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Background: Despite recent advancements, medical technology has not yet reached its peak. Precision medicine is growing rapidly, thanks to machine learning breakthroughs powered by increased computational capabilities. This article explores a deep learning application for computer-aided diagnosis in dermatology. Methods: Using a custom model based on EfficientNetB3 and deep learning, we propose an approach for skin lesion classification that offers superior results with smaller, cheaper, and faster inference times compared to other models. The skin images dataset used for this research includes 8222 files selected from the authors' collection and the ISIC 2019 archive, covering six dermatological conditions. Results: The model achieved 95.4% validation accuracy in four categories—melanoma, basal cell carcinoma, benign keratosis-like lesions, and melanocytic nevi—using an average of 1600 images per category. Adding two categories with fewer images (about 700 each)—squamous cell carcinoma and actinic keratoses—reduced the validation accuracy to 88.8%. The model maintained accuracy on new clinical test images taken under the same conditions as the training dataset. Conclusions: The custom model demonstrated excellent performance on the diverse skin lesions dataset, with significant potential for further enhancements. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to enhance the diagnostic accuracy of contrast-enhanced breast magnetic resonance imaging (MRI) using gadobutrol for differentiating benign breast lesions from malignant ones. Moreover, this study sought to address the limitations of current imaging techniques and criteria based on the Breast Imaging Reporting and Data System (BI-RADS). Materials and Methods: In a multicenter retrospective study conducted in Japan, 200 women were included, comprising 100 with benign lesions and 100 with malignant lesions, all classified under BI-RADS categories 3 and 4. The MRI protocol included 3D fast gradient echo T1- weighted images with fat suppression, with gadobutrol as the contrast agent. The analysis involved evaluating patient and lesion characteristics, including age, size, location, fibroglandular tissue, background parenchymal enhancement (BPE), signal intensity, and the findings of mass and non-mass enhancement. In this study, univariate and multivariate logistic regression analyses were performed, along with decision tree analysis, to identify significant predictors for the classification of lesions. Results: Differences in lesion characteristics were identified, which may influence malignancy risk. The multivariate logistic regression model revealed age, lesion location, shape, and signal intensity as significant predictors of malignancy. Decision tree analysis identified additional diagnostic factors, including lesion margin and BPE level. The decision tree models demonstrated high diagnostic accuracy, with the logistic regression model showing an area under the curve of 0.925 for masses and 0.829 for non-mass enhancements. Conclusion: This study underscores the importance of integrating patient age, lesion location, and BPE level into the BI-RADS criteria to improve the differentiation between benign and malignant breast lesions. This approach could minimize unnecessary biopsies and enhance clinical decision-making in breast cancer diagnostics, highlighting the effectiveness of gadobutrol in breast MRI evaluations. [ABSTRACT FROM AUTHOR]

To retrospectively determine the incidence of intraosseous mandibular lesions among patients who attended the University dental clinic in Tanzania A retrospective study of histological results of the intraosseous mandibular lesions diagnosed between 2016 and 2021. The information gathered included the age and sex of the patient, and histological diagnosis. Data analysis was done using Statistical Package for the Social Sciences version 26 computer program. Out of 1824 reports of patients with oral and maxillofacial lesions retrieved, 475 (26 %) involved the intraosseous part of the mandible. Benign tumors comprised 68.2 % and malignant tumors 14.1 %. Ameloblastoma accounted for 54.3 % of the benign tumors, osteosarcoma comprised 37.3 % of the malignant tumors, and dentigerous cysts made up 70.4 % of mandibular cysts. Intraosseous mandibular lesions are common among patients who were biopsied at the university dental clinic. Although there is no sex predilection, young adults are more affected than other age groups. The majority of the lesions are benign and malignant tumors. [ABSTRACT FROM AUTHOR]

Background: Despite recent advancements, medical technology has not yet reached its peak. Precision medicine is growing rapidly, thanks to machine learning breakthroughs powered by increased computational capabilities. This article explores a deep learning application for computer-aided diagnosis in dermatology. Methods: Using a custom model based on EfficientNetB3 and deep learning, we propose an approach for skin lesion classification that offers superior results with smaller, cheaper, and faster inference times compared to other models. The skin images dataset used for this research includes 8222 files selected from the authors’ collection and the ISIC 2019 archive, covering six dermatological conditions. Results: The model achieved 95.4% validation accuracy in four categories—melanoma, basal cell carcinoma, benign keratosis-like lesions, and melanocytic nevi—using an average of 1600 images per category. Adding two categories with fewer images (about 700 each)—squamous cell carcinoma and actinic keratoses—reduced the validation accuracy to 88.8%. The model maintained accuracy on new clinical test images taken under the same conditions as the training dataset. Conclusions: The custom model demonstrated excellent performance on the diverse skin lesions dataset, with significant potential for further enhancements.

Objective: To investigate the effect of office‐based blue laser therapy of vocal fold polyps on voice. Methods: The medical records and video recordings of patients who underwent office‐based laser therapy in a tertiary referral center between February 2020 and May 2020, and May 2021 and October 2022 was conducted. Only patients with vocal fold polyps who had undergone office‐based blue laser therapy were included. The voice was evaluated before and after surgery using the Voice Handicap Index‐10 (VHI‐10), GRB perceptual evaluation, acoustic analysis, and maximum phonation time. Results: A total of 18 patients were included. The mean age of the study group was 52.5 ± 11.94 years. The male‐to‐female ratio was 2:1. Ten patients of the total group (53.6%) had hemorrhagic polyps and the most common site was the mid‐third of the vocal fold. All patients who presented for follow‐up (n = 15) had partial or complete regression of the lesion (4 and 11, respectively). There was a significant decrease in the mean score of VHI‐10 (17.6 ± 9.97 vs. 4.27 ± 5.76, p < 0.001) and in the means of grade of dysphonia (2.0 ± 0.73 to 0.5 ± 0.63, p < 0.001), roughness (1.88 ± 0.81 to 0.44 ± 0.51, p < 0.001) and breathiness (0.81 ± 0.75 to 0.13 ± 0.34 p < 0.001). There was also a marked decrease in the perturbation parameters (jitter and shimmer) and a significant increase in the MPT from 10.66 ± 4.22 s to 14.26 ± 6.26 s (p = 0.028). Conclusion: Office‐based blue laser therapy is an effective treatment modality in patients with vocal fold polyps. Level of Evidence: 4 Laryngoscope, 133:2712–2718, 2023 [ABSTRACT FROM AUTHOR]

