 48 pages, 23 figures, 8 tables. Accepted to AAS journals. Comments welcome!

We validate the presence of a two-planet system orbiting the 0.15–1.4 Gyr K4 dwarf TOI 560 (HD 73583). The system consists of an inner moderately eccentric transiting mini-Neptune (TOI 560 b, P = 6.3980661 − 0.0000097 + 0.0000095 days, e = 0.294 − 0.062 + 0.13 , M = 0.94 − 0.23 + 0.31 M Nep ) initially discovered in the Sector 8 Transiting Exoplanet Survey Satellite (TESS) mission observations, and a transiting mini-Neptune (TOI 560 c, P = 18.8805 − 0.0011 + 0.0024 days, M = 1.32 − 0.32 + 0.29 M Nep ) discovered in the Sector 34 observations, in a rare near-1:3 orbital resonance. We utilize photometric data from TESS Spitzer, and ground-based follow-up observations to confirm the ephemerides and period of the transiting planets, vet false-positive scenarios, and detect the photoeccentric effect for TOI 560 b. We obtain follow-up spectroscopy and corresponding precise radial velocities (RVs) with the iSHELL spectrograph at the NASA Infrared Telescope Facility and the HIRES Spectrograph at Keck Observatory to validate the planetary nature of these signals, which we combine with published Planet Finder Spectrograph RVs from the Magellan Observatory. We detect the masses of both planets at >3σ significance. We apply a Gaussian process (GP) model to the TESS light curves to place priors on a chromatic RV GP model to constrain the stellar activity of the TOI 560 host star, and confirm a strong wavelength dependence for the stellar activity demonstrating the ability of near-IR RVs to mitigate stellar activity for young K dwarfs. TOI 560 is a nearby moderately young multiplanet system with two planets suitable for atmospheric characterization with the James Webb Space Telescope and other upcoming missions. In particular, it will undergo six transit pairs separated by

We report the detection of a long-period giant planetary companion to the nearby M3V star GJ 463 (=Ross 690). The detection is based on over ten years of highly-precise radial velocity measurements with the High Resolution Spectrograph at the Hobby–Eberly Telescope and the HIRES spectrograph at Keck. With an orbital period of 10 yr and a minimum mass of 1.55 ± 0.15 M Jup, GJ 463 b has a comparable orbital period to Jupiter and hence qualifies as a Jupiter analog around a low-mass star. We demonstrate that the radial velocity signal is not produced by a magnetic activity cycle of the host star. GJ 463 was observed with TESS, and we searched the light curve for any possible signals of stellar or planetary origin, but detected none. This planet is a candidate for possible direct detection with the coronagraph of the upcoming Nancy Grace Roman Space Telescope. We compared Gaia EDR3 with Hipparcos astrometry and detected a significant acceleration, which is likely caused by this long-period planetary companion at a = 3.53 ± 0.07 au.

$\epsilon$~Eridani is a young planetary system hosting a complex multi-belt debris disk and a confirmed Jupiter-like planet orbiting at 3.48 AU from its host star. Its age and architecture are thus reminiscent of the early Solar System. The most recent study of Mawet et al. 2019, which combined radial velocity (RV) data and Ms-band direct imaging upper limits, started to constrain the planet's orbital parameters and mass, but are still affected by large error bars and degeneracies. Here we make use of the most recent data compilation from three different techniques to further refine $\epsilon$~Eridani~b's properties: RVs, absolute astrometry measurements from the Hipparcos~and Gaia~missions, and new Keck/NIRC2 Ms-band vortex coronagraph images. We combine this data in a Bayesian framework. We find a new mass, $M_b$ = $0.66_{-0.09}^{+0.12}$~M$_{Jup}$, and inclination, $i$ = $77.95_{-21.06}^{\circ+28.50}$, with at least a factor 2 improvement over previous uncertainties. We also report updated constraints on the longitude of the ascending node, the argument of the periastron, and the time of periastron passage. With these updated parameters, we can better predict the position of the planet at any past and future epoch, which can greatly help define the strategy and planning of future observations and with subsequent data analysis. In particular, these results can assist the search for a direct detection with JWST and the Nancy Grace Roman Space Telescope's coronagraph instrument (CGI)., Comment: Published in AJ

