Search

Brain tumor detection and monitoring is essential for any indicative system, as evidenced by years of research and the steady improvement of diagnostic techniques. Accordingly, treatment planning is essential to enhancing a patient's quality of life. There is an argument that deep learning could help with the difficulties of diagnosing and treating brain tumors. In this work, we introduced a hybrid deep neural network that combines state-of-the-art image enhancement methods such as contrast stretching, histogram Equalization, and logarithmic transformation with transfer learning, similar to DenseNet169 as well as ResNet149. Work provides a deep aspect of how can we improve the accuracy and efficiency of DCNN for prediction. For data selection, we create custom data which is derived from Br35H and Fig share repository, data containing benign, malignant, and normal images (596,928,364) after enhanced. Performance analyzed different scenarios different like all three enhancement algorithms data train with each neural network and evaluate performance. Performance results show the proposed work has significant improvement with Histogram equalized data with DenseNet169 which generated accuracy of 93.29%, precision of 94%, recall of 88%, score of 93%, and loss of 20.37% which is the highest matrices over all trained neural networks in this work presented. [ABSTRACT FROM AUTHOR]

Introduction Ovarian neoplasms comprises 23% of all gynaecological tumors. They are common tumors in female and ovaries are a common site for benign and malignant neoplasm. This retrospective study aimed to study spectrum, frequency and age distribution with clinicopathological correlation of ovarian tumor. Material and method This is a two-year retrospective study carried out in department of pathology National Institute of Medical sciences and Research, Jaipur (Rajasthan) from 1 June 2020 - 31 May 2022. Result Total 52 ovarian neoplasm were included in this study. It was found that right side (59.60%) was more commonly involved by tumors than left side (40.3%). Most benign ovarian tumors were seen in age group of 21-30 years and malignant ovarian tumors in 61-70 years of age group. The age group ranged from 21 - 70 years. In young patients benign serous cystadenoma was most commonly found. And in old patients mucinous adenocarcinoma was most common. Conclusion The ovarian tumors in our institute represented a wide histological spectrum. As the natural history, treatment modalities and prognosis of ovarian neoplasms differ, thus histomorphological study remains the gold standard for categorization and for proper treatment. [ABSTRACT FROM AUTHOR]

Background: In this study, we wanted to evaluate the bone tumours and tumour-like lesions as they have a very diverse morphology and overlapping patterns. Also, bone microenvironment is an ideal site for metastasis. Materials and methods: This was a hospital based retrospective and prospective study, conducted among 65 patients who presented with bone tumour and tumour-like lesions to the Department of Pathology, JJM Medical College, Davangere, over a period of 5 years with 3 years of retrospective from June 2014 to May 2017 and 2 years of prospective from June 2017 to May 2019 after obtaining clearance from Institutional Ethics Committee and written informed consent from the study participants. Results: Bone tumours and tumour-like lesions comprised of 0.7% of all the neoplasms diagnosed during the study period. Of which, benign bone tumours formed the majority (70.8%).Most of the cases were seen in 2nd decade, femur (43.1%) being the most common site. Osteochondroma was the most common tumour overall with 25 cases (38.6%) followed by giant cell tumour with 10 cases (15.4%). Osteosarcoma was the most common malignant tumour (6.2%). The histopathological and clinic-radiological correlation showed perfect agreement. Conclusion: Bone tumours and tumour-like lesions are mostly diagnosed on histopathology. Correlating with clinical and radiological data is of utmost importance. Benign bone tumours are most commonly encountered with propensity for long bones, especially femur. Immunohistochemistry is of limited value and no set makers are easily available for diagnosing and differentiating bone tumours. [ABSTRACT FROM AUTHOR]

The classification of tumours into benign and malignant continues to date to be a very relevant and significant research topic in the cancer research domain. With the advent of Computer Vision and rapid developments in the fields of deep learning, as well as medical devices and instruments, researchers are therefore utilizing the state‐of‐the‐art deep learning architectures to discover patterns in the medical image data and thereby use this information to detect tumours and classify them as benign or malignant. In this paper, we propose a custom state‐of‐the‐art deep learning architecture, the Inception‐ResNet v2 for the classification of ovarian tumours into the two categories of benign and malignant based on a custom dataset with a validation accuracy of 97.5% and a test accuracy of 67%. Furthermore, a quantum convolutional neural network (QCNN) was also implemented with an accuracy of 92% on the validation dataset. [ABSTRACT FROM AUTHOR]

Breast disease is the prevalent malignant growth in female all over the world and it is expanding in non-industrial nations, where most cases are analysed late. Mammography remains the best symptomatic advance from a treatment standpoint, despite widespread use and investigation of these images. The objective of this paper is to predict and classify the breast cancer using deep learning techniques. The extensive experiments are conducted on Wisconsin Demonstrative Bosom malignant growth (WDBC) dataset extricated from digitized pictures of Random MRI. Deep learning techniques such as deep neural network (DNN), recurrent neural network (RNN) and local linear radial basis function neural network (LLRBFNN) are used for experimental investigation. The performance of the proposed approach is experimented through various metrics such as accuracy, Jaccard index, precision, recall and F1 score. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The ovaries are important organs for reproduction. Ovarian neoplasms have become increasingly important not only because of large variety of neoplastic entities but more because they have gradually increased mortality rate in female genital cancers. The role of IHC is now employed not only for diagnosis but also for other Parameters including prognosis, staging, prediction of response to therapy and for the selection of therapeutic agents. Materials and Methods: This is a prospective study conducted in the Department of Pathology at Fakir Mohan Medical College and hospital, Balasore and S.C.B.Medical College and Hospital, Cuttack, Odisha from March 2019 to February 2020. The gross specimen received were fixed in 10 % formalin for 24hours and from every specimen multiple sections were taken from representative site for histological examination. The number of blocks varied from four to eight in number. Sections were processed in paraffin, which were cut at five microns thickness. Sections were stained with conventional hematoxylin and eosin stain. RESULTS: The age range of the tumors diagnosed varied from 22 to 71 years, with a peak incidence in 4th and 5th decade of life. Maximum benign cases were seen between 30-40 years. Maximum number of malignant tumors were seen between 40-60 years. Youngest patient was 22 years old, oldest was 71 years old. The maximum number of tumors were seen in the 30-40 years. There was a wide range of size variation in ovarian neoplasms in the present study. It ranged from 3x2cm to 30x20cm. Majority of them 40(50.1%) were in the size range of 6-10cm, followed by 33(41.2%) in the size range of 11-19 cm. Serous tumors formed the majority of ovarian neoplasms in the study. There was a total of 64 serous tumors, constituting about 75%. CONCLUSION: The role of IHC is now employed not only for diagnosis but also for other Parameters including prognosis, staging, prediction of response to therapy and for the selection of therapeutic agents. [ABSTRACT FROM AUTHOR]

Objective: To investigate a novel diagnostic model for benign and malignant pulmonary nodule diagnosis based on radiomic and clinical features, including urine energy metabolism index. Methods: A total of 107 pulmonary nodules were prospectively recruited and pathologically confirmed as malignant in 86 cases and benign in 21 cases. A chest CT scan and urine energy metabolism test were performed in all cases. A nomogram model was established in combination with radiomic and clinical features, including urine energy metabolism levels. The nomogram model was compared with the radiomic model and the clinical feature model alone to test its diagnostic validity, and receiver operating characteristic (ROC) curves were plotted to assess diagnostic validity. Results: The nomogram was established using a logistic regression algorithm to combine radiomic features and clinical characteristics including urine energy metabolism results. The predictive performance of the nomogram was evaluated using the area under the ROC and calibration curve, which showed the best performance, area under the curve (AUC) = 0.982, 95% CI = 0.940–1.000, compared to clinical and radiomic models in the testing cohort. The clinical benefit of the model was assessed using the decision curve analysis (DCA) and using the nomogram for benign and malignant pulmonary nodules, and preoperative prediction of benign and malignant pulmonary nodules using nomograms showed better clinical benefit. Conclusion: This study shows that a coupled model combining CT imaging features and clinical features (including urine energy metabolism) in combination with the nomogram model has higher diagnostic performance than the radiomic and clinical models alone, suggesting that the combination of both methods is more advantageous in identifying benign and malignant pulmonary nodules. [ABSTRACT FROM AUTHOR]

