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Acquisition of carbohydrates in the disulfide-linked heavy (H) and light (L) chain molecules of murine myeloma (ADJPC5), i.e., HH, HHL, and LHHL, was investigated. That some mannose and glucosamine residues are acquired by immunoglobulin precursor molecules was demonstrated by the detection of glucosamine and mannose in HH, HHL, and LHHL. In contrast, galactose was observed solely in LHHL molecules, which have an identical electrophoretic mobility to the secreted product. Furthermore, as judged from cells incubated with [(3)H]leucine, the more juvenile molecules HH and HHL were predominant in the rough microsome fraction, whereas LHHL was the principal molecular species in the smooth microsome fraction. Findings of this type were not observed in rabbit lymph node cells. Thus, galactose, as well as mannose and glucosamine, were found in the more juvenile molecule known for this species (HL). Moreover, the ratio of HL:LHHL, as judged from cells incubated with [(3)H]leucine, was about the same in rough and smooth microsomes.

Introduction and aim. Still's disease is a rare systemic inflammatory disease that is mediated by autoimmune processes. It's equivalent to juvenile idiopathic arthritis. The etiology of the disease is unknown. Description of the case. A 24-year-old patient was admitted to the Department of Rheumatology with suspicion of Still's disease. From 5 days before the admission, fever, sore throat, pains and swelling of the joints, a salmon-colored rash appeared. In laboratory tests, elevated CRP, leukocytosis with neutrophilia, anemia were observed, ferritin levels were above normal. Abdominal ultrasonography revealed hepatosplenomegaly. During the stay, recurring daily fevers in the evening were observed, with joint pain and itchy salmon-colored skin. Ultrasound of the lymph nodes was performed, revealing generalized lymphadenopathy. From the beginning of the stay, antibiotic therapy and metiprednisolone infusions were used, observing a temporary resolution of fever and in- flammatory parameters. The patient refused treatment with methotrexate, so cyclosporine was started. On the 10th day of stay recurrence of fever, increase in inflammatory parameters and ferritin were observed. Due to the unclear picture of the disease, a decision to start with prednisone was made. Gradual normalization of inflammatory parameters and improvement of the general condition were observed, but the fever persisted and the level of ferritin increased. Bone marrow puncture was performed. Quite numerous hemophagocytes were observed. Treatment with dexamethasone was initiated and the use of cyclosporine was resumed. General condition improved. Due to the observed steroid dependence, biological therapy was planned, which was postponed due to the positive result of the IGRA test so anti-mycobacterial prophylaxis was started. Then treatment with anakinra was started, resulting in remission of disease. Conclusion. Summing up, the patient was diagnosed with a drug-resistant form of Still's disease with a dangerous complication macrophage activation syndrome. However, the diagnosis of the disease is often problematic, which is mainly due to the lack of specific diagnostic markers. [ABSTRACT FROM AUTHOR]

This is a retrospective review of surgical management for primary lymphedema. Data were extracted from 55 articles from PubMed MEDLINE, Web of Science, SCOPUS, and Cochrane Central Register of Controlled Trials between the database inception and December 2022 to evaluate the outcomes of lymphaticovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT), and outcomes of soft tissue extirpative procedures such as suction-assisted lipectomy (SAL) and extensive soft tissue excision. Data from 485 patients were compiled; these were treated with LVA (n = 177), VLNT (n = 82), SAL (n = 102), and excisional procedures (n = 124). Improvement of the lower extremity lymphedema index, the quality of life (QoL), and lymphedema symptoms were reported in most studies. LVA and VLNT led to symptomatic relief and improved QoL, reaching up to 90 and 61% average circumference reduction, respectively. Cellulitis reduction was reported in 25 and 40% of LVA and VLNT papers, respectively. The extirpative procedures, used mainly in patients with advanced disease, also led to clinical improvement from the volume reduction, as well as reduced incidence of cellulitis, although with poor cosmetic results; 87.5% of these reports recommended postoperative compression garments. The overall complication rates were 1% for LVA, 13% for VLNT, 11% for SAL, and 46% for extirpative procedures. Altogether, only one paper lacked some kind of improvement. Primary lymphedema is amenable to surgical treatment; the currently performed procedures have effectively improved symptoms and QoL in this population. Complication rates are related to the invasiveness of the chosen procedure. [ABSTRACT FROM AUTHOR]

Simple Summary: Constant technological development of modern imaging has led to substantial improvement in management and decision-making in the diagnostic and prognostic process of many different neoplasms. This also applies to cervical cancer. The main evidence, providing the base of recently updated ESGO-ESTRO-ESP recommendations (2023) on the management and treatment of cervical cancer, has been evaluated and reviewed in this paper. Ultrasound has been suggested as a valid alternative to MRI in primary diagnostic workup of cervical cancer if performed by an expert sonographer. Additionally, CT or PET/CT exhibits a substantial role in assessing the extrapelvic spread of the disease in locally advanced cases or when suspicious lymph nodes are detected. The purpose of this article is to provide a comprehensive review of the role of different imaging techniques in staging settings, displaying a focused interest in the use of ultrasound. Following the European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) joint guidelines (2018) for the management of patients with cervical cancer, treatment decisions should be guided by modern imaging techniques. After five years (2023), an update of the ESGO-ESTRO-ESP recommendations was performed, further confirming this statement. Transvaginal/transrectal ultrasound (TRS/TVS) or pelvic magnetic resonance (MRI) enables tumor delineation and precise assessment of its local extent, including the evaluation of the depth of infiltration in the bladder- or rectal wall. Additionally, both techniques have very high specificity to confirm the presence of metastatic pelvic lymph nodes but fail to exclude them due to insufficient sensitivity to detect small-volume metastases, as in any other currently available imaging modality. In early-stage disease (T1a to T2a1, except T1b3) with negative lymph nodes on TVS/TRS or MRI, surgicopathological staging should be performed. In all other situations, contrast-enhanced computed tomography (CECT) or 18F-fluorodeoxyglucose positron emission tomography combined with CT (PET-CT) is recommended to assess extrapelvic spread. This paper aims to review the evidence supporting the implementation of diagnostic imaging with a focus on ultrasound at primary diagnostic workup of cervical cancer. [ABSTRACT FROM AUTHOR]

Communication between tumors and lymph nodes carries substantial significance for antitumor immunotherapy. Remodeling the immune microenvironment of tumor-draining lymph nodes (TdLN) plays a key role in enhancing the anti-tumor ability of immunotherapy. In this study, we constructed a biomimetic artificial lymph node structure composed of F127 hydrogel loading effector memory T (T EM ) cells and PD-1 inhibitors (aPD-1). The biomimetic lymph nodes facilitate the delivery of T EM cells and aPD-1 to the TdLN and the tumor immune microenvironment, thus realizing effective and sustained anti-tumor immunotherapy. Exploiting their unique gel-forming and degradation properties, the cold tumors were speedily transformed into hot tumors via T EM cell supplementation. Meanwhile, the efficacy of aPD-1 was markedly elevated compared with conventional drug delivery methods. Our finding suggested that the development of F127@T EM @aPD-1 holds promising potential as a future novel clinical drug delivery technique. STATEMENT OF SIGNIFICANCE: F127@T EM @aPD-1 show unique advantages in cancer treatment. When injected subcutaneously, F127@T EM @aPD-1 can continuously supplement T EM cells and aPD-1 to tumor draining lymph nodes (TdLN) and the tumor microenvironment, not only improving the efficacy of ICB therapy through slow release, but also exhibiting dual regulatory effects on the tumor and TdLN., Competing Interests: Declaration of competing interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

Background: As an increased number of women beat breast cancer worldwide, the breast cancer related lymphedema has gained more attention recently. The vascularized omentum lymph node transfer has been approached as an useful tool for advanced and recurrent cases. The purpose of the paper is to emphasize the advantages and disadvantages of this method. Materials and Methods: This retrospective study consists of 17 patients known with breast cancer related lymphedema who received vascularized omentum lymph node transfer. Data was recorded between January 2022 and January 2023. Patients diagnosed with secondary lymphedema stage II or III, unresponsive to previous microsurgical lymphovenous bypass were included. Results: The most prevalent affected site was the left upper limb (59%), where edema was mainly identified in the forearm (75%). Nevertheless, more than half of the subjects have previously received lymphaticovenous anastomosis. The correlation between the stage of lymphedema and the postoperative reduction of the volume of the affected limb was -0.26, the slope to reached -0.33, with an intercept value of 2.64. The follow-up period showed reduced upper limb volume and an improved quality of life. Conclusion: Through an experienced hand, this versatile flap brings hope to breast cancer survivors with lymphedema., (Celsius.)