Full list of authors: Scarsdale, Nicholas; Murphy, Joseph M. Akana; Batalha, Natalie M.; Crossfield, Ian J. M.; Dressing, Courtney D.; Fulton, Benjamin; Howard, Andrew W.; Huber, Daniel; Isaacson, Howard; Kane, Stephen R.; Petigura, Erik A.; Robertson, Paul; Roy, Arpita; Weiss, Lauren M.; Beard, Corey; Behmard, Aida; Chontos, Ashley; Christiansen, Jessie L.; Ciardi, David R.; Claytor, Zachary R.; Collins, Karen A.; Collins, Kevin I.; Dai, Fei; Dalba, Paul A.; Dragomir, Diana; Fetherolf, Tara; Fukui, Akihiko; Giacalone, Steven; Gonzales, Erica J.; Hill, Michelle L.; Hirsch, Lea A.; Jensen, Eric L. N.; Kosiarek, Molly R.; de Leon, Jerome P.; Lubin, Jack; Lund, Michael B.; Luque, Rafael; Mayo, Andrew W.; Močnik, Teo; Mori, Mayuko; Narita, Norio; Nowak, Grzegorz; Pallé, Enric; Rabus, Markus; Rosenthal, Lee J.; Rubenzahl, Ryan A.; Schlieder, Joshua E.; Shporer, Avi; Stassun, Keivan G.; Twicken, Joe; Wang, Gavin; Yahalomi, Daniel A.; Jenkins, Jon; Latham, David W.; Ricker, George R.; Seager, S.; Vanderspek, Roland; Winn, Joshua N., We present the discovery of two nearly identically sized sub-Neptune transiting planets orbiting HD 63935, a bright (V = 8.6 mag), Sun-like (Teff = 5560 K) star at 49 pc. TESS identified the first planet, HD 63935 b (TOI- 509.01), in Sectors 7 and 34. We identified the second signal (HD 63935 c) in Keck High Resolution Echelle Spectrometer and Lick Automated Planet Finder radial velocity data as part of our follow-up campaign. It was subsequently confirmed with TESS photometry in Sector 34 as TOI-509.02. Our analysis of the photometric and radial velocity data yielded a robust detection of both planets with periods of 9.0600 ± 0.007 and 21.40 ± 0.0019 days, radii of 2.99 ± 0.14 and 2.90 ± 0.13 R?, and masses of 10.8 ± 1.8 and 11.1 ± 2.4 M?. We calculated densities for planets b and c consistent with a few percent of the planet mass in hydrogen/helium envelopes. We also describe our survey's efforts to choose the best targets for James Webb Space Telescope atmospheric followup. These efforts suggest that HD 63935 b has the most clearly visible atmosphere of its class. It is the best target for transmission spectroscopy (ranked by the transmission spectroscopy metric, a proxy for atmospheric observability) in the so far uncharacterized parameter space comprising sub-Neptune-sized (2.6 R? < Rp < 4 R?), moderately irradiated (100 F? < Fp < 1000 F?) planets around G stars. Planet c is also a viable target for transmission spectroscopy, and given the indistinguishable masses and radii of the two planets, the system serves as a natural laboratory for examining the processes that shape the evolution of sub-Neptune planets. © 2021 Institute of Physics Publishing. All rights reserved., We thank NASA for funding associated with our Key Strategic Mission Support project. We thank the University of California and Google for supporting Lick Observatory and the UCO staff for their dedicated work scheduling and operating the telescopes of Lick Observatory. This paper is based on data collected by the TESS mission. Funding for the TESS mission is provided by NASA's Science Mission Directorate. We acknowledge the use of public TESS data from pipelines at the TESS Science Office and at the TESS SPOC. This research has made use of the Exoplanet Follow-up Observation Program website, which is operated by the California Institute of Technology, under contract with the National Aeronautics and Space Administration under the Exoplanet Exploration Program. Resources supporting this work were provided by the NASA High-end Computing Program through the NASA Advanced Supercomputing Division at Ames Research Center for the production of the SPOC data products. This paper includes data collected by the TESS mission that are publicly available from MAST. This research has made use of the NASA Exoplanet Archive and Exoplanet Follow-up Observation Program website, which are operated by the California Institute of Technology, under contract with the National Aeronautics and Space Administration under the Exoplanet Exploration Program. Based on observations made with the Italian TNG operated on the island of La Palma by Fundacion Galileo Galilei of Istituto Nazionale di Astrofisica at the Spanish Observatorio del Roque de los Muchachos of Instituto de Astrofisica de Canarias under programs CAT19A_162 and CAT19A_96. This work has made use of data from the European Space Agency mission Gaia (https://www.cosmos.esa.int/gaia), processed by the Gaia Data Processing and Analysis Consortium (DPAC, https://www.cosmos.esa.int/web/gaia/dpac/consortium).Funding for the DPAC has been provided by national institutions, in particular the institutions participating in the Gaia Multilateral Agreement. This work is partly supported by JSPS KAKENHI grant Nos. JP17H04574 and JP18H05439, JST PRESTO grant No. JPMJPR1775, and a Grant-in-aid for JSPS Fellows, No. JP20J21872., With funding from the Spanish government through the Severo Ochoa Centre of Excellence accreditation SEV-2017-0709.