Benign vocal fold lesions (BVFLs) are acquired structural anomalies of the vocal folds, and these are primarily a result of vocal abuse or phonotrauma. Phonotraumatic lesions are not generally regarded as recurrent, provided that appropriate behavioral changes are made after resolution or surgical removal. Voice therapy plays a crucial role in this aspect. The aim of this article is to propose a structured pre- and post-operative voice therapy program for patients undergoing surgical intervention for BVFLs. Voice therapy post-surgery has been proven to reduce the rate of recurrence in BVFLs. Having a standard treatment protocol is a useful tool for the therapist, particularly one without extensive voice training.

Introduction: Benign laryngeal lesions usually disrupt the microstructure in the vocal cords causing hoarseness of voice. This study analyses the success rate of voice therapy and factors contributing to better outcomes in surgical treatment of benign vocal fold lesions. Methods: Forty consecutive patients with benign vocal cord lesions complying with the inclusion and exclusion criteria were enrolled and divided into two groups A and B, such that one received speech therapy post surgery for 6 weeks and the other received speech therapy for 12 weeks respectively. Preoperatively all the patients were evaluated by voice fatigue index, GRBAS scale and videolaryngoscopy. Vocal fold relaxation exercises were given preoperatively for patients of both groups. After undergoing conventional microlaryngeal excision surgery, both groups of patients underwent subjective analysis by voice fatigue index, perceptual analysis by GRBAS scale and videolaryngoscopy in regular intervals. Speech therapy was started after 1 week of complete voice rest post operatively and patients were followed up at the end of 1 week, 2 months and 4 months from the date of surgery. Results: There is no statistical difference in characteristics of patients between the two groups. Improvement in the Voice fatigue index and GRBAS scale score is statistically the same in groups A and B. Conclusion: Speech therapy is an important part of voice rehabilitation following microlaryngeal surgery. The misconception that longer speech therapy duration leads to better outcomes did not hold true in this study. Speech therapy postoperatively with proper voice hygiene practices is sufficient to obtain a near normal voice. [ABSTRACT FROM AUTHOR]

Background: Liver diseases represent a significant global health concern, necessitating accurate detection and characterization of focal liver lesions (FLLs). Precise differentiation between benign and malignant lesions, as well as distinguishing primary liver lesions from metastases, is pivotal for effective clinical management. This study aims to compare the efficacy of respiratory-triggered diffusion-weighted single-shot echo planar imaging (RT DW-SS-EPI) and T2 weighted turbo spin echo imaging (T2W TSE) in detecting and characterizing FLLs. Additionally, the study aims to determine the apparent diffusion coefficients (ADCs) of FLLs and normal liver parenchyma. Methods: A total of 30 patients with suspected focal liver lesions and 10 healthy volunteers without FLLs were enrolled. Patients referred for MRI with clinical suspicion of FLLs were included. The study employed respiratory-triggered fat-suppressed singleshot echo-planar DW imaging in the transverse plane with tridirectional diffusion gradients and three b values (0, 500, and 1000 sec/mm²). ADC maps were generated, and routine MR sequences were obtained using a 1.5 Tesla MRI scanner. ADC values were calculated using operator-defined regions of interest (ROIs), and differences in ADC values were analyzed. Results: The study encompassed 85 lesions in 30 patients, including 23 hepatocellular carcinomas (HCCs), 4 cholangiocellular carcinomas, 36 metastatic lesions, and 22 benign lesions. Males comprised 63.3% of participants. DWI demonstrated significantly higher FLL detection rates than T2WI (p < 0.001), particularly for malignant lesions (98.4% with DWI vs. 76.5% with T2WI). No significant difference was observed in detecting HCCs alone. DWI exhibited superior detection capabilities for both liver lobes compared to T2WI. Mean ADC values for various lesion types showed significant differences, with malignant lesions displaying lower ADC values than benign lesions (p < 0.001). Conclusion: Respiratory-triggered diffusion-weighted MRI (RT DWI) emerges as a valuable and contrast-free diagnostic tool for detecting and characterizing focal liver lesions. DWI outperformed T2 weighted imaging in detecting malignant lesions and showed potential for accurate differentiation between benign and malignant lesions based on ADC values. The study highlights DWI's clinical utility for liver lesion evaluation in routine practice. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effectiveness of in-office blue laser therapy on dyspnea in patients with type 3 Reinke's edema. Methods: The medical records and video-recordings of patients with Reinke's edema type 3 who had undergone office-based blue laser therapy between March 2022 and January 2023 were reviewed. The primary outcome measures assessed before and after surgery were dyspnea severity, risk of obstructive sleep apnea (OSA), and disease regression. The severity of dyspnea was measured using the Dyspnea Severity Index (DSI), the risk of OSA was assessed using the STOP-BANG questionnaire, and disease regression was assessed by reviewing the laryngeal examination before and after surgery. The Voice Handicap Index-10 (VHI-10) was used as a secondary outcome measure. Result: A total of 10 patients were included. The mean age of the study population was 58.9 ± 4.2 years. The male-to-female ratio was 2:3. In total, 20 vocal fold lesions were treated among which 18 were reviewed. Eight lesions regressed completely and 10 partially. There was a statistically significant drop in the mean score of DSI after surgery (16.1 ± 10.2 pre-operatively vs 2.3 ± 2.3 post-operatively, p-value < 0.001). The mean STOP-BANG score decreased from 4.8 ± 1.47 to 3.1 ± 1.28 (p-value = 0.001). There was also a significant improvement in VHI-10 score (22.7 ± 7.0 vs 4.4 ± 5.6, p-value < 0.001). Conclusion: Office-based blue laser therapy offers a safe and effective treatment for shortness of breath in patients with type 3 Reinke's edema. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Investigación e Innovación en Ciencias de la Salud (RIICS) is the property of Fundacion Universitaria Maria Cano 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.)