Background: In recent years, the incidence of thyroid nodules has increased significantly. There are various ways to treat thyroid nodules, and ablation therapy is one of the important ways to treat thyroid nodules. However, there are many complications and deficiencies in the current ablation treatment of thyroid nodules, especially the incomplete ablation of thyroid cancer nodules, which limits the further application of ablation technology. Case Summary: In this paper, we report two cases of incomplete ablation of thyroid nodules, one of which underwent surgical treatment due to anxiety after ablation, and the postoperative pathology confirmed that there was still residual papillary thyroid carcinoma, and the other patient underwent an operation after ablation, but visited our medical institution again due to cervical lymph node metastasis in a short period of time, and after radical cervical lymph node dissection, pathology confirmed multiple cervical lymph node metastasis. Radionuclide therapy was performed after surgery, and two patients are currently receiving endocrine suppression therapy, and their condition is stable with no signs of recurrence. Conclusion: The incomplete ablation of thyroid cancer nodules limits the development of ablation therapy, making ablation treatment a double-edged sword. Guidelines and expert consensus can guide their development, but they need to evolve with the times, and a multidisciplinary diagnostic team can help screen the most suitable patients. Only by using this technology more standardly, using the most appropriate technology, and treating the most suitable patients, can benefit more and more patients. [ABSTRACT FROM AUTHOR]

Given the increasingly important role that the use of artificial intelligence algorithms is taking on in the medical field today (especially in oncology), the purpose of this systematic review is to analyze the main reports on such algorithms applied for the prognostic evaluation of patients with head and neck malignancies. The objective of this paper is to examine the currently available literature in the field of artificial intelligence applied to head and neck oncology, particularly in the prognostic evaluation of the patient with this kind of tumor, by means of a systematic review. The paper exposes an overview of the applications of artificial intelligence in deriving prognostic information related to the prediction of survival and recurrence and how these data may have a potential impact on the choice of therapeutic strategy, making it increasingly personalized. This systematic review was written following the PRISMA 2020 guidelines. [ABSTRACT FROM AUTHOR]

Organ-on-a-chip technology is attracting growing interest across various domains as a crucial platform for drug screening and testing and is set to play a significant role in precision medicine research. Lymph nodes, being intricately structured organs essential for the body's adaptive immune responses to antigens and foreign particles, are pivotal in assessing the immunotoxicity of novel pharmaceuticals. Significant progress has been made in research on the structure and function of the lymphatic system. However, there is still an urgent need to develop prospective tools and techniques to delve deeper into its role in various diseases' pathological and physiological processes and to develop corresponding immunotherapeutic therapies. Organ chips can accurately reproduce the specific functional areas in lymph nodes to better simulate the complex microstructure of lymph nodes and the interactions between different immune cells, which is convenient for studying specific biological processes. This paper reviews existing lymph node chips and their design approaches. It discusses the applications of the above systems in modeling immune cell motility, cell–cell interactions, vaccine responses, drug testing, and cancer research. Finally, we summarize the challenges that current research faces in terms of structure, cell source, and extracellular matrix simulation of lymph nodes, and we provide an outlook on the future direction of integrated immune system chips. [ABSTRACT FROM AUTHOR]

Simple Summary: A novel approach for automatic detection of neoplastic lesions in lymph nodes is presented, which incorporates machine learning methods and the new LN-RADS scale. The presented solution incorporates different network structures with diverse datasets to improve the overall effectiveness. Final findings demonstrate that incorporating the LN-RADS scale labels improved the overall diagnosis, especially when compared with current, standard practices. The presented solution is meant as an aid in the diagnosis process. The paper presents a novel approach for the automatic detection of neoplastic lesions in lymph nodes (LNs). It leverages the latest advances in machine learning (ML) with the LN Reporting and Data System (LN-RADS) scale. By integrating diverse datasets and network structures, the research investigates the effectiveness of ML algorithms in improving diagnostic accuracy and automation potential. Both Multinominal Logistic Regression (MLR)-integrated and fully connected neuron layers are included in the analysis. The methods were trained using three variants of combinations of histopathological data and LN-RADS scale labels to assess their utility. The findings demonstrate that the LN-RADS scale improves prediction accuracy. MLR integration is shown to achieve higher accuracy, while the fully connected neuron approach excels in AUC performance. All of the above suggests a possibility for significant improvement in the early detection and prognosis of cancer using AI techniques. The study underlines the importance of further exploration into combined datasets and network architectures, which could potentially lead to even greater improvements in the diagnostic process. [ABSTRACT FROM AUTHOR]

Dendritic cells (DCs) are specialized antigen-presenting cells that are crucial for maintaining self-tolerance, initiating immune responses against pathogens, and patrolling body compartments. Despite promising aspects, DC-based immunotherapy faces challenges that include limited availability, immune escape in tumors, immunosuppression in the tumor microenvironment, and the need for effective combination therapies. A further limitation in DC-based immunotherapy is the low population of migratory DC (around 5%–10%) that migrate to lymph nodes (LNs) through afferent lymphatics depending on the LN draining site. By increasing the population of migratory DCs, DC-based immunotherapy could enhance immunotherapeutic effects on target diseases. This paper reviews the importance of DC migration and current research progress in the context of DC-based immunotherapy. [ABSTRACT FROM AUTHOR]

Simple Summary: Recent advancements in AI have revolutionized cancer research, especially in the analysis of histopathological imaging data with minimal human involvement. Early detection of lymph node metastasis in breast cancer is vital for treatment outcomes. This paper introduces a novel approach that combines representation learning and deep learning (DL) to detect small tumors (STs) without neglecting larger ones. The proposed method uses representation learning to identify STs in histopathology images, followed by DL algorithms for breast cancer detection. Extensive evaluation shows remarkable accuracy in detecting STs without compromising larger-lesion detection. This approach enables early detection, timely intervention, and potentially improved treatment outcomes. The integration of representation learning and DL offers a promising solution for ST detection in breast cancer. By reducing human involvement and leveraging AI capabilities, the proposed method achieves impressive accuracy in identifying STs. Further research and validation could enhance diagnostic capabilities and personalized treatment strategies, ultimately benefiting breast cancer patients. The early diagnosis of lymph node metastasis in breast cancer is essential for enhancing treatment outcomes and overall prognosis. Unfortunately, pathologists often fail to identify small or subtle metastatic deposits, leading them to rely on cytokeratin stains for improved detection, although this approach is not without its flaws. To address the need for early detection, multiple-instance learning (MIL) has emerged as the preferred deep learning method for automatic tumor detection on whole slide images (WSIs). However, existing methods often fail to identify some small lesions due to insufficient attention to small regions. Attention-based multiple-instance learning (ABMIL)-based methods can be particularly problematic because they may focus too much on normal regions, leaving insufficient attention for small-tumor lesions. In this paper, we propose a new ABMIL-based model called normal representative keyset ABMIL (NRK-ABMIL), which addresseses this issue by adjusting the attention mechanism to give more attention to lesions. To accomplish this, the NRK-ABMIL creates an optimal keyset of normal patch embeddings called the normal representative keyset (NRK). The NRK roughly represents the underlying distribution of all normal patch embeddings and is used to modify the attention mechanism of the ABMIL. We evaluated NRK-ABMIL on the publicly available Camelyon16 and Camelyon17 datasets and found that it outperformed existing state-of-the-art methods in accurately identifying small tumor lesions that may spread over a few patches. Additionally, the NRK-ABMIL also performed exceptionally well in identifying medium/large tumor lesions. [ABSTRACT FROM AUTHOR]