Introduction: Thyroid nodules are a common disorder of the thyroid. Most of these are benign and only 5%–30% are malignant. Fine-needle aspiration cytology (FNAC) plays a vital role in differentiating benign from malignant and hence directing toward timely intervention. Liquid-based cytology (LBC) has been recently started in sampling thyroid lesions and has shown good results. The aim of our study was to compare the cytomorphology of thyroid lesions by conventional smear (CS) and LBC method and categorize the lesions according to TBSRTC (The Bethesda System for Reporting Thyroid Cytopathology). Materials and Methods: A prospective study was conducted from January 2018 to June 2019 on 131 patients. Thyroid FNAC samples were taken to prepare 2–5 slides for conventional reporting and one sample for LBC preparation by SurePath method. Staining with hematoxylin and eosin, May–Grünwald–Giemsa, and Papanicolaou stain was done. Cases were reported by TBSRTC and compared. Results: The nonneoplastic lesions constituted the major proportion on both CS (83.2%) and LBC (73.2%). The neoplastic lesions constituted only 9.9% of all the diagnosis both on CS and LBC smear. The kappa agreement between CS and LBC cytology as per The Bethesda System for Reporting Thyroid Cytopathology came out to be 0.715, which was statistically significant. Discussion: Colloid appearance was statistically significant on comparison by both methods. The comparison of ill formed epithelioid granulomas was statistically significant in autoimmune thyroiditis cases. In malignancy cases, nuclear and cytoplasmic details were crisper on CS. Cytoplasm appeared fragile and fragmented on LBC smears. [ABSTRACT FROM AUTHOR]

Anorectal mucosal melanoma (AMM) is a rare, aggressive malignancy. The symptoms of AMM mimic common benign conditions in the anus, such as haemorrhoids; hence diagnosis is often made late, a third of patients having metastasis at first presentation. Surgical resection remains the standard of treatment, and adjuvant therapy is varied, including immunotherapy, brachytherapy, and chemotherapy. The prognosis is poor, with a 5-year survival of 20%. A 65year old woman presented with a five-year history of symptoms suggestive of haemorrhoids and was diagnosed with a malignant anorectal mucosal melanoma after symptoms worsened and further investigation was performed. She underwent surgical resection and is currently receiving adjuvant therapy. The prognosis of AMM, the lack of consensus on the treatment regimen to date, and the need for a high index of suspicion for early diagnosis are discussed. [ABSTRACT FROM AUTHOR]

Malignant tumors of sinonasal region are rare and affect less than 1 in 100,000 people per year. They are histologically diverse group and potentially pose significant management problems due to their proximity to the orbit and intracranial cavity. Although squamous cell carcinoma (SCC) is most common malignant tumor of paranasal cavity, tumors like adenocarcinoma, olfactory neuroblastoma, malignant melanoma, adenoid cystic carcinoma, sarcomas, haemoproliferative tumors, e.g. lymphoma may also occur. Retrospectively study was done in a tertiary care institute from January 2008 to December 2018 in India. Inclusion criteria—all biopsy proven PNS malignancy patients operated by endoscopic approach, irrespective of age and gender. Exclusion criteria- patients diagnosed with nasopharyngeal carcinoma, skin involvement, gross orbital involvement (muscle invasion), metastasis, operated by open approaches. 46 patients who underwent endoscopic tumor removal were reviewed. 36 (78.2%) were males and 10 (4.6%) females. Most common tumor in our study was adenoid cystic carcinoma. Recurrence was seen in 6 patients. Palliative therapy was given to all patients with recurrence. Management of malignant PNS tumor involving anterior skull base is multidisciplinary. R0 resection should be main goal in all malignant PNS malignancy. Tumors invading unresectable areas like cavernous sinus, brain parenchyma, carotids can be left in these places followed by palliation except in cases of squamous cell carcinoma. If R0 cannot be achieved surgically in SCC than patient should be considered inoperable and send for palliation. T1–T3 PNS malignant tumors can be managed by endoscopic approach followed by adjuvant therapy after a period of 6 weeks. Endoscopic excision should be converted to endoscopic assisted open approach in case of T4 tumors. We have tried to give a management protocol for management of malignant PNS tumors. Level of evidence: II. [ABSTRACT FROM AUTHOR]

Low-grade serous carcinoma of the ovary is an uncommon lesion, composing approximately 3% of ovarian neoplasms. It typically arises in association with a serous borderline tumor and is most often at an advanced stage upon diagnosis. Gene mutations in BRAF and KRAS are characteristic. Various histologic architectural patterns are known, such as papillary, micropapillary, inverted micropapillary, glandular and nested. We report a case of low-grade serous carcinoma arising years after a serous borderline tumor and contralateral teratoma; the low-grade serous carcinoma showed two patterns: micropapillary growth and a previously unreported form of solid pattern manifesting as large tumor islands without slit-like spaces. This unusual solid morphology raises the differential diagnosis of high-grade serous carcinoma, which would result in different clinical management. The presence of areas with classic micropapillary architecture, in addition to the absence of high-grade cytonuclear atypia and marked pleomorphism, support the diagnosis of low-grade serous carcinoma. Immunohistochemical stains for p53 and p16 failed to show abnormal patterns characteristic of high-grade serous carcinoma. The patient declined chemotherapy and is on letrozole; she has had recurrent right pleural effusions over six months of follow-up after surgery. [ABSTRACT FROM AUTHOR]

After the first observations of life under the microscope, it took almost two centuries of research before the idea that all living things are composed of cells or their products was speculated. The development of the microscope was a requirement for the discovery of cells. In 1673, the Dutch botanist, Anton van Leeuwenhoek, reported seeing a myriad of microscopic "animalcules" in water. Over several decades, knowledge about the structure and functions of the cell has progressed tremendously due to the advancement in various techniques like next generation sequencing, and genome wide analysis. Cancers are generated from normal cells by random karyotypic rearrangements. Immortality is a common characteristic of cancers, but its origin and purpose are still unclear. Since such rearrangements disturb long-established mitosis genes, cancer karyotypes vary instinctively but are stabilized perpetually by clonal selections for autonomy. The differentiation stage of tumors is a vital aspect in the histopathological classification of solid malignancies, strongly associated with tumor behavior, as an immature tumor is more aggressive than the more differentiated counterpart. The central focus in these events is the cell that undergoes a series of morphological and biochemical changes in course of its transition from normal to a transformed tumor cell; thus acquiring typical characteristics which aids in the process of progression. In this review an attempt has been made to enlighten upon the unusual behavior of a normal cell in transition. [ABSTRACT FROM AUTHOR]

The abnormal growth of cells in the skin causes two types of tumor: benign and malignant. Various methods, such as imaging and biopsies, are used by oncologists to assess the presence of skin cancer, but these are time-consuming and require extra human effort. However, some automated methods have been developed by researchers based on hand-crafted feature extraction from skin images. Nevertheless, these methods may fail to detect skin cancers at an early stage if they are tested on unseen data. Therefore, in this study, a novel and robust skin cancer detection model was proposed based on features fusion. First, our proposed model pre-processed the images using a GF filter to remove the noise. Second, the features were manually extracted by employing local binary patterns (LBP), and Inception V3 for automatic feature extraction. Aside from this, an Adam optimizer was utilized for the adjustments of learning rate. In the end, LSTM network was utilized on fused features for the classification of skin cancer into malignant and benign. Our proposed system employs the benefits of both ML- and DL-based algorithms. We utilized the skin lesion DermIS dataset, which is available on the Kaggle website and consists of 1000 images, out of which 500 belong to the benign class and 500 to the malignant class. The proposed methodology attained 99.4% accuracy, 98.7% precision, 98.66% recall, and a 98% F-score. We compared the performance of our features fusion-based method with existing segmentation-based and DL-based techniques. Additionally, we cross-validated the performance of our proposed model using 1000 images from International Skin Image Collection (ISIC), attaining 98.4% detection accuracy. The results show that our method provides significant results compared to existing techniques and outperforms them. [ABSTRACT FROM AUTHOR]

Introduction: Primary malignant melanomas (MM) of the female urogenital tract are extremely rare and aggressive neoplasms. The majority of these neoplasms occur in postmenopausal women, originate from the vulva and vagina, and involvement of the uterus, cervix, and ovary is exceedingly uncommon. Case Presentation: We presented a patient with MMof the uterine cervix, first diagnosed with a punch biopsy of the lesion, which was distributed fromthe cervicalmass to the vestibule and labiaminor. Sheunderwent anterior pelvic exenteration. Pathology evaluation revealed primaryMMof uterine cervix in FIGOstage III. She received adjuvant treatmentwith radiation and immunotherapy. On her fallow up 1 year after her disease diagnosis, she is still alive without evidence of distantmetastasis. Conclusions: When feasible, pelvic exenteration offers appropriate initialmanagement in cervicalMM. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to build a nomogram based on clinical markers for predicting the malignancy of ovarian tumors (OTs). Method: A total of 1,268 patients diagnosed with OTs that were surgically removed between October 2017 and May 2019 were enrolled. Clinical markers such as post-menopausal status, body mass index (BMI), serum human epididymis protein 4 (HE4) value, cancer antigen 125 (CA125) value, Risk of Ovarian Malignancy Algorithm (ROMA) index, course of disease, patientgenerated subjective global assessment (PG-SGA) score, ascites, and locations and features of masses were recorded and analyzed (p 0.05). Significant variables were further selected using multivariate logistic regression analysis and were included in the decision curve analysis (DCA) used to assess the value of the nomogram model for predicting OT malignancy. Result: The significant variables included post-menopausal status, BMI, HE4 value, CA125 value, ROMA index, course of disease, PG-SGA score, ascites, and features and locations of masses (p 0.05). The ROMA index, BMI (≥ 26), unclear/ blurred mass boundary (on magnetic resonance imaging [MRI]/computed tomography [CT]), mass detection (on MRI/CT), and mass size and features (on type B ultrasound [BUS]) were screened out for multivariate logistic regression analysis to assess the value of the nomogram model for predicting OT malignant risk (p 0.05). The DCA revealed that the net benefit of the nomogram's calculation model was superior to that of the CA125 value, HE4 value, and ROMA index for predicting OT malignancy. Conclusion: We successfully tailored a nomogram model based on selected clinical markers which showed superior prognostic predictive accuracy compared with the use of the CA125, HE4, or ROMA index (that combines both HE and CA125 values) for predicting the malignancy of OT patients. [ABSTRACT FROM AUTHOR]