Abstract Background Early diagnosis of prostate cancer improves its prognosis, while it is essential to upgrade screening tools. This study aimed to explore the value of a novel functional magnetic resonance imaging (MRI) technique, namely amide proton transfer (APT)-weighted MRI, combined with serum prostate-specific antigen (PSA) levels to differentiate malignant prostate lesions from benign prostate lesions. Methods Data of patients who underwent prostate examinations at Chongqing University Cancer Hospital between July 2019 and March 2022 were retrospectively analyzed. All patients underwent T2-weighted imaging (T2WI), APT, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) MRI. Two radiologists analyzed the images independently. The ability of the quantitative parameters alone or in different combinations in differentiating malignant prostate lesions from benign prostate lesions were compared by using receiver operating characteristic (ROC) curves. According to the DeLong test, the combined parameters were significantly different from the corresponding single parameter (P 0.05). APTmax and APTmean had the high values of area under the ROC curve (AUC), which were 0.780 and 0.710, respectively. APTmax had a high sensitivity, and APTmean had a high specificity. The combination of APTmax, APTmean, ADCmean, and PSAD had the highest AUC value (AUC: 0.880, sensitivity: 86.540, specificity: 78.260). Conclusion APTmax, APTmean, ADCmean, ADCmin, tPAD, FPSA, and PSAD showed to have a high value in differentiating malignant prostate lesions from benign prostate lesions in the separate assessment of indexes. The combination of APTmax, APTmean, ADCmean, and PSAD had the highest diagnostic value.

Aims: The traditional approach for the management of benign laryngeal lesions is transoral microsurgery. In cases of anatomic particularities, such as insufficient cervical extension, short mandible, temporomandibular joint ankylosis etc., and contraindications for general anesthesia, transoral microsurgery is not possible. In such cases transnasal flexible endoscopic surgery under local anesthesia can be a relevant alternative. The purpose of the study was to assess the possibilities of flexible endoscopic management of benign nonepithelial lesions of the larynx. Materials and methods: Flexible endoscopic surgical interventions were performed on 315 patients with different benign nonepithelial lesions of the larynx. The larynx pathology was represented by following lesions: myxoid polyp, polypoid degeneration of vocal folds, fibrous polyp, angiofibrous polyp, angiomatous polyp, nonspecific granuloma, cyst, lipoma, neurofibroma and amyloidosis. In 97,8% of the cases interventions were performed under local anesthesia with spontaneous respiration. In 88,6% of the cases interventions were performed as outpatient procedures. Results: In all the cases the expected result was obtained – complete ablation of the visible lesion. In 7 cases repeated interventions were performed for recurrent lesions. Conclusion: Flexible endoscopic surgery is an efficient method for the treatment of benign nonepithelial lesions of the larynx, that offers a relevant therapeutic alternative, especially for the patients who have contraindications for general anesthesia or transoral microsurgery. The advantages of the method, worthy of mentionning, are positive economic effect and time economy, the intervention being possible in an outpatient setting for the majority of patients. [ABSTRACT FROM AUTHOR]

A 34‐year‐old woman with complaints of mandibular swelling that started 4 months earlier was referred to the Oral Diseases Department. Based on the clinical and radiographic appearance, the primary diagnosis was an intraosseous reactive lesion. However, the result of histopathology indicated osteosarcoma. The diagnosis of osteosarcoma is sometimes challenging due to similarity of its clinical manifestation to those of benign lesions. Correct diagnosis and timely referral have a major impact on prognosis and patient survival. [ABSTRACT FROM AUTHOR]

Abstract A 34‐year‐old woman with complaints of mandibular swelling that started 4 months earlier was referred to the Oral Diseases Department. Based on the clinical and radiographic appearance, the primary diagnosis was an intraosseous reactive lesion. However, the result of histopathology indicated osteosarcoma.

Appendiceal mucocele is a rare disease. Sometimes it is discovered accidentally and sometimes it resembles acute appendicitis. The incidence is 0.2% to 0.7% of all appendectomies specimens. A case report of A 35-year female presented to the emergency room with a history of progressively increasing abdominal pain on and off for 3 months. Tenderness in the right lower quadrant of the abdomen was noted with a palpable mass in the right iliac fossa. An abdominal ultrasound examination was performed, and the patient was found to have an Appendicular mucocele-onion peel sign (sonographic layering within a cystic mass). The patient underwent surgery, and the diagnosis was confirmed by the histopathological report. If mucocele is treated incorrectly, pseudomyxoma peritonei which is characterized by a malignant process may develop. The term mucocele is widely used in diagnosing both benign and malignant lesions.