The potential complications related to unplanned conversion to thoracotomy remains a major concern in thoracoscopic lobectomy and may limit the wide adoption of this strategy. We reviewed the literature from 1990 until February 2022, analyzing all papers comparing successful thoracoscopic lobectomy versus converted thoracoscopic lobectomy and/or upfront thoracotomy lobectomy to establish whether unplanned conversion negatively affected outcomes. Thirteen studies provided the most applicable evidence to evaluate this issue. Conversion to thoracotomy was reported to occur in up to 23% of cases (range, 5%–16%). Vascular injury, calcified lymph nodes, and dense adhesions were the most common reasons for conversion. Converted thoracoscopic lobectomy compared to successful thoracoscopic lobectomy was associated with longer operative time and hospital stay in all studies, with higher postoperative complication rates in seven studies, and with higher perioperative mortality rates in four studies. No significant differences were found between converted thoracoscopic lobectomy and upfront thoracotomy lobectomy. Five studies evaluated long‐term survival, and in all papers conversion did not prejudice survival. Surgeons should not fear unplanned conversion during thoracoscopic lobectomy, but to avoid unexpected conversion that may negatively impact surgical outcome, a careful selection of patients is recommended–especially for frail patients. [ABSTRACT FROM AUTHOR]

Several abstracts of studies related to prostate cancer and prostatic diseases are presented including "Distribution of Lymph Nodes in Patients With Prostatic Adenocarcinoma and Lymphadenopathy at Presentation: A Retrospective Review and Implications for Prostate and Pelvis Radiotherapy," "Salvage Cryosurgery for Recurrent Localised Prostate Cancer" and "Changes in Frequency of Acute Spontaneous Urinary Retention in England Over the Last 12 Years."

Simple Summary: Given the important role played by the lymphatic system in tissue drainage, metabolism, water–salt metabolism, and its protective compensatory and immune functions, it is important to further study the role of the lymphatic system in the development of abdominal inflammation. The features of lymph transport through vessels and nodes, the state of formation and biochemical composition of the lymph, the state of innervation of lymph vessels and nodes, and the state of the cellular composition of lymph nodes in the experimental modeling of inflammation in the abdominal cavities of internal organs reveal new insights regarding the mechanisms of this disease. Since, in the literature, only isolated studies regarding the lymphatic system in violation of the abdominal cavity exist, it is clear that the roles and functional states of lymphatic vessels and nodes in inflammation in the abdominal cavity have not yet been studied in a complex and multi-faceted way. This paper provides data regarding the ratios of the functional structures of lymph nodes after inflammation in the abdominal organs. Lymph systems, including lymph nodes, function as filters of tissues and tissue fluids and are places of origin and lymphocyte production for normal physiological functions. They display specific morphological and functional responses in reaction to endogenous and exogenous substances. The morphological pattern of the mesenteric lymph node in experimental rat groups reflects a decrease in its immune function due to the processes of inflammation in the abdominal cavity. These processes work together with the associated organs and their involvement in the abdominal lymph nodes, in which there are discharges of the structure of the paracortical zone under conditions of reduced lymphogenic processes, according to the decrease in the size of the paracortex and the ratios of lymphoid nodes with and without germinal centers. Histological and morphometric analyses show changes in the mesenteric lymph node. These analyses are characterized by changes in the cortical and medullary substances, while the proportion of the cortical structure decreases. We also noted an increase in the number of macrophages in the lymphoid nodes and cerebral sinus, as well as a decrease in the number of mature plasmocytes, the paracortex, and the pulp strands. These changes indicate immunosuppressive effects on the lymph node. Under the conditions of inflammation, the formation of a mixed immune response occurs. [ABSTRACT FROM AUTHOR]

Tremendous progress has been made in the field of lateral lymph nodes (LLNs) in rectal cancer, but no bibliometric analysis in this field has been carried out and published. To reveal the current status and trends in LLNs in rectal cancer, this bibliometric analysis was performed. Cooperation network, co-citation and keyword co-occurrence analyses were conducted. Annual publication, cooperation relationships among authors, institutions and countries, co-cited journal, co-cited author, co-cited reference and keywords were the main outcomes. A total of 345 studies were included in this bibliometric analysis. The number of articles published in this field has been increasing year by year. The authors, institutions and countries worked closely together in this field. Japan has the largest number of published articles, accounting for 51.59% of the total publications. International Journal of Colorectal Disease (30 papers, 8.70%) published the most papers in this field. The JCOG0212 trial was the most cited article. Preoperative chemoradiotherapy, multicenter, lateral lymph node dissection (LLND) and metastasis are recent hot keywords, and LLND had the highest burst strength. In conclusion, this bibliometric analysis found that Japanese institutions and authors dominated the field of LLNs in rectal cancer. The JCOG0212 trial was the most influential article, which had a significant impact on the development of guidelines. LLND is a hotspot in this field with the highest burst strength. Further prospective studies are needed in this field. [ABSTRACT FROM AUTHOR]

Introduction. Cat scratch disease (CSD) is the most common cause of bacterial infectious lymphadenopathy, especially in children, but its diagnosis still remains challenging. Serological assays are widely applied due to their simplicity and the non-invasive sampling. However, these techniques present several limitations, including not well-defined antigen preparation, assay conditions and cutoff titers, severe cross-reactions with other species and organisms, and the notably ranging seroprevalence in the normal population. The objective of this study is to review the literature in order to determine the best diagnostic procedure for the diagnosis of CSD. Methods. Databases including PubMed, Medline, Google Scholar, and Google were searched to determine the best diagnostic procedure for the diagnosis of CSD. A total of 437 papers were identified and screened, and after exclusion of papers that did not fulfill the including criteria, 63 papers were used. Results. It was revealed that sensitivities of serological assays varied from 10% to 100%. Indeed, more than half of the studies reported a sensitivity lower than 70%, while 71% of them had a sensitivity lower than 80%. Moreover, specificities of serological assays ranged from 15% to 100%, with 25 assays reporting a specificity lower than 90%. Conclusion. It is considered that molecular assays should be the gold standard technique for CSD confirmation, and physicians are reinforced to proceed to lymph node biopsy in suspicious CSD cases. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this paper was to clarify the optimal minimum number of lymph node for CEA-elevated (≥ 5 ng/ml) colon cancer patients. Methods: Thirteen thousand two hundred thirty-nine patients from the SEER database and 238 patients from the Second Affiliated Hospital of Harbin Medical University (External set) were identified. For cancer-specific survival (CSS), Kaplan-Meier curves were drawn and data were analyzed using log-rank test. Using X-tile software, the optimal cut-off lymph node count was calculated by the maximal Chi-square value method. Cox regression model was applied to perform survival analysis. Results: In CEA-elevated colon cancer, 18 nodes were defined as the optimal minimum node. The number of lymph node examined (< 12, 12-17 and ≥ 18) was an independent prognosticator in both SEER set (HR12-17 nodes = 1.329, P < 0.001; HR< 12 nodes = 1.985, P < 0.001) and External set (HR12-17 nodes = 1.774, P < 0.032; HR< 12 nodes = 2.741, P < 0.006). Moreover, the revised 18-node standard could identify more positive lymph nodes compared with the 12-node standard in this population. Conclusions: With the purpose of favorable long-term survival and accurate nodal stage for CEA-elevated colon cancer patients, the 18-node standard could be regarded as an alternative to the 12-node standard advocated by the ASCO and NCCN guidelines. [ABSTRACT FROM AUTHOR]