Medical image analysis and disease diagnosis have significantly improved with the use of AI and Machine Learning algorithms. Automated systems for medical image analysis will help the doctors and radiologists understand the anomaly in a short span of time and with better visualization. Such automated systems will help to reduce the time taken for diagnosis by experts. Recently, Computer Vision is industrialized with the advancements in algorithms and hardware. The proposed study aims to develop a computer vision solution for automatic segmentation and classification of ovarian tumours in discriminating between benign and malignant tumours by image‐to‐image translation approach using Conditional Generative Adversarial Network (cGAN). Our method uses a novel algorithm which segments and classifies the images in a single pipeline which makes the algorithm unique and useful. This research also aims to compare its diagnostic accuracy with that of an expert radiologist. The dataset used by in the present study is formulated with images obtained from a hospital and annotated by doctors from the hospital. The obtained results show the proposed study is promising for ovarian cancer segmentation and classification with an average segmentation score of 0.825 for benign and 0.765 for malignant and classification accuracy of 83% for benign and 79% for malignant, precision score of 85% for benign and 80% for malignant and F1 score of 81% for benign and 80.1% for malignant images. The proposed methodology is evaluated on the existing MRI images to perform segmentation and classification. The results obtained shows that the proposed methodology can perform well on other MRI images. In this study, proposed methodology is convenient as separate segmentation need not be done and is giving good result. The same MRI images are segmented using UNet and classified using RESNET 101 and results are compared with the proposed methodology. [ABSTRACT FROM AUTHOR]

Simple Summary: Melanoma is a common skin cancer that can occur on any part of the body. The localization of these lesions influences the incidence and overall outcome. The aim of our study was to analyze the epidemiology, treatment patterns, and survival of patients with melanomas arising on the upper extremities and shoulders and to identify potential differences with melanomas on other parts of the body. We report the specific epidemiology of the upper extremities and shoulders and demonstrate a difference from other sites in terms of age, sex, treatment, and survival. This knowledge will help practitioners improve the quality of management of melanoma. (1) Background: Melanoma is the most common life-threatening cancer among skin cancers. Almost all locations of the skin can be affected by melanoma, and the upper limbs are one of the most frequent locations. We aimed to study the epidemiology and survival outcomes of patients with melanoma localized in the upper extremities compared with other sites. (2) Methods: The National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) database is considered the most representative of the U.S. population; we extracted melanoma cases diagnosed between 2000 and 2019. Several characteristics, including demographical, pathological, and therapeutic, were recorded, and upper extremity melanomas and melanomas from other areas were compared. Overall survival was assessed, and the groups were compared. (3) Results: 69,436 patients had melanoma in the upper limbs and shoulders and 204,794 in other body parts. Overall, 35,267 patients with upper extremity melanoma were males, 34,169 were females, and the mean age was 60. For the rest of the body, there were 118,654 males and 86,140 females, with a mean age of 59. Surgery alone was the most commonly used treatment, while radiation therapy was the least used for all sites. Women appear to have better survival than men. Superficial spreading melanoma is the least lethal subtype, while nodular melanoma is the most dangerous. (4) Conclusion: Women under 50 are more at risk than men of the same age. The trend reverses after age 50 where men are at greater risk. In addition to gender and age, disease stage and major histologic subtypes influence survival. [ABSTRACT FROM AUTHOR]

Simple Summary: Merkel Cell Carcinoma (MCC) is a neuroendocrine skin tumor with malignant characteristics. Multiple regions can be affected, and tumoral incidence and outcomes vary depending on the primary site. A multidisciplinary team management is of paramount importance to offer the best treatment options to patients. Due to the low incidence of MCC, fine analysis of specific regions is limited, particularly the external ear. We performed a population-based analysis of demographic and survival outcomes of external ear MCC. The aim of this study is to offer updated data on tumor behavior and survival outcomes of this specific region. The male gender, an age over 80 years old and a tumor size above 5 cm were risk factors for low overall survival. Gross (<1 cm) and wide (>1 cm) margins of surgical excision offer the best overall survival. (1) Background: Due to its highly aggressive behavior, the ability to identify and manage Merkel Cell Carcinoma (MCC) with a full understanding of its characteristics is essential. Because the external ear is an exposed area, resection can have dramatic consequences on patient's self-image, which is why it is fundamental to detect MCC, typically found on UV-exposed regions such as the ears, at an early stage. (2) Methods: The Surveillance, Epidemiology, and End Results (SEER) database was searched for all external ear MCC between 2000 and 2019. A descriptive analysis based on frequencies was made to describe the demography of pathophysiologic features linked to MCC. Overall survival (OS) was studied and compared between variables with a log rank test. A multivariable Cox regression analysis was then computed to identify independent prognostic factors. (3) Results: A total of 210 patients (160 men) were identified with a median age of 80 years. The median OS was 47 months. Factors associated with lower OS included an age of over 80 years, the male gender, a tumor size of >5 cm, and metastatic disease. Gross (<1 cm) and wide (>1 cm) surgery excision margins were the surgery types with the best OS. (4) Conclusions: MCC of the external ear is diagnosed mostly in old men. Among the 182 patients who received a surgical procedure, gross and wide excision without radiotherapy were associated with the best OS. [ABSTRACT FROM AUTHOR]

Melanotic nerve sheath tumor (MNST) is a rare variant of schwannoma. Here, we report an unusual case of multiple MNST lesions located in the upper limb nerves. The patient presented with a mass on the left wrist in 2016 and another mass on the left thumb in 2017. In both instances, magnetic resonance imaging scans confirmed multiple giant-cell tumors of the tendon sheath. Persistent pain in the left upper limb and numbness in the ring finger and little finger recurred in 2021. High-frequency ultrasound (HFUS) showed that the left brachial plexus nerves (C5-8) were widened compared with those on the contralateral side; the neuroma formed at the lateral cord, and the median nerve was markedly thickened. The surgical findings were consistent with the ultrasound results. Pathology confirmed that the tumors were malignant MNSTs. HFUS is important for preoperative diagnosis and lesion localization, even identifying some lesions that are unrecognized on magnetic resonance imaging; thus, HFUS is crucial for improving surgical strategy and decision-making. [ABSTRACT FROM AUTHOR]

Breast cancer (BC) is one of the deadly forms of cancer, causing mortality worldwide in the female population. The standard imaging procedures for screening BC involve mammography and ultrasonography. However, these imaging procedures cannot differentiate subtypes of benign and malignant cancers. Here, histopathology images could provide better sensitivity toward benign and malignant cancer subtypes. Recently, vision transformers have been gaining attention in medical imaging due to their success in various computer vision tasks. Swin transformer (SwinT) is a variant of vision transformer that works on the concept of non-overlapping shifted windows and is a proven method for various vision detection tasks. Thus, in this study, we investigated the ability of an ensemble of SwinTs in the two-class classification of benign vs. malignant and eight-class classification of four benign and four malignant subtypes, using an openly available BreaKHis dataset containing 7909 histopathology images acquired at different zoom factors of 40×, 100×, 200×, and 400×. The ensemble of SwinTs (including tiny, small, base, and large) demonstrated an average test accuracy of 96.0% for the eight-class and 99.6% for the two-class classification, outperforming all the previous works. Thus, an ensemble of SwinTs could identify BC subtypes using histopathological images and may lead to pathologist relief. [ABSTRACT FROM AUTHOR]

Angiomatoid fibrous histiocytoma (AFH) is a rare neoplasm described for the first time by Enzinger in 1979, and classified by World Health Organization 2020 as intermediate malignant potential neoplasm. It mostly occurs in the subcutis and is characterized by varying proportions of epithelioid, ovoid and spindle cells in a nodular and syncytial growth pattern, with some hemorrhagic pseudovascular spaces. In this paper, we report the clinical case of a 62-year-old man who presented with AFH on the right arm, and relapsed three years after first surgical excision. After a further three years, the patient presented with an intramuscular localization of AFH, and 12 months after this, a pulmonary metastasis of AFH was diagnosed. Given the rarity of the spreading of AFH, we performed Fluorescence In Situ Hybridization (FISH) and we detected EWSR1::CREB1 gene fusion. [ABSTRACT FROM AUTHOR]