Canine oral papillomavirus (CPV1, also known as COPV), the most common cause of non-neoplastic papillomas, has not been shown to cause squamous cell carcinomas (SCC). Furthermore, malignant transformation of benign papillomas to SCC has only been reported in a single group of dogs with severe combined immunodeficiency infected with CPV2. Here, we report a series of 7 dogs with benign CPV1-associated papillomas with histologic evidence of CPV1 causing malignant transformation to carcinoma in situ and ultimately SCC. Expression of p53 and p16 proteins in CPV1-infected cells within the benign papillomas and lesions that progressed into SCC also supported an association between papillomavirus and malignant transformation. Moreover, our retrospective analysis indicated that while there have been increased numbers of viral papillomas with malignant transformation, the number of annually diagnosed canine viral papillomas has remained constant over the past decade in our laboratory. We speculate that either an altered host immunity from increased usage of immunosuppressive drugs or changing environmental factors, e.g. increase exposure to UV radiation, may cause an increased oncogenic potential of this "low-risk" virus. This study aims to raise awareness of the malignant potential of CPV1 and to encourage further investigations into the cause of this suspected change in its oncogenic potential.

Aims: Minimal associated pathological lesions (MAPLs) of the vocal folds are a group of benign disorders commonly related to phonotraumatic conditions and behaviors. Voice therapy (VT) can play a major role in readjusting these maladaptive behaviors and improve overall voice quality, thereby replace surgical intervention in some cases or act as a complementary treatment to enhance the ultimate therapeutic outcomes. This study aims to explore the short-term effect of the Accent method of VT on vocal subjective measures and acoustics in professional users with MAPLs, evaluate the responsiveness of each vocal fold lesion to the VT, and propose a simple model for providing VT to a sector of the population in great need of non-invasive management. Materials and methods: This analytical cross-sectional included fifty professional voice users with different MAPLs were exposed to multidimensional voice assessments before and after receiving VT training in a tertiary care hospital. These assessments include GRBAS score, Multidimensional Voice Program (MDVP) and validated Arabic version Voice Handicap Index (VHI-30). Results: This study showed variable positive effects of VT on the different types of MAPLs. Cysts had the highest level of responsiveness to VT in comparison to other lesions, followed by nodules, polyps, contact granuloma, and Reinke's edema. Conclusions: VT is a substantial solution for managing voice disorders. It should be considered in the management plan of the various types of MAPLs, even in Reinke's edema, which showed the minimum improvement. [ABSTRACT FROM AUTHOR]

Introduction: In systemic malignancies, thyroid carcinoma represents only 1%, but it is the most common endocrine malignancy with poor prognosis. Fine Needle Aspiration (FNA) is considered a requisite tool in providing a rational advent for the clinical management of these nodules. However, when solely based on cytopathological assessment, FNA leads to imprecise biopsy results in 10-20% of all cases. So, immunohistochemical markers, Galectin-3 (Gal-3) and Cytokeratin 19 (CK19) have received considerable attention as diagnostic marker for thyroid cancer. Aim: To study the expression of Gal-3 and CK19 in different thyroid neoplasms. Materials and Methods: This cross-sectional study was conducted at a tertiary care hospital from January 2019 to January 2021 on 120 cases. The thyroidectomy specimens received were fixed in 10% buffered formalin followed by gross examination. The paraffin embedded tissue blocks were subsequently stained for Haematoxylin and Eosin stain (H&E) followed by histopathological reporting. Qualitative immunohistochemical assessment of the marker Gal-3 and CK19 was performed on representative histologic sections of the thyroid neoplasms. Data were analysed using Graph Pad Instat 3. Results: The positive expression of Gal-3 was significantly more in malignant tumours (87.5%) than in benign (36.0%) (p-value

Does use of Facial nerve monitors during parotidectomy decrease incidence of facial paralysis/paresis without use of facial paresis? This study was done to compare the incidence, grade and risk factors of facial palsy in patients undergoing parotidectomy for benign parotid lesions with and without use of facial nerve monitor. This is a retrospective study. Eighty parotid patients operated for benign parotid lesions from 2013 to 2020 were retrospectively analysed. Demography details, history of the patients, history of addictions, clinical examination findings, investigation findings like the biopsy report, FNAC report, imaging i.e., CT / MRI / USG, use of intraoperative facial nerve monitor, time taken to identify the facial nerve, postoperative facial nerve palsy, facial nerve stimulation test and recovery time were analysed. Fifty patients were operated without use of facial nerve monitor, and 30 patients were operated using facial nerve monitor. Postoperative facial nerve complications were seen in 28 out of 80 patients (35%). Postoperative facial nerve complications were observed in 5 out of 30 patients (20%) in whom facial nerve monitoring was used. Marginal mandibular nerve palsy was observed in 4 patients and 1 patient had weakness of both marginal mandibular and orbital branches. While in postoperative facial nerve complications were observed in 25 out of 50 patients (50%), marginal mandibular nerve palsy was observed in 15 patients (40%), grade 3 facial palsy was observed in 3 out of 50 patients (6%), and grade 4 facial palsy were observed in 2 out of 50 patients (4%). The use of intraoperative FNM significantly lowered the incidence of paralysis. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical manifestations, radiologic features, pathological features, and immunophenotype of minute pulmonary meningothelial-like nodules (MPMNs). Method: This is a retrospective observational study. We collected the clinical data of 7 cases of MPMNs, and performed comprehensive characterization using a combination of clinical, morphological, radiologic and immunohistochemical assessments. Results: Of the 7 cases of MPMNs, 6 were female and 1 was male. The median age was 55 years. All MPMNs were multiple in lung with the size from 0,01 to 0,5cm. Chest CT examination showed ground-glass attenuation or solid nodules. Four cases were concomitant with carcinoma and/or pneumonia, and 3 cases occurred alone. Four of the 7 patients had no obvious symptoms; 3 patients had chest pain or cough or shortness of breath or hemoptysis. Multiple white nodules were found macroscopically, and the diseased cells grew along the alveolar septum, with relatively normal morphology, rich cytoplasm, unclear cell boundary, and uniform nucleus with delicate chromatin and without atypia; and the diseased cells showed nest or whorls distribution. EMA, PR, CD56 and vimentin were positive in all cases by immunohistochemistry. Conclusions: MPMNs are rare benign lesions in the lung, often multiple, usually less than 0.5cm in diameter, most of which have no obvious clinical symptoms. MPMNs are often found by chest CT, and occur independently or concomitant with other lesions. The positive immunohistochemical staining of EMA, PR, CD56, vimentin supports the diagnosis. [ABSTRACT FROM AUTHOR]