Introduction: Mucinous ovarian carcinoma is often diagnosed early and can affect young patients. The preservation of the female reproductive organ is one of the critical issues, especially for nulliparous women. This case report aims to reconsider the safe outcome of fertility-sparing surgery for infiltrative type mucinous ovarian carcinoma. Case Presentation: A 28-year-old woman with a right mucinous ovarian carcinoma, infiltrative subtype stage IA was treated by right salpingo-oophorectomy, omentectomy, and lymph nodes staging. A 5-year follow-up showed no signs of relapse, and she completed two full-term natural pregnancies. Conclusion: Conservative surgery is a crucial matter for this patient category. The infiltrative type has a poorer prognosis, but few papers have reported the outcome and the safety of fertility-sparing surgery in this context. [ABSTRACT FROM AUTHOR]

Metastatic cervical lymph nodes are a frequent finding in head and neck squamous cell carcinoma (HNSCC). If a non-surgical approach is primarily chosen, a therapy response evaluation of the primary tumor and the affected lymph nodes is necessary in the follow-up. Supplementary contrast-enhanced ultrasound (CEUS) can be used to precisely visualize the microcirculation of the target lesion in the neck, whereby malignant and benign findings differ in their uptake behavior. The same applies to many other solid tumors. For various tumor entities, it has already been shown that therapy monitoring is possible through regular contrast-enhanced sonography of the primary tumor or the affected lymph nodes. Thus, in some cases, maybe in the future, a change in therapy strategy can be achieved at an early stage in the case of non-response or, in the case of therapy success, a de-escalation of subsequent (surgical) measures can be achieved. In this paper, a systematic review of the available studies and a discussion of the potential of therapy monitoring by means of CEUS in HNSCC are presented.

Background. Disparity between patient report and physician perception of pain from radiotracer injection for sentinel node biopsy is thought to center on the severity of the intervention, ethnic composition of population queried, and socioeconomic factors. Objective. The objectives of this study were, first, to explore agreement between physicians' and their breast cancer patients' pain assessment during subareolar radionucleotide injection; and second, to evaluate potential ethnic differences in ratings. Methods. A trial was conducted, from January 2006 to April 2009, where 140 breast cancer patients were randomly assigned to standard topical lidocaine-4% cream and 99mTc-sulfur colloid injection, or to one of three other groups: placebo cream and 99mTc-sulfur colloid injection containing NaHCO3, 1% lidocaine, or NaHCO3 + 1% lidocaine. Providers and patients completed numeric pain scales (0-10) immediately after injection. Results. Patients and providers rated pain similarly over the entire cohort (median, 3 vs 2, P = 0.15). Patients rated pain statistically significantly higher than physicians in the standard (6 vs 5, P = 0.045) and placebo + NaHCO3 (5 vs 4, P = 0.032) groups. No significant difference in scores existed between all African Americans and their physicians (3 vs 4, P = 0.27). Conclusion. Patient-physician pain assessment congruence over the less painful injections and their statistically similar scores with the more painful methods suggests the importance of utilizing the least painful method possible. Providers tended to underestimate patients with the highest pain ratings-those in the greatest analgesic need. Lack of statistical difference between African American and physician scores may reflect the equal-access-to-care over the entire patient cohort, supporting the conclusion that socioeconomic factors may lie at the heart of previously reported discrepancies. [ABSTRACT FROM AUTHOR]

The gold standard for diagnosing lymph node metastasis of papillary thyroid carcinoma is to analyze the whole slide histopathological images (WSIs). Due to the large size of WSIs, recent computer-aided diagnosis approaches adopt the multi-instance learning (MIL) strategy and the key part is how to effectively aggregate the information of different instances (patches). In this paper, a novel transformer-guided framework is proposed to predict lymph node metastasis from WSIs, where we incorporate the transformer mechanism to improve the accuracy from three different aspects. First, we propose an effective transformer-based module for discriminative patch feature extraction, including a lightweight feature extractor with a pruned transformer (Tiny-ViT) and a clustering-based instance selection scheme. Next, we propose a new Transformer-MIL module to capture the relationship of different discriminative patches with sparse distribution on WSIs and better nonlinearly aggregate patch-level features into the slide-level prediction. Considering that the slide-level annotation is relatively limited to training a robust Transformer-MIL, we utilize the pathological relationship between the primary tumor and its lymph node metastasis and develop an effective attention-based mutual knowledge distillation (AMKD) paradigm. Experimental results on our collected WSI dataset demonstrate the efficiency of the proposed Transformer-MIL and attention-based knowledge distillation. Our method outperforms the state-of-the-art methods by over 2.72% in AUC (area under the curve). [ABSTRACT FROM AUTHOR]

Background: To evaluate the safety and efficacy of radiofrequency ablation (RFA), microwave ablation (MWA), and laser ablation (LA) for the treatment of cervical metastatic lymph nodes (CMLNs) of papillary thyroid carcinoma (PTC). Methods: The Pubmed, EMBASE, Web of Science, and Cochrane Library databases were searched for studies on the safety and efficacy of thermal ablations (RFA, MWA, and LA) for the treatment of CMLNs of PTC until March 30, 2022. A review of 334 potential papers identified 17 eligible papers including 312 patients. Fixed-effects model or random-effects model was used to evaluate the pooled proportions of volume reduction rate (VRR), complete disappearance, and recurrence, and pooled estimates of changes in the largest diameter, volume, and serum Tg after ablation. The pooled proportions of overall and major complications were calculated. Subgroup analysis based on treatment modalities. The heterogeneity among studies was analyzed by using Q statistics and inconsistency index I2. MINORS scale was used to evaluate the quality of the studies. Results: 17 eligible studies were finally identified, including 312 patients and 559 CMLNs. The pooled proportions of VRR, complete disappearance and recurrence of CMLNs were 91.28% [95% confidence interval (CI): 86.60-95.97%], 67.9% [95% CI: 53.1-81.1%] and 7.8% [95%CI: 3.0-14.1%], respectively. The pooled estimates of changes in the largest diameter, volume and serum Tg were 8.12 mm [95%CI: 6.78-9.46 mm], 338.75 mm3 [95%CI: 206.85 -470.65 mm3] and 5.96 ng/ml [95%CI: 3.68-8.24 ng/ml], respectively. The pooled proportions of overall and major complications were 2.9% [95%CI: 0.3-7.1%] and 0.3% [95%CI: 0-1.9%], respectively. Significant between-study heterogeneity was observed for complete disappearance (P<0.01, I2 =88.6%), VRR (P<0.001, I2 =99.9%), recurrence (P=0.02, I2 =47.76%), overall complications (P<0.02, I2 =44.8%), and changes in the largest diameter (P < 0.001, I2 =82.6%), volume (P<0.001, I2 =97.0%), and serum Tg (P < 0.001, I2 =93.7%). Subgroup analysis showed heterogeneity of the VRR among the treatment modality (I2 range: 84.4-100%). The VRR of MWA was the highest (97.97%), followed by RFA (95.57%) and LA (84.46%) (P < 0.001). Conclusion: All thermal ablations were safe and effective for the treatment of CMLNs of PTC. However, each treatment had significant heterogeneity in VRR. Compared with RFA and MWA, LA was less effective in reducing the volume of CMLNs of PTC. [ABSTRACT FROM AUTHOR]