Anorectal amelanotic melanoma is a rare and aggressive disease with high morbidity and mortality. A conclusive diagnosis of anorectal amelanotic melanoma poses a challenge to pathologists and clinicians due to the protean nature of this entity, be it in its initial clinical assessment appearing as non pigmented polypoidal growths usually mistaken for haemorrhoids or anorectal polyps. Histomorphologically, these entities get categorised in bewildering array of diagnoses like spindle cell carcinoma, Gastrointestinal Stromal Tumour (GIST), High grade sarcomas and even lymphoma. Thus Immunohistochemistry (IHC) remains a vital tool for conclusive diagnosis. The purpose of the present case series is to discuss in detail about the three patients all aged above 55 years and clinically assessed with anorectal polypoidal growths. All three cases on histopathological evaluation were diagnosed as spindle cell neoplasm with no discernible melanin pigments. The IHC performed on all three cases turned positive for S-100 and Human Melanoma Black 45 (HMB 45). This case series highlights the challenging and bewildering nature of presentation of anorectal amelanotic melanomas, by virtue of its rarity and hence justifies the need for it to be considered as a possible differential diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Benign and malignant pelvic masses can occur in different age groups, primary diagnosis and choosing the appropriate surgical procedure is very important. Ultrasound (USG) is the diagnostic test of choice in evaluating pelvic masses, while Computed Tomography (CT) scan is most helpful as a second-line study, for in-depth evaluation of the abdomen and pelvis. Aim: To compare the findings of ultrasound and CT scans of pelvic masses with definitive histopathological or laboratory findings. Materials and Methods: A cross-sectional study was conducted at Government Medical College and Rajindra Hospital, Patiala, Punjab, India, from December 2014 to September 2015. Sixty patients from Outpatient and Inpatient Department, with clinical suspicion of pelvic pathology, were evaluated sonographically and then by CT scan. Ultrasound characterisation of mass as high or low risk was done based on septae and solid part echogenicity. CT findings used to diagnose malignancy were cystic solid mass, necrosis in a solid lesion, cystic lesion with thick, irregular walls or septa, and/or papillary projections. The presence of ascites, lymphadenopathy, omental cake, peritoneal deposits, mesenteric deposits was noted to diagnose metastasis. Data was analysed using Statistical Package for Social Sciences (SPSS) version 16.0. A p-value was calculated using Chi-square test. For finding, the level of agreement between USG/CT scan and histopathology, Kappa statistic was applied. Results: Ultrasound had sensitivity of 73.7%, specificity of 80.3%, Positive Predictive Value (PPV) of 53.8% and Negative Predictive Value (NPV) of 90.7%. Computed tomography scan had a sensitivity of 78%, specificity of 95.08%, PPV of 83.3%, and NPV of 93.5%. Kappa statistics showed moderate level of agreement between USG and histopathological findings (k=0.47, p-value=0.017) and good level of agreement between CT scan and histopathological findings (k=0.68, p-value=0.001). Conclusion: Ultrasound with its good sensitivity can be used as an effective screening modality for pelvic masses. Computed tomography scan has better specificity than USG and should be used as a confirmatory investigation. [ABSTRACT FROM AUTHOR]

Background: There is considerable overlap in radiologic features of tubercular and malignant spinal lesions on conventional magnetic resonance imaging (MRI). Purpose: To evaluate the role of dynamic contrast-enhanced (DCE) MRI perfusion parameters in differentiating vertebral malignancy from spinal tuberculosis. Material and Methods: This was a prospective study and we enrolled consecutive patients presenting with a clinical/radiologic evidence of vertebral lesions. DCE-MRI of the spine was performed using 3D volume interpolated breath-hold examination (VIBE) sequence after intravenously injecting 0.1 mmol/kg body weight of gadopentetate dimeglumine. We used Tofts model to calculate DCE parameters that included Ktrans (transfer constant), kep (rate constant), ve (fractional volume of extracellular extravascular space), and iAUC (initial area under the curve). We compared the mean value of each perfusion parameter by type of lesion (tubercular/malignant) at 0.05 significance level and performed receiver operating characteristic curve analysis. Results: We could confirm histologic/cytologic diagnosis in 35 of the 45 patients recruited. Of these, 19 were tubercular and 16 were malignant lesions. The mean (± standard deviation) of kep (min−1) was significantly higher (2.89 ± 3.3) in malignant compared to tubercular lesions (0.81 ± 0.19), whereas ve was significantly lower in malignant (0.27 ± 0.13 mL/g) compared to benign lesions (0.47 ± 0.12 mL/g) at 0.05 significance level. kep cutoff of ≥1.17 min−1 had a sensitivity of 93.8% and specificity of 100% with a diagnostic accuracy of 94.4% in detecting malignant disease. Conclusion: High kep is the single best predictor of malignant vertebral lesions. We recommend kep cutoff value of ≥1.17 min−1 that has high diagnostic accuracy in identifying malignant lesions. [ABSTRACT FROM AUTHOR]

Malignant or aggressive primary musculoskeletal tumors are rare and encompass a wide variety of bone and soft tissue tumors. Given the most common site for metastasis from these primary musculoskeletal tumors is to the lung, chest imaging is integral in both staging and surveillance. Extrapulmonary metastases are rarely encountered with only a few exceptions. Following primary tumor resection, surveillance of the primary tumor site is generally recommended. Local surveillance imaging recommendations differ between primary tumors of bone origin versus soft tissue origin. This document consolidates the current evidence and expert opinion for the imaging staging and surveillance of these tumors into five clinical scenarios. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer-reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which peer-reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation. [ABSTRACT FROM AUTHOR]

Background: Incidental indeterminate solitary solid pulmonary nodule is a progressively common finding on CT worldwide. Once detected, there are a number of imaging modalities that can be done to help in nodule characterization and differentiating benign from malignant nodules. Through these imaging modalities, there are PET CT, SPECT and dynamic CE-CT. Dynamic CE-CT is a functional test that help in assessment of the vascularity of the nodule which reverb the degree of angiogenesis of that nodule so can help in differentiating benign from malignant pulmonary nodules. The purpose of this study was to evaluate the role of Dynamic CE-CT in characterization of solitary pulmonary nodules. Detect what are the important parameters on dynamic CE-CT to differentiate benign from malignant nodules and detect their cutoff values. Results: The pre-enhancement value shows cutoff point of 26.50 HU with sensitivity 93.8% and specificity 75% with accuracy rate 90% in differentiating benign from malignant pulmonary nodules. Peak enhancement value (at 2 min) shows cutoff point of 40.00 HU with sensitivity 96.9% and specificity 87.5% with accuracy rate 95% in differentiating benign from malignant pulmonary nodules. Net enhancement value shows cutoff point of 19.00 HU with sensitivity 96.9% and specificity 87.5% with accuracy rate 95% in differentiating benign from malignant pulmonary nodules. Conclusion: Dynamic CE-CT is a useful tool in differentiating benign from malignant pulmonary nodules. Peak and net enhancement values are important parameters with high sensitivity and specificity in differentiating benign from malignant pulmonary nodules. [ABSTRACT FROM AUTHOR]

Purpose: No evidence exists to support the use of tunneled non-cuffed pigtail drainage catheters in patients with refractory ascites or pleural effusion. The purpose of this study was to determine the feasibility of non-cuffed tunneled pigtail drainage catheters in patients with refractory ascites or pleural effusions. Materials and Methods: Between October 5, 2020 and May 25, 2021, 34 pigtail catheters were implanted in 27 patients (17 males, 10 females; average age: 65.66 ± 12.04 years) under either ultrasound or computed-tomography guidance (19 catheters for ascites, 15 catheters for pleural effusion). Twenty-eight catheters (82.35%) were implanted for malignant etiologies, and 6 catheters (17.65%) were implanted for benign etiologies. The catheters (size: 8–14 French) were implanted through a subcutaneous tunnel. Complication rate and factors related to complications were analyzed. Catheter lifetime was analyzed with Kaplan–Meier method. Results: Patency ranged from 3 to 211 days. None of the patients experienced a major complication (e.g., peritonitis and empyema). Meanwhile, 8 minor complications were observed including 3 catheter occlusion, 3 ascites leakage, 1 peri-catheter local skin infection, 1 peri-catheter local skin reaction. None of the etiologies were related to the catheter complications. However, the 8-F catheter was associated with a significantly higher complication rate (odds = 5.5, p = 0.044). The estimated mean [CI] dwelling time of a catheter was 59.18 [32.97, 85.39] days. Conclusions: Image-guided insertion of tunneled peritoneal or pleural pigtail external drainage catheters achieved with a 100% technical success rate and resulted in an acceptable complication rate and catheter lifetime for the management of refractory ascites or pleural effusion. [ABSTRACT FROM AUTHOR]