Copyright of Pädiatrie & Pädologie is the property of Springer Nature 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: Papillary lesions of the breast include a spectrum of entities ranging from benign papilloma to malignant papillary carcinoma. The overlapping morphological features in benign and malignant lesions make their accurate sub categorisation difficult. Definitive surgical management decisions on papillary lesions of breast based on fine needle aspiration cytology report alone is a matter of concern. Aim: To evaluate the cytomorphological features of papillary lesions of breast and its concordance with histopathology. Materials and Methods: This retrospective study was conducted in Department of Pathology at Regional Cancer Centre, Thiruvananthapuram, Kerala, India (tertiary cancer centre) from January 2017 to June 2017. Total 28 cases diagnosed as papillary lesions/neoplasm on nipple discharge/fine needle aspiration cytology (FNAC) from January 2014 to December 2016 were reviewed and concordance with histopathology where ever available was analysed. Cytomorphological features that were analysed included cellularity, complex folded and branching epithelial sheets, stromal bare nuclei, cyst macrophages, single cells and atypia. Results: Total 28 cases of papillary lesions diagnosed by cytology were identified with mean age of 51 years. Out of 28, 22 cases had histopathology concordance. Most common diagnosis in cytology was papillary neoplasm, accurate categorisation into benign or malignant could not be done in cytology in most of the cases. Most common diagnosis in histopathology was carcinoma, in-situ and invasive. Of total 22 cases, 16 cases showed true papillae. Majority of the cytomorphological features assessed were statistically insignificant in differentiating benign and malignant lesions. Fifteen cases out of the total 22 cases turned out to be malignant in final histopathology. Out of the total 22 cases wherein histopathology correlation was available, cytology could give a conclusive diagnosis of malignancy in two cases and could give a suggestion of malignancy in seven cases. Out of these nine cases where cytology favoured malignancy, one case turned out to be benign in histopathology while the rest eight cases were malignant. In five cases cytology gave benign diagnosis, one of these turned out to be malignant in histopathology, rest four cases histopathological diagnosis was in concordance with cytology. In eight cases cytology gave an equivocal diagnosis of papillary neoplasm, where further categorisation into benign and malignant category was not possible. Out of these equivocal cases, six turned out to be malignant in histopathology and two were benign. Conclusion: Cytomorphological features of papillary lesions of the breast are not unique and are inadequate for consistent categorisation into benign and malignant lesions. Excision biopsy with adequate sampling and immunostaining with myoepithelial markers and Oestrogen and Progesterone Receptors (ER and PR) are essential for accurate categorisation of papillary neoplasms of breast. [ABSTRACT FROM AUTHOR]

Introduction: Papillary lesions of the breast include a spectrum of entities ranging from benign papilloma to malignant papillary carcinoma. The overlapping morphological features in benign and malignant lesions make their accurate sub categorisation difficult. Definitive surgical management decisions on papillary lesions of breast based on fine needle aspiration cytology report alone is a matter of concern. Aim: To evaluate the cytomorphological features of papillary lesions of breast and its concordance with histopathology. Materials and Methods: This retrospective study was conducted in Department of Pathology at Regional Cancer Centre, Thiruvananthapuram, Kerala, India (tertiary cancer centre) from January 2017 to June 2017. Total 28 cases diagnosed as papillary lesions/neoplasm on nipple discharge/fine needle aspiration cytology (FNAC) from January 2014 to December 2016 were reviewed and concordance with histopathology where ever available was analysed. Cytomorphological features that were analysed included cellularity, complex folded and branching epithelial sheets, stromal bare nuclei, cyst macrophages, single cells and atypia. Results: Total 28 cases of papillary lesions diagnosed by cytology were identified with mean age of 51 years. Out of 28, 22 cases had histopathology concordance. Most common diagnosis in cytology was papillary neoplasm, accurate categorisation into benign or malignant could not be done in cytology in most of the cases. Most common diagnosis in histopathology was carcinoma, in-situ and invasive. Of total 22 cases,16 cases showed true papillae. Majority of the cytomorphological features assessed were statistically insignificant in differentiating benign and malignant lesions. Fifteen cases out of the total 22 cases turned out to be malignant in final histopathology. Out of the total 22 cases wherein histopathology correlation was available, cytology could give a conclusive diagnosis of malignancy in two cases and could give a suggestion of malignancy in seven cases. Out of these nine cases where cytology favoured malignancy, one case turned out to be benign in histopathology while the rest eight cases were malignant. In five cases cytology gave benign diagnosis, one of these turned out to be malignant in histopathology, rest four cases histopathological diagnosis was in concordance with cytology. In eight cases cytology gave an equivocal diagnosis of papillary neoplasm, where further categorisation into benign and malignant category was not possible. Out of these equivocal cases, six turned out to be malignant in histopathology and two were benign. Conclusion: Cytomorphological features of papillary lesions of the breast are not unique and are inadequate for consistent categorisation into benign and malignant lesions. Excision biopsy with adequate sampling and immunostaining with myoepithelial markers and Oestrogen and Progesterone Receptors (ER and PR) are essential for accurate categorisation of papillary neoplasms of breast.