We report the discovery of a $M=67\pm2~\mathrm{M_J}$ brown dwarf transiting the early M dwarf TOI-2119 on an eccentric orbit ($e=0.3362 \pm 0.0005$) at an orbital period of $7.200861 \pm 0.000005$ days. We confirm the brown dwarf nature of the transiting companion using a combination of ground-based and space-based photometry and high-precision velocimetry from the Habitable-zone Planet Finder. Detection of the secondary eclipse with TESS photometry enables a precise determination of the eccentricity and reveals the brown dwarf has a brightness temperature of $2100\pm80$ K, a value which is consistent with an early L dwarf. TOI-2119 is one of the most eccentric known brown dwarfs with $P, 31 pages, 8 figures, 3 tables, published in AJ, minor revisions to match published version

Space-based transit missions such as Kepler and TESS have demonstrated that planets are ubiquitous. However, the success of these missions heavily depends on ground-based radial velocity (RV) surveys, which combined with transit photometry can yield bulk densities and orbital properties. While most Kepler host stars are too faint for detailed follow-up observations, TESS is detecting planets orbiting nearby bright stars that are more amenable to RV characterization. Here we introduce the TESS-Keck Survey (TKS), an RV program using ~100 nights on Keck/HIRES to study exoplanets identified by TESS. The primary survey aims are investigating the link between stellar properties and the compositions of small planets; studying how the diversity of system architectures depends on dynamical configurations or planet multiplicity; identifying prime candidates for atmospheric studies with JWST; and understanding the role of stellar evolution in shaping planetary systems. We present a fully-automated target selection algorithm, which yielded 103 planets in 86 systems for the final TKS sample. Most TKS hosts are inactive, solar-like, main-sequence stars (4500 K < Teff < 6000 K) at a wide range of metallicities. The selected TKS sample contains 71 small planets (Rp < 4 Re), 11 systems with multiple transiting candidates, 6 sub-day period planets and 3 planets that are in or near the habitable zone of their host star. The target selection described here will facilitate the comparison of measured planet masses, densities, and eccentricities to predictions from planet population models. Our target selection software is publicly available (at https://github.com/ashleychontos/sort-a-survey) and can be adapted for any survey which requires a balance of multiple science interests within a given telescope allocation., 23 pages, 10 figures, 5 tables

We present the validation of two planets orbiting M dwarfs, TOI-1696b and TOI-2136b. Both planets are mini-Neptunes orbiting nearby stars, making them promising prospects for atmospheric characterization with the James Webb Space Telescope (JWST). We validated the planetary nature of both candidates using high-contrast imaging, ground-based photometry, and near-infrared radial velocities. Adaptive optics images were taken using the ShARCS camera on the 3 m Shane Telescope. Speckle images were taken using the NN-Explore Exoplanet Stellar Speckle Imager on the WIYN 3.5 m telescope. Radii and orbital ephemerides were refined using a combination of the Transiting Exoplanet Survey Satellite, the diffuser-assisted Astrophysical Research Consortium (ARC) Telescope Imaging Camera (ARCTIC) imager on the 3.5 m ARC telescope at Apache Point Observatory, and the 0.6 m telescope at Red Buttes Observatory. We obtained radial velocities using the Habitable-Zone Planet Finder on the 10 m Hobby–Eberly Telescope, which enabled us to place upper limits on the masses of both transiting planets. TOI-1696b (P = 2.5 days; R p = 3.24 R ⊕; M p < 56.6 M ⊕) falls into a sparsely populated region of parameter space considering its host star’s temperature (T eff = 3168 K, M4.5), as planets of its size are quite rare around mid- to late-M dwarfs. On the other hand, TOI-2136b (P = 7.85 days; R p = 2.09 R ⊕; M p < 15.0 M ⊕) is an excellent candidate for atmospheric follow-up with the JWST.

