Search Results (1,629)

Helicobacter pylori is a gastric pathogen that induces chronic gastritis, which may progress to neutrophilic activity, glandular atrophy, intestinal metaplasia, and gastric carcinoma. The aim of this study was to evaluate H. pylori-induced tissue damage. A total of 602 gastric biopsy samples were collected, categorized, and analyzed using hematoxylin and eosin and Giemsa staining, followed by molecular confirmation through PCR targeting the species-specific 16S rRNA gene. H. pylori density and histopathological features were evaluated and graded according to the updated Sydney classification system. H. pylori was detected in 55% (n = 334) of cases, and the antrum (50.83%, p < 0.00001) was the predominant site. A slightly higher prevalence was observed in females, accounting for 56.9% compared to males at 43.1%, which was attributed to sociocultural exposure differences. Individuals aged 11–40 years accounted for 58.3% (n = 195), highlighting early-age acquisition of infection. H. pylori infection was significantly linked to moderate-to-severe inflammation (63.2%, p < 0.00001) and neutrophilic activity (53.3%, p < 0.00001). Intestinal metaplasia and atrophy were infrequent, present in 0.6% (95% CI, 0.02, p = 0.149) and 0.9% (95% CI, 0.05, p = 0.430) of individuals. H. pylori infection causes chronic inflammation and neutrophilic infiltration of the stomach mucosa. Early identification and histopathological examination are essential in assessing H. pylori-related gastric pathology. Full article

Glioblastoma (GBM) is the most malignant primary brain tumor, characterized by extensive heterogeneity, invasiveness, infiltrating behavior, and resistance to standard therapies, including radiation and temozolomide (TMZ). Despite considerable efforts in investigating its pathophysiology, GBM represents one of the most challenging cancers to treat, with a median survival rate under 15 months and a 5-year survival rate below 5%. A major barrier to progress in GBM therapy development is the lack of reliable preclinical models that faithfully recapitulate the tumor’s molecular heterogeneity, invasive behavior, and complex microenvironment. Traditional cell lines and xenograft models often fail to reflect the key pathological features of human GBM, including immune suppression, vascular abnormalities, and treatment resistance. In recent years, attention has focused on the development of numerous clinically relevant GBM models based on brain organoids as a powerful “disease-in-a-dish” model. They strongly mimic GBM key histopathological and molecular features, such as the tumor’s cellular heterogeneity, genetic landscape, and microenvironment, enabling more accurate studies of tumor biology, invasion, and therapeutic response in a controlled in vitro setting. Notably, research in microgravity offers a unique and promising platform to study cancer biology under conditions that enhance tissue self-organization, mimic aspects of tumor growth, and potentially unveil novel therapeutic vulnerabilities. This review compares organoids to conventional preclinical models, tracing their historical development and salient features, focusing on the preparation and use of organoids in GBM research. We also introduce a novel and promising field of organoid application: space-based organoid brain research. Full article

Background: Renal Cell Carcinoma (RCC) is the most common type of kidney cancer and requires accurate histopathological grading for effective prognosis and treatment planning. However, manual grading is time-consuming, subjective, and susceptible to inter-observer variability. Objective: This study proposes EAT-Net (Efficient Attention Transformer Network), a dual-stream deep learning model designed to automate and enhance RCC grade classification from histopathological images. Method: EAT-Net integrates EfficientNetB0 for local feature extraction and a Vision Transformer (ViT) stream for capturing global contextual dependencies. The architecture incorporates Squeeze-and-Excitation (SE) modules to recalibrate feature maps, improving focus on informative regions. The model was trained and evaluated on two publicly available datasets, KMC-RENAL and RCCG-Net. Standard preprocessing was applied, and the model’s performance was assessed using accuracy, precision, recall, and F1-score. Results: EAT-Net achieved superior results compared to state-of-the-art models, with an accuracy of 92.25%, precision of 92.15%, recall of 92.12%, and F1-score of 92.25%. Ablation studies demonstrated the complementary value of the EfficientNet and ViT streams. Additionally, Grad-CAM visualizations confirmed that the model focuses on diagnostically relevant areas, supporting its interpretability and clinical relevance. Conclusion: EAT-Net offers an accurate, and explainable framework for RCC grading. Its lightweight architecture and high performance make it well-suited for clinical deployment in digital pathology workflows. Full article