Appendiceal mucocele is a rare disease. Sometimes it is discovered accidentally and sometimes it resembles acute appendicitis. The incidence is 0.2% to 0.7% of all appendectomies specimens. A case report of A 35-year female presented to the emergency room with a history of progressively increasing abdominal pain on and off for 3 months. Tenderness in the right lower quadrant of the abdomen was noted with a palpable mass in the right iliac fossa. An abdominal ultrasound examination was performed, and the patient was found to have an Appendicular mucocele-onion peel sign (sonographic layering within a cystic mass). The patient underwent surgery, and the diagnosis was confirmed by the histopathological report. If mucocele is treated incorrectly, pseudomyxoma peritonei which is characterized by a malignant process may develop. The term mucocele is widely used in diagnosing both benign and malignant lesions. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the study was to characterize benign lesions showing increased 68Ga-FAPI-04 uptake on FAPI PET/CT.Methods: We retrospectively reviewed 182 patients with suspected various cancers who were performed 68Ga-FAPI-04 PET/CT imaging from August 2020 to December 2020. The diagnoses of the benign lesions were made by the CT findings (CT), other imaging information (OII) (contrast enhance CT, FDG PET, ultrasound, MRI or others), clinical information (CI) (medical history, laboratory examination, symptom, physical sign and follow-up information) or histological biopsy (HB).Results: A total of 185 primary malignant tumors were detected by FAPI PET/CT with the median SUVmax of 9.0 (range from 0.97 to 25.71). There were 360 benign lesions with increased FAPI uptake were detected in 146 (146/182, 80.2%) patients with the median SUVmax of 3.64 (range from 1.39 to 21.56), including inflammatory processes (n = 231, 64.2%), exostosis (n = 54, 15%), hemorrhoid (n = 47, 13.1%), fracture (n = 17, 4.7%), hepatic fibrosis (n = 4, 1.1%), and others (n = 7, 1.9%).Conclusion: Benign lesions with increased 68Ga-FAPI-04 uptake are common. The overall SUVmax of benign lesions is lower than that of malignant tumors, however there is a large overlap of SUVmax range. Similar to FDG PET, some benign lesions can be easily diagnosed by combining CT findings, special location and clinical data, but there are still some lesions that may be confused with malignant lesions, which need to be paid more attention.Trail Registration: NIH ClinicalTrials.gov (NCT04499365). [ABSTRACT FROM AUTHOR]

Introduction: In systemic malignancies, thyroid carcinoma represents only 1%, but it is the most common endocrine malignancy with poor prognosis. Fine Needle Aspiration (FNA) is considered a requisite tool in providing a rational advent for the clinical management of these nodules. However, when solely based on cytopathological assessment, FNA leads to imprecise biopsy results in 10-20% of all cases. So, immunohistochemical markers, Galectin-3 (Gal-3) and Cytokeratin 19 (CK19) have received considerable attention as diagnostic marker for thyroid cancer. Aim: To study the expression of Gal-3 and CK19 in different thyroid neoplasms. Materials and Methods: This cross-sectional study was conducted at a tertiary care hospital from January 2019 to January 2021 on 120 cases. The thyroidectomy specimens received were fixed in 10% buffered formalin followed by gross examination. The paraffin embedded tissue blocks were subsequently stained for Haematoxylin and Eosin stain (H&E) followed by histopathological reporting. Qualitative immunohistochemical assessment of the marker Gal-3 and CK19 was performed on representative histologic sections of the thyroid neoplasms. Data were analysed using Graph Pad Instat 3. Results: The positive expression of Gal-3 was significantly more in malignant tumours (87.5%) than in benign (36.0%) (p-value <0.001). In Papillary Thyroid Carcinomas (PTC) and in Follicular Variant of Papillary Thyroid Carcinomas (FVPTC) expression of Gal-3 was notably higher than in Follicular Adenoma (FA) (p-value=0.01 and p-value=0.0001, respectively). Follicular Thyroid Carcinomas (FTC) had higher expression FA (p-value=0.003). In malignant tumours (71.8%), positive expression of CK19 was significantly more than benign tumours (24.0%) (p-value <0.001). Significant difference in expression of CK19 was seen between PTC and FTC (p-value=0.019). Between PTC and FA, differences in expression were significant (p-value <0.001). Significant difference in expression was also seen between FVPTC and FTC (p-value=0.032) as well as with FA (p-value=0.028). Conclusion: The most sensitive marker is Gal-3 for the diagnosis of thyroid malignancies. When combined with CK19, the specificity increases in identifying the thyroid cancers. More combination of markers together with Gal-3 and CK19 can be useful in the distinction between malignant and benign thyroid tumours because it is essential for further treatment and long-term management of the patient. [ABSTRACT FROM AUTHOR]

objective　To investigate the value of MRI diagnosis of nodular breast benign and malignant lesions. Methods　Retrospective analysis of 71 patients with nodular breast disease confirmed by pathology in our hospital, Perform MRI multi-parameter imaging before surgery, Select DCE-MRI and DWI for analysis, After processing：TIC time-signal curve, peak time, peak enhancement rate, SImax peak and ADC apparent diffusion coefficient, Combined with morphological characteristics：rough edges, ring strengthening, edge burr sign and leaf leaf sign for analysis. Results　43 malignant lesions, 28 benign lesions.There were 22 TIC time-signal curves of type I, with 17 cases of benign lesions and 5 cases of malignant lesions.There were 35 cases of type Ⅱ, of which 24 were malignant and 11 were benign.14 of type Ⅲ are all malignant lesions.The TIC time-signal curve types of benign and malignant lesions are different, and the difference is statistically significant (P < 0.05)；The peak time, peak enhancement rate, SImax peak and ADC apparent diffusion coefficient of benign and malignant lesions were significantly different, and the difference was statistically significant ( P < 0.05) . Conclusion　MRI dynamic enhanced scanning hemodynamic parameters, ADC combined with morphological features are of great value in the diagnosis of breast nodular benign and malignant diseases. [ABSTRACT FROM AUTHOR]