Copyright of Veterinarska Stanica is the property of Croatian Veterinary Institute and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To propose a deep learning-based classification framework, which can carry out patient-level benign and malignant tumors classification according to the patient's multi-plane images and clinical information. Methods: A total of 430 cases of spinal tumor, including axial and sagittal plane images by MRI, of which 297 cases for training (14072 images), and 133 cases for testing (6161 images) were included. Based on the bipartite graph and attention learning, this study proposed a multi-plane attention learning framework, BgNet, for benign and malignant tumor diagnosis. In a bipartite graph structure, the tumor area in each plane is used as the vertex of the graph, and the matching between different planes is used as the edge of the graph. The tumor areas from different plane images are spliced at the input layer. And based on the convolutional neural network ResNet and visual attention learning model Swin-Transformer, this study proposed a feature fusion model named ResNetST for combining both global and local information to extract the correlation features of multiple planes. The proposed BgNet consists of five modules including a multi-plane fusion module based on the bipartite graph, input layer fusion module, feature layer fusion module, decision layer fusion module, and output module. These modules are respectively used for multilevel fusion of patient multi-plane image data to realize the comprehensive diagnosis of benign and malignant tumors at the patient level. Results: The accuracy (ACC: 79.7%) of the proposed BgNet with multi-plane was higher than that with a single plane, and higher than or equal to the four doctors' ACC (D1: 70.7%, p=0.219; D2: 54.1%, p<0.005; D3: 79.7%, p=0.006; D4: 72.9%, p=0.178). Moreover, the diagnostic accuracy and speed of doctors can be further improved with the aid of BgNet, the ACC of D1, D2, D3, and D4 improved by 4.5%, 21.8%, 0.8%, and 3.8%, respectively. Conclusions: The proposed deep learning framework BgNet can classify benign and malignant tumors effectively, and can help doctors improve their diagnostic efficiency and accuracy. The code is available at https://github.com/research-med/BgNet. [ABSTRACT FROM AUTHOR]

Background: Cancer-associated fibroblasts (CAFs) are the important component of the tumor microenvironment (TME). Previous studies have found that some pro-malignant CAFs participate in the resistance to radiotherapy as well as the initiation and progression of tumor recurrence. However, the exact mechanism of how radiation affects CAFs remains unclear. This study aimed to explore the effect and possible mechanism of radiationactivated CAFs, and its influence on lung cancer. Methods: CAFs were isolated from surgical specimens in situ and irradiated with 8Gy x-rays. The changes in cell morphology and subcellular structure were observed. CAFs marker proteins such as FAP and a-SMA were detected by Western Blotting. Cell counting kit-8 (CCK8) assay, flow cytometry, wound healing assay, and transwell chamber assay was used to detect the activation of cell viability and migration ability. A nude mouse xenograft model was established to observe the tumorigenicity of irradiated CAFs in vivo. The genomic changes of CAFs after radiation activation were analyzed by transcriptome sequencing technology, and the possible mechanisms were analyzed. Results: The CAFs showed a disorderly growth pattern after X-ray irradiation. Subcellular observations suggested that metabolism-related organelles exhibited more activity. The expression level of CAFs-related signature molecules was also increased. The CAFs irradiated by 8Gy had good proliferative activity. In the (indirect) co-culture system, CAFs showed radiation protection and migration induction to lung cancer cell lines, and this influence was more obvious in radiation-activated CAFs. The radiation protection was decreased after exosome inhibitors were applied. Vivo study also showed that radiation-activated CAFs have stronger tumorigenesis. Transcriptome analysis showed that genes were enriched in several procancer signaling pathways in radiation-activated CAFs. Conclusions: Our study confirmed that CAFs could be activated by ionizing radiation. Irradiation-activated CAFs could promote cancer cell proliferation, migration, radiotherapy tolerance, and tumorigenesis. These results suggested that irradiation-activated CAFs might participate in the recurrence of lung cancer after radiotherapy, and the inhibition of CAFs activation may be an important way to improve clinical radiotherapy efficacy. [ABSTRACT FROM AUTHOR]

In patients with distributed stomach and pelvic cancers, acute and subacute digestive obstruction is a common occurrence. MBO (dangerous gut check) is predicted to occur in the year 1028. ovarian malignancies account for 5.542 percent of colorectal illnesses and 4% of colorectal cancers. In general, it is estimated to occur in 2% of all patients with a cutting-edge threat. It addresses a pattern of recurrence in some patients and a progression of illness in others. As a result, a show with an entrail check has a significant impact on both patients and their families. This audit depicts the current MBO administration, as well as the clinical, interventional, and careful approaches that are used in combination to improve outcomes in these difficult patients. Case presentation: She is, a 50-year-old Female admitted to rural hospital with the objection of torment in mid-region, Nausea, and regurgitating seance 2 days. The patient has no set of experiences of Hypertension and Diabetes Mellitus Tuberculosis and asthma, Patient was cognizant and situated, All scheduled examination was finished. Patient colonoscopy shows climbing colon friable, lumen impeding mass, and various biopsies taken from the mass. Impression Carcinoma climbing colon. Decisions: A 50-year-old female patient conceded to the emergency clinic with the main grievance of torment in mid-region, Nausea, and heaving seen 2 days. After all examination patient was analyzed as an instance of Subacute little Intestinal obstacle auxiliary to harmful prehepatic flex. Presently she is going to be under treatment. Presently tolerant guess is better compared to past and counsel the patient for the ordinary multi-day follow up. [ABSTRACT FROM AUTHOR]

In patients with solitary thyroid nodules, the first course of action is to determine whether the nodule is benign or malignant. Many investigations are used to differentiate between benign and malignant nodules so as to avoid surgery in those who don't need it. Among these, FNAC and USG are commonly used in association with clinical features but there are drawbacks of each technique. The present study was undertaken to assess the diagnostic effectivity of thyrotropin (also known as TSH) to thyroglobulin ratio in correlation with histopathology in euthyroid patients having solitary thyroid nodule. This is a prospective study carried out on 48 euthyroid cases of solitary thyroid nodule. All patients subjected to FNAC, USG, thyrotropin and thyroglobulin assay. Then, they underwent surgery and histopathological examination (HPE) of the specimens done. Finally, the histopathology reports were correlated with the thyrotropin to thyroglobulin ratio in order to evaluate their sensitivity and specificity by statistical methods. The sensitivity and specificity of thyrotropin to thyroglobulin ratio was 100% and 100% respectively. All malignant lesions according to thyrotropin to thyroglobulin ratio were confirmed by histopathology indicating its excellence. Therefore, TSH to thyroglobulin ratio helps in planning the correct management and avoids second surgery. It was found that serum TSH:Tg is a safe, reliable and effective diagnostic modality with a high sensitivity and specificity and is the single best investigation for preoperative evaluation of solitary thyroid nodule to differentiate between benign and malignant nodules. [ABSTRACT FROM AUTHOR]

Skin Cancer is one of the acute diseases listed under top 5 groups in 2020 report of World Health Organisation. This research aims to propose a Convolutional Neural Network framework to extract and evaluate the suspicious skin region. This framework consists following phases; (i) Image collection and resizing, (ii) Suspicious skin section extraction using VGG-UNet, (iii) Deep-feature extraction, (iv) Handcrafted features mining from the suspicious skin section, (v) serial feature integration, and (vi) Classifier training and validation. This research considered dermoscopy images of International Skin Imaging Collaboration benchmark dataset for the experimental assessment and the result of the proposed framework is separately analysed for segmentation and classification tasks. In this work, benign and malignant class images are considered for the examination and during the classification task, integration of the deep and handcrafted features are considered. The experimental results of this study present a segmentation accuracy of > 98% with UNet and a classification accuracy of > 98% with VGG16 combined with Random Forest classifier. [ABSTRACT FROM AUTHOR]

Objective: Phyllodes tumors (PTs) are a rare group of breast tumors. Most malignant transformations are in situ carcinomas that are extremely rare and are limited to individual cases in the literature. The presence of in situ/invasive carcinomas is important as this may alter clinical judgment and management. In this study, we aimed to determine the association of in situ/invasive carcinomas among PTs. Materials and Methods: This retrospectively designed study included cases diagnosed with PTs between 2011 and 2020 in the pathology department of a tertiary level hospital. Tumors were grouped into benign, borderline and malignant, according to stromal overgrowth, stromal atypia, stromal cellularity and mitotic activity. In addition, age, location, type of operation, tumor diameter, and surgical margin information were recorded. In situ and/or invasive carcinoma foci accompanying the PTs were assessed. Results: A total of 29 patients diagnosed with PTs were identified, among whom 14 (48.2%) had benign PTs, 10 (34.4%) had borderline PTs, and 5 (17.2%) had malignant PTs. Of the patients with PTs, 3 (10.3%) had coexistent invasive carcinoma and 1 (3.4%) had carcinoma in situ. In this cohort the incidence of coexistence of PT and carcinoma was 4/29 (13.7%), which is much higher than previously reported (1.1% and 6%). The incidence of carcinoma was 2/5 (40%) in malignant PT patients and 2/10 (20%) in borderline PT patients. The coexistence of malignant PTs and carcinoma was significantly higher than those of benign and borderline PTs (p<0.05). Conclusion: The multidisciplinary team dealing with breast diseases has a great responsibility in both diagnosis and treatment. We anticipate that these rates will increase with an increase in the awareness and importance of this coexistence of carcinoma and PTs. [ABSTRACT FROM AUTHOR]