This paper explores the relationship between the clinical value of vasodilator-stimulated phosphoprotein (VASP) in lung cancer tissue and its diagnosis and severity. Totally 100 patients who were clinically diagnosed with lung cancer from January 2018 to December 2020 were enrolled in our study. They were assigned into two groups according to the presence of lymph node metastasis. The VASP levels were measured by flow cytometry. The correlation between the expression of VASP in tumor tissue and the clinical characteristics and prognosis in patients was analyzed. The diagnostic efficacy of plasma VASP with squamous cell carcinoma antigen (SCC), neuron-specific enolase (NSE), cytokeratin-19 fragment (CYFRA21-1), prosecretin-releasing peptide (proGRP), and lung cancer was analyzed. The results were compared with APACHE III score to evaluate the accuracy of VASP in determining the severity of patients. This paper finds that the value of VASP in the non-lymph node metastasis group was significantly higher than that in the healthy control group, and the VASP level in the lymph node metastasis group was significantly higher than that in the non-lymph node metastasis group and the healthy control group (all p values <0.05). The APACHE III score of the lymph node metastasis group was higher than that of the non-lymph node metastasis group (p value <0.05). The diagnostic efficacy of VASP is similar to that of SCC, NSE, CYFRA21-1, and proGRP. The plasma VASP value was statistically different in the survival group and the death group, with higher level observed in the death group compared to survival group (all p values <0.05). The value of plasma VASP alone and acute physiology and chronic health evaluations III (APACHE III) score for lung cancer mortality was similar (47.06% vs. 52.94%, p value >0.05). Similar accuracy was observed in VASP and APACHE III score in predicting mortality of lung cancer (84.37% vs. 85.77%, p value>0.05). This paper concludes that the level of VASP correlates to the severity of the lung cancer and survival of the patients. [ABSTRACT FROM AUTHOR]

Almost from the time that autopsies were first routinely carried out, darkening of lungs with increasing age was described. Different explanations for the origin of the accumulating black pigment arose and by the early nineteenth century three hypotheses had emerged: 1) soot inhaled into the lungs from the air; 2) carbon accumulating in the lungs from abnormal pulmonary carbon dioxide metabolism; and, 3) pigment derived from the blood. In 1813 the English physician and chemist George Pearson published a paper in which he described the recovery of the black pigment from lungs and its chemical analysis. Pearson declared the black pigment to be airborne carbon/soot from the burning of coal and wood. He described these particles depositing in 'black spots' in the terminal airways and accumulating in the peribronchial lymph nodes, forming 'black glands'. Despite Pearson's prescient account, debate continued and the true explanation, given in that paper, was not fully accepted until the late nineteenth century. [ABSTRACT FROM AUTHOR]

With the emergence of sentinel node technology, many patients can be staged histopathologically using lymphatic mapping and selective lymphadenectomy. Structural imaging by using US, CT and MR permits precise measurement of lymph node volume, which is strongly associated with neoplastic involvement. Sentinel lymph node detection has been an ideal field of application for nuclear medicine because anatomical data fails to represent the close connections between the lymphatic system and regional lymph nodes, or, more specifically, to identify the first draining lymph node. Hybrid imaging has demonstrated higher accuracy than standard imaging in SLN visualization on images, but it did not change in terms of surgical detection. New alternatives without ionizing radiations are emerging now from "non-radiological" fields, such as ophthalmology and dermatology, where fluorescence or opto-acoustic imaging, for example, are widely used. In this paper, we will analyze the advantages and limits of the main innovative methods in sentinel lymph node detection, including innovations in lymphoscintigraphy techniques that persist as the gold standard to date. [ABSTRACT FROM AUTHOR]

Dual-energy computed tomography (DECT) is one of the most promising technological innovations made in the field of imaging in recent years. Thanks to its ability to provide quantitative and reproducible data, and to improve radiologists' confidence, especially in the less experienced, its applications are increasing in number and variety. In thoracic diseases, DECT is able to provide well-known benefits, although many recent articles have sought to investigate new perspectives. This narrative review aims to provide the reader with an overview of the applications and advantages of DECT in thoracic diseases, focusing on the most recent innovations. The research process was conducted on the databases of Pubmed and Cochrane. The article is organized according to the anatomical district: the review will focus on pleural, lung parenchymal, breast, mediastinal, lymph nodes, vascular and skeletal applications of DECT. In conclusion, considering the new potential applications and the evidence reported in the latest papers, DECT is progressively entering the daily practice of radiologists, and by reading this simple narrative review, every radiologist will know the state of the art of DECT in thoracic diseases. [ABSTRACT FROM AUTHOR]

Introduction: Pyogenic granulomas (PGs) are benign lesions that are very common in the upper aerodigestive tract. These lesions occur due to hormonal imbalance or due to a predisposing traumatic factor. They are relatively rare in the lower respiratory tract. There are few published papers of Pyogenic granulomas (PG) involving the lower airway in the past 30 years. Aim: A case of pyogenic granuloma of larynx mimicking malignancy has been presented along with the systematic review on methods of diagnosis, successful management, and prevention of pyogenic granuloma recurrence in the lower respiratory tract. Materials and Methods: This systematic review of literature included reports from 1981 till date, where complete details of the records were available. These reports were collected from the search engines "PubMed" and "Google Scholar" using the MeSH terms "pyogenic granuloma" OR "lobular capillary hemangioma" AND "lower respiratory tract". The results were reviewed by three different authors independently with a main focus on methods of diagnosis and successful management and prevention of recurrence. Results: A 59-year-old male patient presented to ENT Department with hoarseness of voice for the past six months. On examination with video laryngoscope, a pale pinkish polypoidal mass originating from the anterior commissure and extending into the subglottic wedge with normal vocal cord mobility was noted. Neck examination showed splaying of thyroid cartilage with tenderness and there were no palpable lymph nodes. CT examination suggested a neoplastic etiology of thyroid cartilage erosion. The patient was managed by microlaryngeal excision of the mass and histopathological analysis revealed pyogenic granuloma with no evidence of malignancy. From the 25 papers reviewed, a predisposing trauma like a history of intubation/lower airway procedures like bronchoscopy or laryngoscopy is not a prerequisite for the occurrence of pyogenic granuloma of the lower airway. The lesions can be excised via microlaryngoscopy or using the bronchoscope depending on the site of lesion. The various surgical modalities used for excision are cold steel dissection, laser excision and cryotherapy. conclusion: Meticulous dissection and removal of the lesion with post operative measures to prevent additional trauma like antireflux measures and appropriate antibiotic therapy seems to be helpful in preventing recurrence. Role of steroids in the management of pyogenic granuloma has not been supported by adequate literature. Further studies are required to comment on the adequacy of duration of follow-up. [ABSTRACT FROM AUTHOR]

