The role of 18F-FDG PET/CT in lymphoma staging and treatment response assessment is well established in the literature. Beyond these conventional applications, it can also serve as a powerful tool for guiding biopsy decisions in diagnostically challenging cases. We present the case of a 67-year-old man with suspected lymphoma, in whom initial diagnostic procedures-including bone marrow aspiration-failed to yield conclusive results. A multidisciplinary team utilized 18F-FDG PET/CT to identify an accessory spleen exhibiting metabolic activity comparable to the primary spleen. Given its accessibility and diagnostic potential, the accessory spleen was surgically excised, leading to a definitive diagnosis of mantle cell lymphoma. This case underscores the strategic role of PET/CT in biopsy site selection, offering a safer and less invasive diagnostic alternative and reinforcing its crucial role in lymphoma management. (c) 2025 Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
BACKGROUND:For optimal outcomes in caudal septal deviation repair, it is crucial to establish a secure and stable fixation between the septal cartilage (SC) and the anterior nasal spine (ANS) of the maxilla. METHOD:This technical note presents a dual-stage septum-to-nasal spine fixation suture technique developed to overcome the rotational and stability limitations that may occur when an F8 suture alone is applied in certain cases. CONCLUSION:By achieving multidirectional stabilization without increasing procedural complexity, this technique offers a practical and improved method for SC-ANS fixation.
IgA nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. We assessed whether the Ratio of Globally Sclerotic Glomeruli (RoGSG) on diagnostic biopsy predicts subsequent kidney outcomes in a nationwide, multi‑center registry. Among 326 adults with idiopathic IgAN (mean age 39.1 ± 12.8 years; 60.1% male), 43 patients (13.2%) met a 5 year composite outcome defined as any of: doubling of serum creatinine or ≥ 50% decline in eGFR from baseline, eGFR < 15 mL/min/1.73 m2, or initiation of kidney replacement therapy. Receiver operating characteristic analysis identified a RoGSG cutoff of 28.86% for predicting the composite outcome (AUC 0.917, 95% CI 0.885–0.949; sensitivity 93.0%; specificity 84.5%). Using this threshold, 47.6% of patients with RoGSG ≥ 28.86% versus 1.2% with RoGSG < 28.86% reached the composite outcome. In multivariable models adjusted for clinical and pathologic covariates, high RoGSG, grade 2 tubular atrophy/interstitial fibrosis, and non‑response to initial immunosuppression were independent predictors of adverse outcomes. The prognostic association of RoGSG persisted in key subgroups, including those with nephrotic syndrome and those with initial treatment response. These findings support RoGSG as a readily available histopathologic marker that may improve risk stratification in IgAN; however, prospective studies and external validation in independent cohorts are required before any clinical adoption.
Core stabilization exercises are a crucial intervention in Adolescent Idiopathic Scoliosis (AIS), as they are widely accessible and specifically address trunk muscle weakness and neuromuscular deficits that are considered potential contributors to curve progression. The aim of this study was to demonstrate the effects of core stabilization based exercise training on muscle strength, neuromuscular control, quality of life, and Cobb angle improvement in patients with AIS. Thirty two patients with AIS were included in this prospective, randomized, and controlled study. Participants were randomly divided into two groups as training group (n = 16) and control group (n = 16). Two individuals were lost to follow-up, resulting in a final analytical sample of 30 participants, with 15 in the training group and 15 in the control group. Training group received core stabilization based exercise training. Control group received traditional exercises. These interventions were carried out in 16 sessions under the supervision of a physiotherapist 2 days a week to be applied daily for 8 weeks. Muscle strength (Biodex isokinetic dynamometer), neuromuscular control (sEMG), Cobb angle, quality of life (SRS-22 questionnaire), perception of cosmetic deformity (WRVAS), trunk rotation angle, and spinal flexibility were assessed at the beginning and end of the study. Between-group comparisons were performed using analysis of covariance (ANCOVA) with baseline values as covariates, and statistical significance was set at p < 0.05. Compared with the control group, the training group demonstrated significantly greater improvements in trunk muscle strength and neuromuscular control, with significant changes observed in the majority of parameters (p < 0.05). A clinically meaningful reduction in Cobb angle was observed in the training group (mean decrease: 5.7°, p < 0.001). Significant between-group improvements were also found in trunk rotation angle, spinal flexibility, quality of life, and perception of cosmetic deformity (p < 0.05). Based on comprehensive and objective assessments, and after adjusting for baseline differences, these findings indicate that core stabilization based exercise training may provide meaningful benefits for patients with AIS and support its consideration as a complementary component of conservative management.
The epididymis frequently exhibits a broad spectrum of non-neoplastic epithelial and stromal alterations that may mimic neoplastic or obstructive processes in orchiectomy specimens. Existing data are mostly derived from single-institution series. This multi-institutional study aimed to provide a comprehensive, contemporary, multi-institutional analysis of the prevalence, spectrum, and clinicopathological associations of epididymal morphological variations in a large orchiectomy cohort. This retrospective study included 1,528 orchiectomy specimens from multiple academic centers. All hematoxylin and eosin–stained slides containing epididymal tissue were systematically reviewed using a standardized protocol. Morphological features assessed included atrophy, intranuclear inclusions, lipofuscin pigment, cribriform hyperplasia, Paneth cell–like metaplasia, nuclear atypia, clear cell change, smooth-muscle proliferation, vascular and duct ectasia, myxoid change, calcification, hematoma, and inflammation. Associations with underlying testicular pathologies were analyzed statistically. 66