Inflammatory myofibroblastic tumor is usually a benign tumor of mesenchymal origin that is rarely found in the larynx. This case explores the unique laryngeal location and presentation of this tumor as well as the challenging radiographic and histologic findings. [ABSTRACT FROM AUTHOR]

Background: Medical technology is far from reaching its full potential. An area that is currently expanding is that of precision medicine. The aim of this article is to present an application of precision medicine—a deep‐learning approach to computer‐aided diagnosis in the field of dermatology. Materials and Methods: The main dataset was proposed in the edition of the ISIC Challenge that took place in 2019 and included 25 331 dermoscopic images from eight different categories of lesions—three of them were malignant and five benign. The behavior of the model was also tested on a dataset collected from the second Department of Dermatology, of the Colentina Clinical Hospital. Results: The overall accuracy of the model was 78.11%. Of the total 5031 samples included in the test subset, 3958 were correctly classified. The accuracy of the model on the clinical dataset is lower than that obtained in the first instance. Conclusion: The architecture of the model can be considered of general use, being able to be adapted in an optimal way for a wide range of classifications. The model has achieved performance within the expected limits but can be further improved by new methods. [ABSTRACT FROM AUTHOR]

Background: The introduction of photodynamic therapy (PDT) in various branches of the dental field such as endodontics, implantology, periodontology, and restorative dentistry and oral medicine has become useful in recent decades. This systematic review presents an overview of the literature to evaluate the usefulness of topical PDT for the treatment of benign oral soft tissue lesions and to identify limitations in prior studies to improve PDT applications. Methods: We performed a review of the literature using different search engines (PubMed, ISI Web of Science, and the Cochrane Library) employing MeSH terms such as "Photodynamic therapy" and "PDT" in conjunction with other terms. We utilized the Population, Intervention, Comparison, Outcomes, and Study design (PICOS) method to define our study eligibility criteria. Results: Initial results were 1513. Finally, there were only 21 studies that met our selection criteria. We divided the 21 selected items into two groups: inflammatory diseases and infective diseases. Conclusions: Although topical PDT is an easy to perform and well‐tolerated treatment and appears to be a valid method with promising results in the treatment of benign lesions of the oral cavity's soft tissues, further studies are needed to complete the current knowledge of this technique. [ABSTRACT FROM AUTHOR]

Background The mechanism of postparotidectomy facial palsy is not only clear but also there is a great heterogenecity in the reported risk factors for that complication. The authors conducted this study to report the incidence of facial nerve dysfunction after parotidectomy for benign lesions and to identify the risk factors for this complication. Patients and methods This prospective cross-sectional study included 73 cases that were allocated into two groups according to the incidence of facial palsy: group A included 54 cases that did not develop facial palsy, and group B included 19 cases diagnosed with it. The incidence of postoperative facial palsy was our primary outcome, whereas risk factors for that complication were the secondary outcomes. The following factors were collected and statistically tested as risk factors: age, sex, BMI, preexisting comorbidities, tumor site, tumor side, operative time, and postoperative pathology. Results Although basic patient demographics were comparable between the two groups, the prevalence of diabetes was higher in group B. Moreover, deep-located tumors, large-sized tumors, and prolonged operative time were also observed in cases that developed facial palsy. Tumor pathology showed no significant difference between the two groups. Conclusion Facial nerve palsy is a common complication that could be encountered after parotidectomy even for benign lesions. In our study, deep tumor location, tumor diameter greater than 3 cm, and diabetes mellitus are independent risk factors for this complication. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: A variety of laryngeal pathologies are increasingly being managed with in‐office KTP laser (IOKTP) endoscopic procedures. The primary goal of this study was to identify patient characteristics and disease‐related features that correlated with tolerance for IOKTP. Study Design: Retrospective chart review. Methods: The study was a retrospective review of adult patients undergoing office‐based laryngeal laser procedures between November 2016 and December 2019 at a tertiary care center. Two blinded otolaryngologist reviewers scored videotaped recordings of IOKTP procedures and assessed severity and distribution of disease using a modified Derkay score, and evaluated procedure tolerance using a visual analog scale. Results: A total of 56 patients who received IOKTP procedures for laryngeal pathology were reviewed, 42 male and 14 female, with a mean age of 61 years. Gender, age, and BMI were not correlated with tolerance. There was a moderate, negative correlation between tolerance and total number of pathological anatomic laryngeal subsites (rs(56) = −0.35, P =.01). There was a weak, negative correlation between tolerance and total modified Derkay score (rs(56) = −0.29, P =.03). The median tolerance score was lower for patients with posterior lesions (Mdn = 6.4) compared with patients with non‐posterior lesions (Mdn = 7.4), P =.04, and lower for current or former smokers (Mdn = 6.5) compared with never smokers (Mdn = 7.3), P =.04. Conclusion: Patients with large disease burden or posterior lesions and patients with smoking history may exhibit poorer tolerance of IOKTP procedures, factors which can help guide pre‐procedural counseling and management decisions. Level of Evidence: IV Laryngoscope, 131:E2292–E2297, 2021 [ABSTRACT FROM AUTHOR]

Abstract Inflammatory myofibroblastic tumor is usually a benign tumor of mesenchymal origin that is rarely found in the larynx. This case explores the unique laryngeal location and presentation of this tumor as well as the challenging radiographic and histologic findings.