INTRODUCTION The underlying factors of oral squamous cell cancers (OSCC) have been elucidated, but studies have focused little on etiological differences in affected oral cavity sites. The aim of this retrospective study was to clarify the role of carcinogen exposure in OSCC of different oral cavity areas. METHODS A cross-sectional study of patients with primary OSCC was conducted retrospectively, based on patient records from Helsinki University Hospital, Finland, between January 2016 and December 2020. The patients' self-reported history of tobacco smoking and alcohol use was explained by tumor site, age, sex, tumor size, and lymph node status in a logistic regression model. The information on smoking and alcohol use was compiled from a patient background form. RESULTS In 519 patients, tumors occurred most often in the tongue (51%), gingiva (21%), or floor of the mouth (FOM; 15%). FOM had 26-fold greater odds for a history of smoking and alcohol use than other tumor sites (OR=25.78; 95% CI: 8.02-82.95; p<0.001). Gingival and buccal sites were associated significantly less with smoking and alcohol use (OR=0.43, 95% CI: 0.28-0.67; p<0.001 and OR=0.47; 95% CI: 0.25-0.92; p<0.026, respectively). Patients of older age were less likely to have a history of smoking and alcohol use (AOR=0.95; 95% CI: 0.94-0.97; p<0.001) than younger patients. Tumor size (T3-4) and FOM increased the odds for history of smoking and alcohol use (AOR=1.73; 95% CI: 1.15-2.60; p=0.009 and AOR=26.15; 95% CI: 8.01-84.84; p<0.001, respectively). CONCLUSIONS OSCC of oral cavity sites has notable differences in etiology. FOM seems to be related almost exclusively to conventional smoking and heavy alcohol use. [ABSTRACT FROM AUTHOR]

Background: Papillary thyroid carcinoma (PTC), being the most common thyroid malignancy, is a slow-growing tumor and is usually limited to the thyroid. Extra thyroid extension is uncommon; besides, invasion to the vasculature seems to be extremely rare and usually indicates aggressive nature of the disease. Case presentation: We present a case of a 40-year-old lady who referred with a palpable neck mass a month after total thyroidectomy which its histopathologic examination revealed follicular variant of PTC; the same variant as prior thyroidectomy. Preoperative ultrasonography failed to comment on the intravascular component of the mass. Surgical procedure confirmed a mass attaching and infiltrating to the internal jugular vein, which turned out to be persistent disease. Conclusions: Awareness of this entity is important for surgeons, oncologists and radiologist as it can influence patient management. [ABSTRACT FROM AUTHOR]

Patients with primary colorectal cancer can present with obstructions, tumor bleeding, or perforations, which represent acute complications. This paper aimed to analyze and compare the clinical and pathological profiles of two patient groups: one with colorectal cancer and a related complication and another without any specific complication. We performed a five-year retrospective study on colorectal cancer patients admitted to a surgery unit and comparatively explored the main clinical and pathological features of the tumors belonging to the two groups. A total of 250 patients with colorectal cancer were included in the analysis. Of these, 117 (46.8%) had presented a type of complication. The comparative analysis that examined several clinical and pathological parameters showed a statistically significant difference for unfavorable prognosis factors in the group with complications. This was evident for features such as vascular and perineural invasion, lymph node involvement, pathological primary tumor stage, and TNM stage. Colorectal cancers with a related complication belonged to a group of tumors with a more aggressive histopathologic profile and more advanced stages. Furthermore, the comparable incidence of cases in the two groups of patients warrants further efforts to be made in terms of early detection and prognosis prediction of colorectal cancer. [ABSTRACT FROM AUTHOR]

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Simple Summary: Lymph node staging is very important for the prognosis of patients with gastric cancer. Currently, the internationally accepted lymph node staging method is the 8th AJCC staging, which divides lymph nodes into different stages according to the number of positive lymph nodes. This staging method is simple and convenient, but ignores the laterality of lymph nodes. In this paper, we for the first time combined the location and number information of positive lymph nodes to create a novel lymph node staging system for gastric cancer. After training cohort and validation cohort tests, this staging is more accurate in predicting the prognosis of patients than the 8th AJCC staging. Background: Lymph node metastasis location and number significantly affects the prognosis of patients with gastric cancer (GC). This study was designed to examine a new lymph node hybrid staging (hN) system to increase the predictive ability for patients with GC. Methods: This study analyzed the gastrointestinal treatment of GC at the Harbin Medical University Cancer Hospital from January 2011 to December 2016, and selected 2598 patients from 2011 to 2015 as the training cohort (hN) and 756 patients from 2016 as the validation cohort (2016-hN). The study utilized the receiver operating characteristic curve (ROC), c-index, and decision curve analysis (DCA) to compare the prognostic performance of the hN with the 8th edition of AJCC pathological lymph node (pN) staging for GC patients. Results: The ROC verification of the training cohort and validation cohort based on each hN staging and pN staging showed that for each N staging, the hN staging had a training cohort with an AUC of 0.752 (0.733, 0.772) and a validation cohort with an AUC of 0.812 (0.780, 0.845). In the pN staging, the training cohort had an AUC of 0.728 (0.708, 0.749), and the validation cohort had an AUC of 0.784 (0.754, 0.824). c-Index and DCA also showed that hN staging had a higher prognostic ability than pN staging, which was confirmed in the training cohort and the verification cohort, respectively. Conclusion: Lymph node location-number hybrid staging can significantly improve the prognosis of patients with GC. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer is the most frequent cancer affecting women, and axillary lymph nodes (ALNs) are the most common initial site of metastatic spread. In patients with positive ALNs undergoing neoadjuvant chemotherapy (NACT), it is necessary to localize and identify the lymph node metastases in order to perform less invasive axillary surgery, such as targeted axillary dissection (TAD). In this setting, the choice of the most appropriate localization methods is crucial to correctly orientate the removal of the pathological ALNs. This is more important considering that ALNs can become non-palpable after NACT. National Comprehensive Cancer Network (NCCN) guidelines also suggest their possible use in a non-NACT setting, particularly in patients candidate to SLNB with limited numbers of positive ALNs in whom ALNs have been biopsied. Targeted axillary dissection (TAD) is an axillary staging technique after NACT that involves the removal of biopsy-proven metastatic lymph nodes in addition to sentinel lymph node biopsy (SLNB). This technique avoids the morbidity of traditional axillary lymph node dissection and has shown a lower false-negative rate than SLNB alone. Therefore, marking positive axillary lymph nodes before NACT is critical in order to locate and remove them in the subsequent surgery. Current localization methods include clip placement with intraoperative ultrasound, carbon-suspension liquids, localization wires, radioactive tracer-based localizers, magnetic seeds, radar reflectors, and radiofrequency identification devices. The aim of this paper is to illustrate the management of axillary lymph nodes based on current guidelines and explain the features of axillary lymph node markers, with relative advantages and disadvantages. [ABSTRACT FROM AUTHOR]

Background: Pregnancy-induced immunological changes contribute to the maternal immune tolerance. Nuclear factor kappa B (NF-κB) pathway participates in regulating both innate and adaptive immunities, and lymph nodes play key roles in adaptive immune reaction. However, it is unclear whether early pregnancy changes the expression of NF-κB family in maternal lymph node in sheep., Methods: In this study, the samples of inguinal lymph nodes were collected from ewes on day 16 of the estrous cycle, and on days 13, 16 and 25 of pregnancy, and expression of NF-κB family, including NF-κB p105 (NFKB1), NF-κB p100 (NFKB2), p65 (RELA), RelB (RELB) and c-Rel (REL), were analyzed through real-time quantitative PCR, Western blot and immunohistochemical analysis., Results: The expression levels of NF-κB p105 and c-Rel downregulated, but NF-κB p100 upregulated on day 25 of pregnancy. The expression levels of p65, RelB and c-Rel peaked at day 13 of pregnancy, and expression level of RelB was higher during early pregnancy comparing to day 16 of the estrous cycle. In addition, p65 protein was located in the subcapsular sinus and lymph sinuses., Conclusion: This paper reported for the first time that early pregnancy has effects on the expression of NF-κB family, which may contribute to the maternal immunoregulation through blood circulation and lymph circulation during early pregnancy in sheep., (© 2022. The Author(s).)