We confirm the planetary nature of TOI-532b, using a combination of precise near-infrared radial velocities with the Habitable-zone Planet Finder, TESS light curves, ground based photometric follow-up, and high-contrast imaging. TOI-532 is a faint (J$\sim 11.5$) metal-rich M dwarf with Teff = $3957\pm69$ K and [Fe/H] = $0.38\pm0.04$; it hosts a transiting gaseous planet with a period of $\sim 2.3$ days. Joint fitting of the radial velocities with the TESS and ground-based transits reveal a planet with radius of $5.82\pm0.19$ R$_{\oplus}$, and a mass of $61.5_{-9.3}^{+9.7}$ M$_{\oplus}$. TOI-532b is the largest and most massive super Neptune detected around an M dwarf with both mass and radius measurements, and it bridges the gap between the Neptune-sized planets and the heavier Jovian planets known to orbit M dwarfs. It also follows the previously noted trend between gas giants and host star metallicity for M dwarf planets. In addition, it is situated at the edge of the Neptune desert in the Radius--Insolation plane, helping place constraints on the mechanisms responsible for sculpting this region of planetary parameter space., 19 pages, 9 figures, 4 tables. arXiv admin note: text overlap with arXiv:2006.14546

Barnard’s star is among the most studied stars given its proximity to the Sun. It is often considered the radial velocity (RV) standard for fully convective stars due to its RV stability and equatorial decl. Recently, an M sin i = 3.3 M ⊕ super-Earth planet candidate with a 233 day orbital period was announced by Ribas et al. New observations from the near-infrared Habitable-zone Planet Finder (HPF) Doppler spectrometer do not show this planetary signal. We ran a suite of experiments on both the original data and a combined original + HPF data set. These experiments include model comparisons, periodogram analyses, and sampling sensitivity, all of which show the signal at the proposed period of 233 days is transitory in nature. The power in the signal is largely contained within 211 RVs that were taken within a 1000 day span of observing. Our preferred model of the system is one that features stellar activity without a planet. We propose that the candidate planetary signal is an alias of the 145 day rotation period. This result highlights the challenge of analyzing long-term, quasi-periodic activity signals over multiyear and multi-instrument observing campaigns.

We measured the Rossiter-McLaughlin effect of WASP-107b during a single transit with Keck/HIRES. We found the sky-projected inclination of WASP-107b's orbit, relative to its host star's rotation axis, to be $|\lambda| = {118}^{+38}_{-19}$ degrees. This confirms the misaligned/polar orbit that was previously suggested from spot-crossing events and adds WASP-107b to the growing population of hot Neptunes in polar orbits around cool stars. WASP-107b is also the fourth such planet to have a known distant planetary companion. We examined several dynamical pathways by which this companion could have induced such an obliquity in WASP-107b. We find that nodal precession and disk dispersal-driven tilting can both explain the current orbital geometry while Kozai-Lidov cycles are suppressed by general relativity. While each hypothesis requires a mutual inclination between the two planets, nodal precession requires a much larger angle which for WASP-107 is on the threshold of detectability with future Gaia astrometric data. As nodal precession has no stellar type dependence, but disk dispersal-driven tilting does, distinguishing between these two models is best done on the population level. Finding and characterizing more extrasolar systems like WASP-107 will additionally help distinguish whether the distribution of hot-Neptune obliquities is a dichotomy of aligned and polar orbits or if we are uniformly sampling obliquities during nodal precession cycles., Comment: 13 pages, 6 figures, to be published in The Astronomical Journal