Background: The purpose of this study was to determine the pathological and ultrasound (US) features of benign nonpalpable breast lesions (NPBLs) classified as Breast Imaging Reporting and Data System (BI‐RADS) category 4C or 5. Methods: Between 2003 and 2007, 849 consecutive NPBLs detected at US and classified as BI‐RADS category 4C (505) or 5 (344) initially underwent US‐guided fine needle aspiration (FNA) at our institution. Benign diagnoses were established according to surgical excision findings or during a minimal 6‐month imaging follow‐up (mean, 3.7 years [SD, 2.6 years]). US BI‐RADS features were reviewed and compared retrospectively using a chi‐square test for the following pathological categories: epithelial and fibrous proliferation (EFP), cystic and papillary lesion (C&P), inflammatory lesion (IL), benign tumor (BT), intramammary lymph node (ILN), intraepithelial proliferative lesion (IPL), and nonspecific morphological alteration (NMA). The performance of FNA in the diagnosis of benignity was assessed. Results: Of 849 NPBLs, 110 (12.9%) NPBLs were benign: 88 (17.4%) were BI‐RADS category 4C, and 22 (6.4%) were BI‐RADS category 5. Forty‐four (40%) were EFPs, 21 (19%) were C&Ps, 13 (12%) were NMAs, 11 (10%) were ILs, 11 (10%) were BTs, 8 (7%) were IPLs, and 2 (2%) were ILNs. Lesion shape, US pattern distribution, and posterior features showed statistically significant differences between these categories (P <.05): 33 (75%) EFPs exhibited posterior shadowing, 18 (86%) C&Ps were homogenous, 9 (82%) ILs were heterogeneous, 11 (100%) BTs were homogeneous, 9 (82%) BTs were oval, and 6 (75%) IPLs were irregularly shaped. Of the 110 benign NPBLs, FNA diagnosis was falsely positive in 7 (6%), suspicious in 10 (9%), and benign in 90 (82%), and 3 (3%) were inadequate for diagnosis. Conclusion: A diverse array of benign NPBLs can be classified as BI‐RADS category 4C or 5 on US, each showing specific imaging presentations. This article describes the ultrasound, cytological and histological features of benign non‐palpable breast lesions classified as highly suspicious for malignancy on imaging studies (BIRADS categories 4C and 5) and sampled by USFNA. [ABSTRACT FROM AUTHOR]

• In newly discovered focal liver lesions the main clinical problem is to determine their character as benign of malignant. • Quantitative measurements of liver lesions may add objectivity to the conventional visual assessment. • Quantitative measurements of liver lesions are a reliable tool for differentiating benign from malignant lesions, however caution must be taken in the case of hepatic adenomas, as their signal intensities fall closer to those of malignant lesions. • There are significant differences in the ROI values among different types of FLLs. For benign lesions, the ROI values in the T2-w, ADC, and in the T1-w postcontrast sequence were found significantly higher compared to their counterparts in malignant lesions. The study aims at assessing the quantitative features which distinguish focal liver lesions (FLLs) in gadoxetic acid (GA) enhanced liver MRI and at determining whether these features can accurately differentiate benign from malignant lesions. 107 patients with 180 unequivocal FLLs in previous examinations were included in a single-center retrospective study. All patients underwent a MRI test of the liver with GA. 99 benign and 74 malignant lesions were included. The group of benign lesions consisted of 60 focal nodular hyperplasias (FNH), 22 hemangiomas (HMG), 6 hepatic adenomas (HA), and 11 other benign lesions (1 angiomyolipioma, 6 lesions histopathology diagnoses as benign without further specification, or ones lacking features of malignancy, and 4 lesions radiologically diagnosed as benign which remained stable in the follow-up studies). The group of malignant lesions consisted of primary 51 hepatocellular carcinomas, 12 metastases, and 11 metastases from melanoma malignum (MM meta). 7 FLLs were excluded (4 cases of uncertain histopathological diagnosis, 2 cholangiocarcinomas, and 1 regenerative nodule). For the included lesions ROI (region of interest) measurements were taken by two observers in the T2-w, ADC (apparent diffusion coefficient) and in the T1-w sequence in the hepatobiliary phase (HBP). The interobserver agreement was evaluated with the Wilcoxon test. The Kruskal – Wallis, Mann – Whitney U and post hoc Dunn's tests were applied to assess if there were any significant differences in the ROI values between individual lesions. The variables with the p values of < 0.05 were considered statistically significant. We found significant differences in the ROI values between lesions with p < 0.0001. Strikingly high ROI values in the T2-w sequence were found for HMG. The lowest ADC values were encountered for metastases and MM metastases. The highest ROI values in the HBP were found for FNH, and the lowest for metastases. We also found statistically significant differences in the ROI values between benign and malignant lesions with benign lesions presenting statistically higher ROI values compared to malignant lesions. There were significant differences in the ROI values among different types of FLLs. The predominant quantitative feature in the T2-w sequence was a strikingly high ROI value for HMG. Benign lesions presented statistically higher ROI values in the T2-w, ADC, and HBP sequences compared to malignant lesions. This was true for all lesions except for HA. [ABSTRACT FROM AUTHOR]

This prospective multicentric study aiming to determine the incidence of complications (malignant transformation, torsion or rupture) during conservative management of adnexal masses was performed in two Portuguese tertiary referral hospitals. It included ≥18-year-old, non-pregnant patients with asymptomatic adnexal masses (associated IOTA ADNEX risk of malignancy < 10%) sonographically diagnosed between January 2016 and December 2020. Conservative patient management consisted of serial clinical and ultrasound assessment up to 60 months of follow-up, spontaneous resolution of the formation or surgical excision (median follow-up: 17.8; range 9–48 months). From the 573 masses monitored (328 premenopausal and 245 postmenopausal adnexal masses), no complications were observed in 99.5%. The annual lesion growth rates and increases in morphological complexity were similar in the premenopausal and postmenopausal patients. Spontaneous resolution, evidenced in 16.4% of the patients, was more common in the premenopausal group (p < 0.05). Surgical intervention was performed in 18.4% of the cases; one borderline and one invasive FIGO IA stage cancer were diagnosed. There was an isolated case of ovary torsion (0.17%). These data support conservative management as a safe option for sonographically benign, stable and asymptomatic adnexal masses before and after menopause and highlight the need for expedite treatment of symptomatic or increased-morphological-complexity lesions.