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Although malignant melanoma (MM) most frequently tends to metastasize to the regional lymph nodes, liver, lung and brain, several unusual sites of metastasis have been described in the literature. Among these, the metastatic involvement of gallbladder or uterus represents an exceptional event, usually associated with diffuse metastatic disease or observed as an autopsy finding. In this paper, we present two unusual cases of isolated MM metastasis to these anatomic sites, arising in a 71-year-old man and a 54-year-old woman, for whom no information on previous malignancies was known at the time of the histological examination. The clinico-pathologic features are described, emphasizing that MM metastasis must be included in the differential diagnosis when dealing with patients with a previous diagnosis of MM and onset of a novel mass/lesion even at unusual sites. [ABSTRACT FROM AUTHOR]

Single-cell biology has revolutionized the way we understand biological processes. In this paper, we provide a more tailored approach to clustering and analyzing spatial single-cell data coming from immunofluorescence imaging techniques. We propose Bayesian Reduction for Amplified Quantization in UMAP Embedding (BRAQUE) as an integrative novel approach, from data preprocessing to phenotype classification. BRAQUE starts with an innovative preprocessing, named Lognormal Shrinkage, which is able to enhance input fragmentation by fitting a lognormal mixture model and shrink each component towards its median, in order to help further the clustering step in finding more separated and clear clusters. Then, BRAQUE's pipeline consists of a dimensionality reduction step performed using UMAP, and a clustering performed using HDBSCAN on UMAP embedding. In the end, clusters are assigned to a cell type by experts, using effects size measures to rank markers and identify characterizing markers (Tier 1), and possibly characterize markers (Tier 2). The number of total cell types in one lymph node detectable with these technologies is unknown and difficult to predict or estimate. Therefore, with BRAQUE, we achieved a higher granularity than other similar algorithms such as PhenoGraph, following the idea that merging similar clusters is easier than splitting unclear ones into clear subclusters. [ABSTRACT FROM AUTHOR]

The simulation of immune response is a challenging task because quantitative data are scarce. Quantitative theoretical models either focus on specific cell–cell interactions or have to make assumptions about parameters. The broad variation of, e.g., the dimensions and abundance between lymph nodes as well as between individual patients hampers conclusive quantitative modeling. No theoretical model has been established representing a consensus on the set of major cellular processes involved in the immune response. In this paper, we apply the Petri net formalism to construct a semi-quantitative mathematical model of the lymph nodes. The model covers the major cellular processes of immune response and fulfills the formal requirements of Petri net models. The intention is to develop a model taking into account the viewpoints of experienced pathologists and computer scientists in the field of systems biology. In order to verify formal requirements, we discuss invariant properties and apply the asynchronous firing rule of a place/transition net. Twenty-five transition invariants cover the model, and each is assigned to a functional mode of the immune response. In simulations, the Petri net model describes the dynamic modes of the immune response, its adaption to antigens, and its loss of memory. [ABSTRACT FROM AUTHOR]

Background: The objective of this paper is to explore the value of a delta-radiomic model of the axillary lymph node (ALN) using dynamic contrast-enhanced (DCE) MRI for early prediction of the axillary pathological complete response (pCR) of breast cancer patients after neoadjuvant chemotherapy (NAC). Methods: A total of 120 patients with ALN-positive breast cancer who underwent breast MRI before and after the first cycle of NAC between October 2018 and May 2021 were prospectively included in this study. Patients were divided into a training (n = 84) and validation (n = 36) cohort based on the temporal order of their treatments. Radiomic features were extracted from the largest slice of targeted ALN on DCE-MRI at pretreatment and after one cycle of NAC, and their changes (delta-) were calculated and recorded. Logistic regression was then applied to build radiomic models using the pretreatment (pre-), first-cycle(1st-), and changes (delta-) radiomic features separately. A clinical model was also built and combined with the radiomic models. The models were evaluated by discrimination, calibration, and clinical application and compared using DeLong test. Results: Among the three radiomic models, the ALN delta-radiomic model performed the best with AUCs of 0.851 (95% CI: 0.770–0.932) and 0.822 (95% CI: 0.685–0.958) in the training and validation cohorts, respectively. The clinical model yielded moderate AUCs of 0.742 (95% CI: 0.637–0.846) and 0.723 (95% CI: 0.550–0.896), respectively. After combining clinical features to the delta-radiomics model, the efficacy of the combined model (AUC = 0.932) in the training cohort was significantly higher than that of both the delta-radiomic model (Delong p = 0.017) and the clinical model (Delong p < 0.001) individually. Additionally, in the validation cohort, the combined model had the highest AUC (0.859) of any of the models we tested although this was not statistically different from any other individual model's validation AUC. Calibration and decision curves showed a good agreement and a high clinical benefit for the combined model. Conclusion: This preliminary study indicates that ALN-based delta-radiomic model combined with clinical features is a promising strategy for the early prediction of downstaging ALN status after NAC. Future axillary MRI applications need to be further explored. [ABSTRACT FROM AUTHOR]

Background: In the present paper, the main diagnostic tool for re-evaluation of axillary lymph node involvement and planning of surgery after neoadjuvant chemotherapy (NAC) is ultrasound whose accuracy we aimed to determine herein. The high precision of ultrasound in diagnosis of metastatic axillary lymph nodes in untreated patients is well known; however, its worth in patients who received NAC is highly controversial. Method: We enrolled 165 breast cancer patients receiving NAC in this retrospective cohort study. They all had undergone post-NAC ultrasound done before surgery. The ultrasound reports were reassessed and validated by a breast radiologist. Finally, the histopathology reports were compared to those of the ultrasound. Results: Among 165 surveyed post-NAC ultrasounds, 53 women had positive results and 112 had negative results. Pathology and ultrasound reports were accordant in 93 women and adverse in 112 others. The false negative rate of post-NAC axillary ultrasound was calculated as 60.6%. The sensitivity and specificity of post-NAC AxUS were 39.4% and 79%, respectively. After NAC, there were certain changes in ultrasound reports from positive to negative in 50% and pathologic complete clearance was observed in just 28% of the women who were initially clinically lymph node positive. Conclusion: Ultrasound was not found to be an accurate and appropriate tool for evaluation of axillary lymph node involvement in breast cancer patients who receive NAC. By changing the primarily established surgical plan from ALND to SLNB, based on the ultrasound findings, patients may remain undertreated. Furthermore, the axillary nodes pathologic clearance after NAC was observed in less than one third of the women who were initially clinically node positive; accordingly, surgeons should be cautious about the optimum response of axillary metastatic lymph nodes to NAC. [ABSTRACT FROM AUTHOR]

The complex anatomy of the carotid space within a small confined area is unique to the head and neck and allows for a vast array of pathology. This paper will review the anatomy of the carotid space from the skull base to the thorax, defining its borders at multiple levels, as well as its contents. The paper will also describe the myriad of mass lesions and vascular pathologies that may occur within the carotid space. The discussion will include anatomic considerations in differential diagnoses, imaging features, and lesion characteristics across multiple imaging modalities including CT, MRI, ultrasound, and conventional angiography. Entities discussed include paragangliomas, nerve sheath tumors, meningioma, fibromuscular dysplasia, carotidynia, thrombus, dissection, pseudoaneurysm, and pathology of the deep cervical chain lymph nodes. Understanding the complex and unique anatomy of the carotid space, as well as the nuances of navigating a broad differential, will empower the reader to make an accurate diagnosis. [ABSTRACT FROM AUTHOR]

The article presents a list of forthcoming papers related to immunology. Some of the papers include "Inhibitory p41 Isoform of Invariant Chain and Its Potential Target Enzymes Cathepsins L and H in Distinct Populations of Macrophages in Human Lymph Nodes," by V. Zavašnik-Bergant, A. Schweiger, T. Bevec, R. Golouh, V. Turk, J. Kos, and " Echinococcus Multilocularis Proliferation in Mice and Respective Parasite 14-3-3 Gene Expression is Mainly Controlled by an CD4 + T cell Mediated Immune Response," by W. Dei, A. Waidvogel, M. Siles-Lucas, Bruno Gottistein.