Objective: To assess the predictive ability of a multi-parametric MRI-based radiomics signature (RS) for the preoperative evaluation of Ki-67 proliferation status in sinonasal malignancies. Methods: A total of 128 patients with sinonasal malignancies that underwent multi-parametric MRIs at two medical centres were retrospectively analysed. Data from one medical centre (n = 77) were used to develop the predictive models and data from the other medical centre (n = 51) constitute the test dataset. Clinical data and conventional MRI findings were reviewed to identify significant predictors. Radiomics features were determined using maximum relevance minimum redundancy and least absolute shrinkage and selection operator algorithms. Subsequently, RSs were established using a logistic regression (LR) algorithm. The predictive performance of RSs was assessed using calibration, decision curve analysis (DCA), accuracy, and AUC. Results: No independent predictors of high Ki-67 proliferation were observed based on clinical data and conventional MRI findings. RS-T1, RS-T2, and RS-T1c (contrast enhancement T1WI) were established based on a single-parametric MRI. RS-Combined (combining T1WI, FS-T2WI, and T1c features) was developed based on multi-parametric MRI and achieved an AUC and accuracy of 0.852 (0.733–0.971) and 86.3%, respectively, on the test dataset. The calibration curve and DCA demonstrated an improved fitness and benefits in clinical practice. Conclusions: A multi-parametric MRI-based RS may be used as a non-invasive, dependable, and accurate tool for preoperative evaluation of the Ki-67 proliferation status to overcome the sampling bias in sinonasal malignancies. Key Points: • Multi-parametric MRI-based radiomics signatures (RSs) are used to preoperatively evaluate the proliferation status of Ki-67 in sinonasal malignancies. • Radiomics features are determined using maximum relevance minimum redundancy (mRMR) and least absolute shrinkage and selection operator (LASSO) algorithms. • RSs are established using a logistic regression (LR) algorithm. [ABSTRACT FROM AUTHOR]

Background: With rising rates of hepatocellular carcinoma, Egypt has the highest global prevalence of hepatocellular carcinoma (HCC). It has been demonstrated that intra-arterial lipiodol ethanol combination embolization is efficient in the treatment of HCC. Objective: To highlight the efficacy of the intra-arterial ethanol embolization in treatment of hepatocellular carcinoma with malignant portal vein thrombosis (PVT). Patients and Methods: This follow up study was conducted on 46 patients with hepatocellular carcinoma and malignant portal vein thrombosis done in National Liver Institute, Menoufiya University from March 2020 to March 2022. Results: Status and reaction at the conclusion of the research both substantially correlated with PVT (P<0.001). Complete responses were more frequently found in grade II patients (4 patients) than in grade III patients (12 patients), according to data (50.00%). In this trial, 46 patients were involved; 8 patients (17.4%) died, and 38 patients (82.6%) survived; 26.1% of these patients declined follow-up or lost touch, and 17.4% had a full response. Status at the conclusion of the program was revealed to be significantly negatively correlated with PVT grade. However, there was no discernible relationship between study status at the conclusion and gender, ascites, Child score, or number of sessions. Conclusion: Trans arterial ethanol embolization (TAELE) can be used for early-stage HCC, as well as for intermediate-stage disease if other curative modalities are not feasible and can be considered when treating selected patients with segmental portal vein tumor thrombosis (PVTT) (grade I) and preserved liver function. [ABSTRACT FROM AUTHOR]

Background: Previous studies on oral submucous fibrosis (OSF) mostly focused on the activation of fibroblasts and collagen metabolism, while little involved in the epithelium. As we have reported the role of differentiated embryo-chondrocyte expressed gene 1 (DEC1) in oral cancer and other precancerous lesions, this research aimed to explore its role in the OSF epithelium.Methods: Expression of DEC1 and other proteins were investigated in tissue array constructed with 33 OSF and 14 normal oral mucosa (NOM) tissues. Human oral keratinocytes treated with arecoline and/or hypoxia were used to simulate OSF epithelium and detected for morphological and protein alterations. Inhibition of DEC1 was used to explore its mediating role. Finally, animal models of OSF constructed by locally arecoline injecting in buccal mucosa were used to verify our findings.Results: DEC1 overexpression could be detected in the epithelium of OSF compared with that in NOM followed by phosphorylated FAK and Akt, and DEC1 showed a significant positive correlation with them. Cytology experiment revealed that OSF-like treatment could upregulate DEC1 expression followed by phosphorylated FAK, Akt, but inhibit E-cadherin, while knockdown of DEC1 could suppress the effects. In addition, OSF mice revealed higher expression of DEC1 in the epithelium of buccal mucosa, along with synchronized alterations of phosphorylated FAK and Akt.Conclusion: In the epithelium of OSF, overexpression of DEC1 induced activation of FAK/Akt signal axis, caused mesenchymal transition in epithelial cells, and may promote malignant transformation of OSF. Targeting DEC1 in OSF could be promising a new target for the diagnosis and treatment of this process. [ABSTRACT FROM AUTHOR]

Background: The diagnosis of malignant glioma confers a poor prognosis in the pediatric population. In the adult demographic, racial disparities exist with respect to access to care and survival. Yet to date no efforts have been made to characterize racial disparities in the care of malignant pediatric gliomas. Correspondingly, the aim of this study was to understand if racial disparities exist in the setting of malignant pediatric gliomas. Methods: All pediatric malignant gliomas patients with known race status (White, Black, Other) in the US National Cancer Database (NCDB) between the years 2005–2016 were retrospectively reviewed. Demographic, socioeconomic and clinical data were then abstracted and analyzed by comparison and regression techniques. Results: A total of 1803 pediatric malignant glioma cases were identified, with 48% female and a median age of 8 years old. Brainstem locations were reported in 48% of cases. Socioeconomically, there were statistically significant differences with respect to insurance status, yearly income, household education level and metropolitan residences between the racial groups (all P < 0.01). With respect to treatment, there was statistical difference in the proportion of patients treated with surgical resection (White 43% vs Black 34% vs Other 37%, P = 0.02). There were no differences between race groups for radiation therapy (P = 0.73) or chemotherapy (P = 0.12). The odds of surgical resection were significantly less in the Black group compared to the White group (OR 0.69, P < 0.01), although there was no difference in overall survival between the two groups in those treated with (P = 0.44) or without (P = 0.27) surgical resection. Primary associations of surgical resection in the Black group were brainstem location (P < 0.05) and lower yearly household income quartiles (P < 0.05). Conclusions: Racial disparities exist amongst the management of pediatric malignant gliomas, with undefined impact on survival and quality of life. In this perspective, we identified associations between Black patients and access to surgical treatment. Understanding that there are many elements to patient care, including quality of life, should encourage all clinicians and carers to consider racial disparities appropriately when managing malignant pediatric glioma patients. [ABSTRACT FROM AUTHOR]

Copyright of Diversitas Journal is the property of Diversitas Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The nuclear features that are thought to be classic indicators of thyroid nodules are not fully observed in core needle biopsies (CNB). The aim of this study was to evaluate the histopathological differences between CNB samples and resection sections. Material and methods: The haematoxylin and eosin-stained CNB and resection sections of thyroid nodules were retrospectively re-evaluated in terms of nuclear and architectural parameters. The evaluations were conducted by 2 pathologists. Statistical analysis was applied in 80 selected cases diagnosed as benign (n = 37) and papillary carcinoma/suspicious for papillary carcinoma (n = 43). Results: The nuclear findings in the CNB were more subtle than in the resection sections. The nuclei were smaller (measurements of the nuclear areas, major axes, and minor axes in CNB and resection sections were 52.62 µm2, 9.89 µm, 6.75 µm, 129.18 µm2, 14.53 µm, and 10.79 µm, respectively). Hypochromia was detected in 46.5% of the papillary carcinoma cases. Grooves and pseudoinclusions were the other nuclear features that could be detected. However, nuclear contour irregularity was the most reliable finding that could predict papillary carcinoma diagnosis in the CNB sections (v: 0.82, p < 0.001). Conclusions: We believe that the histopathological differences we found have an important place in diagnostics and should be emphasized, and new diagnostic algorithms should be developed. [ABSTRACT FROM AUTHOR]