Small planets on close-in orbits tend to exhibit envelope mass fractions of either effectively zero or up to a few percent depending on their size and orbital period. Models of thermally-driven atmospheric mass loss and of terrestrial planet formation in a gas-poor environment make distinct predictions regarding the location of this rocky/non-rocky transition in period-radius space. Here we present the confirmation of TOI-1235 b ($P=3.44$ days, $r_p=1.738^{+0.087}_{-0.076}$ R$_{\oplus}$), a planet whose size and period are intermediate between the competing model predictions thus making the system an important test case for emergence models of the rocky/non-rocky transition around early M dwarfs ($R_s=0.630\pm 0.015$ R$_{\odot}$, $M_s=0.640\pm 0.016$ M$_{\odot}$). We confirm the TESS planet discovery using reconnaissance spectroscopy, ground-based photometry, high-resolution imaging, and a set of 38 precise radial-velocities from HARPS-N and HIRES. We measure a planet mass of $6.91^{+0.75}_{-0.85}$ M$_{\oplus}$, which implies an iron core mass fraction of $20^{+15}_{-12}$% in the absence of a gaseous envelope. The bulk composition of TOI-1235 b is therefore consistent with being Earth-like and we constrain a H/He envelope mass fraction to be $, Accepted to The Astronomical Journal. 8 figures & 5 tables. Table 2 is provided in the arXiv source code

BACKGROUND: Granulomatous inflammation of the breast is an inflammatory process with multiple etiologies. It can accompany breast carcinoma or be idiopathic. It often presents clinically in a fashion mimicking carcinoma. Idiopathic granulomatous mastitis is strongly associated with lactation and is reported to occur in postpartum patients. This is the second fine needle aspiration (FNA) report of idiopathic granulomatous inflammation in the breast of a pregnant woman. CASE: A 27-year-old, 7-month-pregnant woman presented with a hard nodule in her right breast; on ultrasound examination it showed mixed echogenicity, suspicious for carcinoma. FNA showed granulomatous inflammation. The smears were highly cellular, with many clusters of and single epithelioid cells displaying moderate pleomorphism and prominent nucleoli in a background composed of neutrophils, plasma cells, lymphocytes and multinucleated cells. Core needle biopsy revealed a nonnecrotizing, granulomatous lesion. CONCLUSION: The diagnosis of granulomatous inflammation can be challenging, and the cytologic features can be difficult to separate from those of carcinoma. The relatively rare occurrence of this lesion and its cytologic features make it a potentially difficult diagnosis and diagnostic pitfall.

The modified Steiner stain is a non-specific silver stain for identifying bacteria in formalin-fixed, paraffin-embedded tissues. The principle behind its use is that bacteria are first sensitized using uranyl nitrate solution, making them able to precipitate silver from a silver nitrate solution. It is used routinely for staining gastric biopsies to identify Helicobacter pylori. Upon staining a gastric biopsy from a patient with acquired immunodeficiency syndrome (AIDS) and cytomegalovirus gastritis, we recognized that this technique also stains the viral inclusions of cytomegalovirus-infected cells. We then proceeded to stain 43 consecutive cytomegalovirus-positive gastrointestinal biopsies from 33 immunocompromised patients based on positive cytomegalovirus immunohistochemistry (DAKO-cytomegalovirus monoclonal antibody, clones DDG9 and CCH2). We also stained eight cytomegalovirus-infected, non-gastrointestinal tissue s, including lung, adrenal gland, ovary, skin and neural tissue, to ensure that the stain was staining the cytomegalovirus-infected cells and not argyrophilic or argentaffin neuroendocrine cells of the gastrointestinal tract. In 40 of the 43 cytomegalovirus-infected gastrointestinal biopsies, we saw positive staining with the modified Steiner stain (93% sensitivity). The cytomegalovirus-infected, non-gastrointestinal tissues all stained positively with the modified Steiner stain. Because the modified Steiner stain is frequently used to identify Helicobacter pylori in gastric biopsies, we propose that it be studied further for possible use either as a screen or as a confirmatory tool, or both, for cytomegalovirus inclusions in gastrointestinal biopsies.