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Transmembrane protease serine 4 (TMPRSS4) is a cancer-associated protease associated with prognosis in various types of cancer. Mechanistically, TMPRSS4 mainly regulates malignant phenotypes, such as tumor invasion and metastasis, by either the epithelial to mesenchymal transition (EMT) program or promoting the proliferation of cancer cells. To date, TMPRSS4 and immune infiltration in thyroid carcinoma (TC) are largely unknown. Thus, this paper evaluated the expression of TMPRSS4 in tumor tissue through the Tumor Immune Estimation Resource (TIMER) database, and Oncomine, and its correlation with clinical parameters by UALCAN databases. Furthermore, we analyzed its prognostic value from Kaplan-Meier Plotter database, and the relationship between TMPRSS4 and the abundance of tumor-infiltrating lymphocytes (TILs) in TC in TISIDB, screening potential immune targets to explore novel mechanisms for the clinical management of TC. Finally, we assessed the correlation between TMPRSS4 and some immune markers to uncover a potential immune-related biomarker in TC patients by TIMER2.0. The results revealed that TMPRSS4 was highly expressed in TC and was also associated with lymphatic metastasis, advanced stage, histological subtype, and favorable clinical outcome. The stratified analysis based on immune cell content showed that decreased TMPRSS4 had worse prognosis in CD8+ T cell-enriched TC patients. TMPRSS4 was positively correlated with tumor immune infiltration and the expression of gene markers of immune cells. Notably, its expression was lower in the lymphocyte-depleted subtype than in other immunosubtypes in TC. Moreover, TMPRSS4 was closely related to chemokines as well as their receptors and the immunosuppressive checkpoints CTLA-4, PD-1, and HLA-G. In conclusion, TMPRSS4 may act as a novel biomarker predicting prognosis and immune infiltration in TC. [ABSTRACT FROM AUTHOR]

* Context.--In 1954, Benjamin Castleman, MD, described what was then believed to be a new entity in lymph node pathology. Initially labeled "Hyperplasia of the mediastinal node" and then "Localized mediastinal lymph node hyperplasia resembling thymoma," we now recognize the condition with the eponym "Castleman disease." We document a paper that describes the same condition, a half century before Castleman did. Objective.--To report the striking resemblance between Castleman disease and the lymph node reported in the paper published by Edwin R. LeCount, MD, titled "Lymphoma, a benign tumor representing a lymph gland in structure," published in Journal of Experimental Medicine in 1899. We also provide an overview of the remarkable achievements of LeCount. Design.--We compared the elucidation in the original paper by LeCount with the morphologic details in the papers published by Castleman et al. Material on the life of LeCount was compiled from the scientific literature, the Internet, and the files of the University of Chicago. Results.--LeCount's description and illustrations of the lymph node are uncannily similar to the onion-skinning and vascularity that Castleman documented. Conclusions.--LeCount deserves credit for his depiction of a hitherto-unreported entity. [ABSTRACT FROM AUTHOR]

In this paper, we aim to evaluate the entity of inter-fraction organ motion and deformation in stereotactic body radiotherapy (SBRT) treatments for nodal oligometastatic prostate cancer (PCa). Thirty-three patients with lymph nodes showing oligometastatic PCa treated with SBRT were included. Organs at risk (OARs) were delineated using both simulation computer tomography (s-CT) and daily cone beam CTs (CBCTs) using the Raystation planning system. For each OAR, the union volume (UV) between all the CBCTs and s-CT was computed. An expanded volume (EV) of the s-CT OARs was applied using six different margins (3, 5, 8, 10, 15, and 20 mm). A percentage volume (V%) was computed to assess the intersection between each EV and UV. The OAR deformation and motion were further evaluated using the dice similarity coefficient (DSC) and mean distance to agreement (Mean_DA). The percentage maximum dose variations for all the OARs were estimated. A recalculation with higher dose prescriptions was performed by prescribing 36 Gy/3 fx, as well as 45 Gy/3 fx. The cauda showed the highest matching (DSC = 0.72; Mean_DA = 0.14 cm), and the colon showed the lowest one (DSC = 0.37; Mean_DA = 0.44 cm). The minimum margin, which ensured a V% > 95%, was 3 mm (97.5%) for the cauda and 15 mm (96.6%) for the colon. All the OARs reached the compliance of the constraints in each session. Regarding 36 Gy-plans, the ileum punctual compliance Dmax failed in 58.8% of patients, and it failed in 70.6% of the patients for the ileum, 7.14% for the colon, and 12.5% for the bladder in the case of 45 Gy-plans. This study is an ancillary study of the RADIOSA clinical trial (AIRC IG-22159) and can be used as a benchmark for dose escalation. [ABSTRACT FROM AUTHOR]

Polyhydramnios represents a complication found in 0.2–2% of pregnancies, and it is usually diagnosed between 31 and 36 weeks of pregnancy. Although most cases of polyhydramnios are idiopathic, maternal diabetes or foetal malformations constitute frequent causes of the excessive accumulation of the amniotic fluid. Considering the latter, polyhydramnios may rarely be caused by foetal abdominal tumours, with the incidence rate of 2–14 cases per 100,000 live births. Congenital neonatal leukaemia (CNL) is a rare disease with a reported incidence rate of 5–8.6 cases per million live births. In the prenatal period, the ultrasound abnormalities associated with CNL include hepatomegaly and splenomegaly. In this paper, we presented a case of polyhydramnios caused by mechanical pressure on the foetal gastrointestinal tract by an enlarged lymph node in the course of CNL, as well as reviewing the available literature on foetal abdominal tumours with concurrent polyhydramnios. [ABSTRACT FROM AUTHOR]

The human leucine-rich repeat-containing protein 15 (LRRC15) is a membrane protein identified as a marker of CAF (cancer-associated fibroblast) cells whose overexpression is positively correlated with cancer grade and outcome. Nuclear molecular imaging (i.e., SPECT and PET) to track LRRC15 expression could be very useful in guiding further therapeutic strategies. In this study, we developed an ScFv mouse phage-display library to obtain small fragment antibodies against human LRRC15 for molecular imaging purposes. Mice were immunized with recombinant human LRRC15 (hLRRC15), and lymph node cells were harvested for ScFv (single-chain variable fragment) phage-display analysis. The built library was used for panning on cell lines with constitutive or induced expression after transfection. The choice of best candidates was performed by screening various other cell lines, using flow cytometry. The selected candidates were reformatted into Cys-ScFv or Cys-diabody by addition of cysteine, and cloned in mammalian expression vectors to obtain batches of small fragments that were further used in site-specific radiolabeling tests. The obtained library was 1.2 × 107 cfu/µg with an insertion rate >95%. The two panning rounds performed on cells permittedenrichment of 2 × 10−3. Screening with flow cytometry allowed us to identify 28 specific hLRRC15 candidates. Among these, two also recognized murine LRCC15 and were reformatted into Cys-ScFv and Cys-diabody. They were expressed transiently in a mammalian system to obtain 1.0 to 4.5 mg of Cys fragments ready for bioconjugation and radiolabeling. Thus, in this paper, we demonstrate the relevance of the phage-display ScFv library approach for the fast-track development of small antibodies for imaging and/or immunotherapy purposes. [ABSTRACT FROM AUTHOR]