Increased tissue rigidity is an emerging hallmark of cancer as it plays a critical role in promoting cancer growth. However, the field lacks a defined characterization of tissue rigidity in dual-stage carcinogenesis of lung squamous cell carcinoma (SCC) in vivo. Pre-malignant and malignant lung SCC was developed in BALB/c mice using N-nitroso-tris-chloroethylurea (NTCU). Picro sirius red staining and atomic force microscopy were performed to measure collagen content and collagen (diameter and rigidity), respectively. Then, the expression of tenascin C (TNC) protein was determined using immunohistochemistry staining. Briefly, all tissue rigidity parameters were found to be increased in the Cancer group as compared with the Vehicle group. Importantly, collagen content (33.63 ± 2.39%) and TNC expression (7.97 ± 2.04%) were found to be significantly higher (p < 0.05) in the Malignant Cancer group, as compared with the collagen content (18.08 ± 1.75%) and TNC expression (0.45 ± 0.53%) in the Pre-malignant Cancer group, indicating increased tissue rigidity during carcinogenesis of lung SCC. Overall, tissue rigidity of lung SCC was suggested to be increased during carcinogenesis as indicated by the overexpression of collagen and TNC protein, which may warrant further research as novel therapeutic targets to treat lung SCC effectively. [ABSTRACT FROM AUTHOR]

Segmentation of cancerous tissues in breast ultrasound images is a challenging task that can be achieved through various image processing and machine learning techniques. This paper presents an early automatic diagnostic method for breast cancer in ultrasound images and classifying the cancer as benign or malignant. Automatic images processing-based techniques were applied to process segment and classify cancerous tissues. The proposed method for early detection of breast tumor in ultrasound images typically involves three key steps: preprocessing, segmentation, and feature extraction and classification. The accuracy of proposed method was evaluated by comparing the segmented images with the gold standard or ground truth (GT), which was manually formed by an experienced radiologist. Areabased evaluation of segmentation was performed in which root mean squared error was 0.0435 and relative absolute error was 0.2085% for the total instances. The true positive result was 96% while false positive result was 3.11 %. The early detection of breast cancer in ultrasound images using the proposed image processing-based technique accurately detect breast cancer and classify cancer as benign or malignant. It also eliminates the drawbacks in the existing methods by introducing new features like shadows in the images using masking and adjusting contrast functions. [ABSTRACT FROM AUTHOR]

Introduction: The salivary glands are subjected to various pathological conditions ranging from simple inflammation to most complex malignant lesions. Majority of these lesions can be diagnosed by simple histopathological examination. But, as these salivary gland lesions are not common, the incidence of these varies in different geographic locations. Aim: To study the spectrum of different salivary gland lesions and demographic data in a tertiary care hospital serving northeast coastal area of Andhra Pradesh. Materials and Methods: This was a retrospective study conducted in Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh, India. Total of 85 salivary gland lesions were analysed for a period of four years (December 2015 to November 2019). From the records of Histopathology, Department of Pathology, data was retrieved. Typing of the salivary gland tumours were done using sections stained with Haematoxylin and Eosin (H&E). All the cases were analysed and divided according to the demographics and histological type. Descriptive statistics were used and data was tabulated in frequency and percentages. Results: A total of 85 salivary gland lesions were studied, of which 14 (16%) were non neoplastic and 71 (84%) were neoplastic in nature. Among the neoplastic lesions, 56 (66%) were benign and 15 (18%) were malignant. There was slight male preponderance with a ratio of M:F=1.3:1. Majority of the tumours occurred in parotid gland (73), followed by submandibular gland (7) and minor salivary glands (5). All the tumours were classified and graded according to World Health Organisation (WHO), while Brandwein Grading System was followed for mucoepidermoid carcinoma. Pleomorphic adenoma was the most frequent benign tumour and mucoepidermoid carcinoma was the most common malignant tumour. Conclusion: Though benign salivary gland tumours are more frequently encountered in the present study, malignant salivary gland tumours are not uncommon

Introduction: The incidence of non-melanoma skin cancers (NMSCs) is increasing over the last few decades. This necessitates an early diagnosis which is nowadays aided by dermoscopy. Once diagnosed early, the treatment armamentarium is diverse and includes both topical and surgical modalities. Objective: Our aim was to diagnose pre-malignant and malignant NMSCs at an early stage and treat them as per the standard protocol. Materials and Materials: Out of 136 patients of pre-malignant and malignant tumors enrolled, 100 were taken up for treatment. These were then classified into various subtypes on the basis of clinical examination and dermoscopy. The selected patients were subjected to topical treatment or surgical modalities, wide local excision or flap excision, based on the type of tumor and its size. Results: The pre-malignant group included actinic keratoses, Bowen’s disease, and keratoacanthoma, whereas the malignant group included undifferentiated squamous cell carcinoma (SCC), differentiated SCC, pigmented basal cell carcinoma (BCC), nodulo-ulcerative BCC, and superficial BCC. Actinic keratoses, superficial BCCs, and five cases of keratoacanthoma were treated with topical therapies with a resolution of 90% in 86.8% cases. All the remaining cases (62 in number) were treated with conventional and flap surgery with 88% and 89.1% clearance rates, respectively, with complications in only 7 patients. Conclusion: A prompt identification of NMSCs can enable selection of the appropriate treatment modality for a specific lesion and thus reduce their associated morbidity and mortality.

Objective: To report a single-center experience in non-epithelial malignant ovarian tumours (NEMOT), by presenting different clinical and pathological characteristics, management and outcomes. Methods: We retrospectively reviewed electronic files of all female patients who underwent surgery for NEMOT at the Gynecology Department of King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from July 2003 to July 2019. We collected baseline demographic, anthropomorphic and clinical data; pathological characteristics; management and follow-up data; and outcomes including residual disease, recurrence and last follow-up status (deceased or alive). Results: Thirty-three women were included; mean (standard deviation) age = 33.24 (17.72) years, range = 4, 86 years. Granulosa cell tumor was the most frequent subtype diagnosed in 17 (51.5%) patients, followed by germ cell tumours 13 (39.4%). The majority of patients were diagnosed at FIGO Stage I (22, 66.7%) and with tumor Grade 1 (23, 69.7%), while 8 (24.2%) were diagnosed with Grade 3 tumors. Granulosa cell and Sertoli-Leydig cell tumours were diagnosed at an older age (mean age = 39.30 vs. 23.92 years) compared to germ cell tumours, respectively (P = 0.012). Two-third of the patients benefited from conservative surgery including oophorectomy + staging, and 16 (48.5%) benefited from chemotherapy with bleomycin, etoposide and platinum being the most common protocol (13, 39.4%) for germ cell tumours. Postoperatively, only 2 (6.1%) patients had residual disease. Recurrence and mortality were reported in one and four patients, respectively, resulting in recurrence rate = 3.0% (95% confidence interval [CI] = 0.01%, 15.8%) and mortality rate = 12.1% (95% CI = 3.4%, 28.2%). Conclusions: The present series of NEMOT was predominated by sex cord-stromal cell tumors, which were diagnosed in patients with older age, while germ cell tumours were underrepresented. Although survival rates were comparable to those reported internationally, more consideration should be given to following up patients regarding fertility outcomes to provide a more comprehensive evaluation of treatment success and quality of care.

Objective: Most pancreatic tumors are epithelial, and, among these, more than 90% are of ductal origin. However, a variety of mesenchymal tumors may involve the pancreas and may manifest different clinicopathological characteristics. The literature on mesenchymal tumors in the pancreas is largely limited to individual case reports or analyses of small series, predominantly focusing on radiologic features. Material and Method: Authors' institutional and consultation databases were reviewed to identify the mesenchymal tumors involving the pancreas. Results: Forty cases were identified; twenty-five (63%) tumors were benign/borderline, and the remaining fifteen (37%) were malignant. Of the benign/borderline tumors; 9 were solitary fibrous tumors, 6 gastrointestinal stromal tumors (GISTs), 4 schwannomas, 2 desmoid type fibromatosis, 1 lymphangioma, 1 ganglioneuroma, 1 inflammatory myofibroblastic tumor, and 1 low grade mesenchymal neoplasm. Malignant tumors included 6 cases of leiomyosarcomas, 4 liposarcomas, 2 rhabdomyosarcomas, 1 epithelioid angiosarcoma, 1 malignant peripheral nerve sheet tumor, and 1 undifferentiated pleomorphic sarcoma. Four cases (multicystic schwannoma, desmoid fibromatosis, lymphangioma and inflammatory myofibroblastic tumor) were preoperatively misdiagnosed as a primary epithelial tumor of the pancreas. Conclusion: Mesenchymal tumors rarely involve the pancreas. They are usually benign/borderline neoplasms but may be diagnostically challenging, especially clinically/radiologically, as they may form cystic and/or large lesions in the pancreas. Mesenchymal tumors should be considered in both the clinical/radiological and pathological differential diagnosis of pancreatic lesions.