Endoscopic biopsy forceps vary in size and design. The purpose of this prospective randomized study was to compare the quality and quantity of gastric tissue obtained by needle and non-needle versions of standard biopsy forceps and newly designed large capacity forceps. Fifty consecutive patients who underwent endoscopy with gastric biopsy forceps were enrolled in the study. There was no significant difference in the presence of crush artifact between the two forceps, both with and without the presence of a needle. Both needle and non-needle versions of the large capacity biopsy forceps were found to obtain significantly larger sized specimens (p = 0.02) than needle and non-needle versions of the standard biopsy forceps. Overall, there was no significant difference in the depth of specimen obtained when comparing the large capacity forceps to standard forceps. Needle versions of each forceps were found to obtain significantly deeper biopsies than non-needle versions of each forceps. In conclusion, our study found that large capacity forceps obtained larger specimens than standard biopsy forceps. Further clinical trials with a larger study population need to be undertaken to determine the impact of these findings on the determination of diagnoses.

Collagenous fibroma (desmoplastic fibroblastoma) is a recently described entity in the medical literature. This entity has been reported in various locations, including the upper extremities, posterior neck, upper back, lower extremities, abdominal wall, and hip. We report an interesting case of an 88-year-old man who presented with an apparent goiter involving the right anterolateral neck. Histologic studies revealed a well-circumscribed, paucicellular lesion composed of stellate and spindle-shaped fibroblasts separated by bundles of collagen. No mitotic figures, necrosis, or calcification was observed. The stellate and spindle-shaped cells were positive for vimentin and focally positive for desmin, indicating myofibroblastic differentiation. Our case exemplifies the diagnostic difficulties that these tumors may pose from the clinical and radiologic standpoint when they clinically present as a goiter.

We report herein a unique case of an esophageal collision tumor composed of a papillary adenocarcinoma and a large cell neuroendocrine carcinoma arising in a Barrett esophagus. Hematoxylin-eosin and silver staining patterns, immunohistochemistry, and electron microscopy of the large cell neuroendocrine component are discussed.

Background: The importance of histologic interpretation to establish the diagnosis of diseases affecting the small bowel is well recognized. There is no consensus regarding enteroscopic biopsy technique and the number of biopsies required to enable an adequate histologic diagnosis. Purpose: To assess the utility of endoscopically obtained biopsies in the histologic evaluation of the small bowel and to compare the quality of biopsies obtained taking one piece ("single-bite") versus two pieces ("double-bite") with a single passage of the forceps. Methods: Patients undergoing push enteroscopy (Olympus SIF-100) requiring small bowel biopsies were included in the study. A standard biopsy forceps with serrated jaws and central needle (Boston Scientific/Microvasive, Watertown, MA) was utilized. A total of nine specimens were taken from each patient: three "single-bite" and three "double-bite" biopsies in alternative fashion. A specimen was considered adequate for interpretation if contained full thickness mucosa with two or more contiguous, complete, and well oriented villous-crypt gland complexes, and there was no interference due to squashing or fragmentation. Specimens from each patient were evaluated individually for the above criteria and as a group to assess suitability to make a histological diagnosis. Results: Thirty patients were included in the study for an expected total of 270 biopsy specimens. All 90 "single-bite" (100%) but only 153/180 (85%) expected "double-bite" specimens were recovered (p

A benign clear cell tumor occurring in the trachea of a 48-year-old woman is described. This is the first such case to be reported with location outside of the lung parenchyma. Symptoms consisted of dyspnea on exertion, nonproductive cough, and finally fairly brisk hemoptysis. Histology and electron microscopy confirmed the diagnosis.

A woman had a primary pedunculated malignant melanoma. This is a rare form of presentation and may result in clinical confusion with seborrheic keratosis, fibroepithelial papilloma, or granuloma pyogenicum. The aggressive nature of the lesion was indicated by the presence of erosion and bleeding. Though the tumor cells were present only in the pedunculated mass, it had metastasized to regional lymph nodes at the time of surgery.

A 55-year-old female developed myalgias, arthralgias, fever, and abnormal liver function four weeks following intake of allopurinol. Granulomas were found in the liver. Withdrawal of allopurinol resulted in gradual improvement of clinical, biochemical, and histological lesions in this patient. To our knowledge, this is the second case report of granulomatous hepatitis following intake of allopurinol.

An unusual band on the cathodic side of the membrane was found on lactate dehydrogenase electrophoresis of blood specimens from 18 patients. Fifteen patients died shortly after the finding. No specific cause was found for the unique band, but most of the patients had arteriosclerotic cardiovascular disease with acute passive hyperemia of the liver, and prerenal azotemia.