Introduction: Nonhematologic tumors in children differ biologically and histologically from adults in terms of incidence, type of tumor, and tendency to regress spontaneously. The study was aimed to evaluate the pattern, frequency, and histopathological spectrum of solid tumors and to correlate histopathological findings with immunohistochemistry (IHC) wherever feasible. Materials and Methods: This observational study was a retrospective analysis of all solid tumors of children less than 18 years, conducted over a period of 5 years. The specimens were analyzed grossly and microscopically with IHC wherever feasible. All leukemias and myeloproliferative neoplasms/myeloproliferative disorders were excluded from the study. Results: A total of 261 solid tumors were seen in the age of 2 days to 17 years with the median age being 10.41 years. The M: F ratio was 1.6:1. Benign tumors were more common (59.39%), with soft tissue tumors being more frequent. Lymphomas and reticuloendothelial cell tumors constituted the majority (27%) of malignant tumors. Conclusion: This institution-based study depicted the pattern of childhood tumors. As most of the studies have focused on malignant tumors, data on the prevalence of benign pediatric tumors is scarce. Pediatric tumors need to have a dedicated pediatric cancer registry for assessing the magnitude of the problem. This study provides useful insight into the pattern of benign and malignant pediatric tumors in the northwest region of India, which can be utilized in planning health policies. The present study also proves the importance of IHC in making the final diagnosis.

Purpose: In mucinous ovarian tumors, preoperative prediction of histological subgroup is important for treatment approach. Therefore, we aimed to determine salient magnetic resonance imaging (MRI) findings and estimate optimal cut off values for quantitative features in differential diagnosis of benign, borderline and malignant mucinous ovarian tumors.Between January 2011 and December 2021, preoperative MRI scans of 50 patients with mucinous ovarian tumors (n = 54) were evaluated retrospectively. MRI findings [size, signal intensity, contrast pattern, features of loculation, wall, septa and mural nodule (MN), diffusion restriction] were investigated. There were benign, borderline, and malignant groups based on histopathological results. The relationship between radiological and histopathological results was analyzed by performing Kruskal Wallis test, Pearson’s chi-squared test, receiver operating characteristic analysis.In our study, there were 54 mucinous ovarian tumors in 50 patients. Of 54, 33 were benign, 13 borderline and eight malignant tumors. In comparison of three groups, tumor size, number of loculation, number and frequency of MN were higher and apparent diffusion coefficient (ADC) value were lower in malignant group (p < 0.05). Septa thickness was lower with optimal cut off value of 2.45 mm in benign group compared to borderline and malignant groups [sensitivity: 79%, specificity: 75%, AUC (Area under the curve): 0.861] (p < 0.05). T2-weighted (T2-w) signal intensity ratio (SIR) of MN was higher in borderline compared to malignant group, with a cut-off value of 3.9 (sensitivity: 85%, specificity: 83%, AUC: 0.943) (p < 0.05). Ascites was also significant in malignant group (p < 0.05).T2-w SIR of MN with a cut off value of 3.9 is beneficial for differential diagnosis. By awareness of some salient MRI findings (size, septa thickness, number of loculation, number and T2-w SIR of MN, ADC value and ascites), preoperative prediction of histological subgroup of mucinous tumors for appropriate treatment planning is possible.Methods: In mucinous ovarian tumors, preoperative prediction of histological subgroup is important for treatment approach. Therefore, we aimed to determine salient magnetic resonance imaging (MRI) findings and estimate optimal cut off values for quantitative features in differential diagnosis of benign, borderline and malignant mucinous ovarian tumors.Between January 2011 and December 2021, preoperative MRI scans of 50 patients with mucinous ovarian tumors (n = 54) were evaluated retrospectively. MRI findings [size, signal intensity, contrast pattern, features of loculation, wall, septa and mural nodule (MN), diffusion restriction] were investigated. There were benign, borderline, and malignant groups based on histopathological results. The relationship between radiological and histopathological results was analyzed by performing Kruskal Wallis test, Pearson’s chi-squared test, receiver operating characteristic analysis.In our study, there were 54 mucinous ovarian tumors in 50 patients. Of 54, 33 were benign, 13 borderline and eight malignant tumors. In comparison of three groups, tumor size, number of loculation, number and frequency of MN were higher and apparent diffusion coefficient (ADC) value were lower in malignant group (p < 0.05). Septa thickness was lower with optimal cut off value of 2.45 mm in benign group compared to borderline and malignant groups [sensitivity: 79%, specificity: 75%, AUC (Area under the curve): 0.861] (p < 0.05). T2-weighted (T2-w) signal intensity ratio (SIR) of MN was higher in borderline compared to malignant group, with a cut-off value of 3.9 (sensitivity: 85%, specificity: 83%, AUC: 0.943) (p < 0.05). Ascites was also significant in malignant group (p < 0.05).T2-w SIR of MN with a cut off value of 3.9 is beneficial for differential diagnosis. By awareness of some salient MRI findings (size, septa thickness, number of loculation, number and T2-w SIR of MN, ADC value and ascites), preoperative prediction of histological subgroup of mucinous tumors for appropriate treatment planning is possible.Results: In mucinous ovarian tumors, preoperative prediction of histological subgroup is important for treatment approach. Therefore, we aimed to determine salient magnetic resonance imaging (MRI) findings and estimate optimal cut off values for quantitative features in differential diagnosis of benign, borderline and malignant mucinous ovarian tumors.Between January 2011 and December 2021, preoperative MRI scans of 50 patients with mucinous ovarian tumors (n = 54) were evaluated retrospectively. MRI findings [size, signal intensity, contrast pattern, features of loculation, wall, septa and mural nodule (MN), diffusion restriction] were investigated. There were benign, borderline, and malignant groups based on histopathological results. The relationship between radiological and histopathological results was analyzed by performing Kruskal Wallis test, Pearson’s chi-squared test, receiver operating characteristic analysis.In our study, there were 54 mucinous ovarian tumors in 50 patients. Of 54, 33 were benign, 13 borderline and eight malignant tumors. In comparison of three groups, tumor size, number of loculation, number and frequency of MN were higher and apparent diffusion coefficient (ADC) value were lower in malignant group (p < 0.05). Septa thickness was lower with optimal cut off value of 2.45 mm in benign group compared to borderline and malignant groups [sensitivity: 79%, specificity: 75%, AUC (Area under the curve): 0.861] (p < 0.05). T2-weighted (T2-w) signal intensity ratio (SIR) of MN was higher in borderline compared to malignant group, with a cut-off value of 3.9 (sensitivity: 85%, specificity: 83%, AUC: 0.943) (p < 0.05). Ascites was also significant in malignant group (p < 0.05).T2-w SIR of MN with a cut off value of 3.9 is beneficial for differential diagnosis. By awareness of some salient MRI findings (size, septa thickness, number of loculation, number and T2-w SIR of MN, ADC value and ascites), preoperative prediction of histological subgroup of mucinous tumors for appropriate treatment planning is possible.Conclusion: In mucinous ovarian tumors, preoperative prediction of histological subgroup is important for treatment approach. Therefore, we aimed to determine salient magnetic resonance imaging (MRI) findings and estimate optimal cut off values for quantitative features in differential diagnosis of benign, borderline and malignant mucinous ovarian tumors.Between January 2011 and December 2021, preoperative MRI scans of 50 patients with mucinous ovarian tumors (n = 54) were evaluated retrospectively. MRI findings [size, signal intensity, contrast pattern, features of loculation, wall, septa and mural nodule (MN), diffusion restriction] were investigated. There were benign, borderline, and malignant groups based on histopathological results. The relationship between radiological and histopathological results was analyzed by performing Kruskal Wallis test, Pearson’s chi-squared test, receiver operating characteristic analysis.In our study, there were 54 mucinous ovarian tumors in 50 patients. Of 54, 33 were benign, 13 borderline and eight malignant tumors. In comparison of three groups, tumor size, number of loculation, number and frequency of MN were higher and apparent diffusion coefficient (ADC) value were lower in malignant group (p < 0.05). Septa thickness was lower with optimal cut off value of 2.45 mm in benign group compared to borderline and malignant groups [sensitivity: 79%, specificity: 75%, AUC (Area under the curve): 0.861] (p < 0.05). T2-weighted (T2-w) signal intensity ratio (SIR) of MN was higher in borderline compared to malignant group, with a cut-off value of 3.9 (sensitivity: 85%, specificity: 83%, AUC: 0.943) (p < 0.05). Ascites was also significant in malignant group (p < 0.05).T2-w SIR of MN with a cut off value of 3.9 is beneficial for differential diagnosis. By awareness of some salient MRI findings (size, septa thickness, number of loculation, number and T2-w SIR of MN, ADC value and ascites), preoperative prediction of histological subgroup of mucinous tumors for appropriate treatment planning is possible. [ABSTRACT FROM AUTHOR]