Background/Objectives: Glioblastoma (GBM) is an aggressive primary brain tumor marked by diffuse infiltration into surrounding brain tissue. The peritumoral zone often appears normal on imaging yet harbors microscopic invasion. While perfusion-based studies, such as arterial spin labeling (ASL), have profiled this region, longitudinal radiomic monitoring remains limited. This study investigates delta radiomics using multiparametric MRI (mpMRI) in a GBM mouse model to track subtle peritumoral changes over time. Methods: A G7 GBM xenograft model was established in nine nude mice, imaged at 9- and 12 weeks post-implantation using MRI (T1W, T2W, T2 mapping, DWI-ADC, FA, and ASL) and co-registered histopathology (H&E, HLA staining). Tumor and peritumoral regions were manually segmented, and 107 radiomic features (shape, first-order, texture) were extracted per sequence and histology. The delta features were calculated and compared between timepoints. Results: The robust T2W texture and T2 map first-order features demonstrated the greatest sensitivity and reproducibility in capturing temporal peritumoral brain zone changes, distinguishing between time points used by K-mean. Conclusions: Delta radiomics offers added value over static analysis for early monitoring of peritumoral brain zone changes. The first-order and texture features of radiomics could serve as robust biomarkers of peritumoral invasion. These findings highlight the potential of longitudinal MRI-based radiomics to characterize glioblastoma progression and inform translational research. Full article

Pulmonary veno-occlusive disease (PVOD) is a rare and under-recognized cause of pulmonary hypertension. It is characterized by fibrotic obstruction of small pulmonary veins and venules. Its clinical presentation closely mimics pulmonary arterial hypertension (PAH), leading to frequent misdiagnosis, delayed recognition, and potentially harmful exposure to PAH-specific vasodilator therapy. This review aims to synthesize our evolving understanding of PVOD, discussing its etiologies, role of genetic underpinnings, histopathologic features, pathophysiology, clinical presentation, and characteristic imaging findings. It then discusses management strategies emphasizing early recognition, supportive care, avoidance of inappropriate PAH therapies due to poor response, and timely referral for lung transplantation. Despite advances in identification and management, PVOD remains a fatal condition with a median survival of less than two years, underscoring the importance of early recognition and multidisciplinary care. Full article

Background: PLACK syndrome is an ultra-rare autosomal recessive disorder caused by biallelic loss-of-function variants in CAST, which encodes calpastatin, an endogenous inhibitor of calpains. The syndrome is classically defined by peeling skin, leukonychia, acral punctate keratoses, cheilitis, and knuckle pads. Although the phenotype has been largely restricted to dermatological manifestations, emerging reports suggest dilated cardiomyopathy (DCM) as a systemic complication. Methods: We investigated five affected children from three sibships of an extended consanguineous family. Clinical evaluation and genome sequencing (GS) followed by segregation analysis of the targeted mutation test (TMT) were performed. Histopathological examination of an explanted heart was conducted in one child who underwent heart transplantation. Results: All affected children exhibited typical dermatological features of PLACK syndrome. Four developed severe DCM, two of whom required orthotopic heart transplantation. GS, performed in three affected children, identified a novel homozygous frameshift variant in CAST (NM_001750.7:c.1177dup, p.Arg393Profs*4), which segregated with the disease within the family. No additional plausible variants in known cardiomyopathy-associated genes were detected. Histopathological examination of the explanted heart demonstrated hypertrophied cardiomyocytes with nuclear enlargement, hyperchromasia, and fibrosis. Conclusions: Our findings expand the phenotypic spectrum of PLACK syndrome to include severe DCM and suggest CAST deficiency as a novel cause of recessively inherited cardiomyopathy. The favorable short-term outcome following transplantation highlights a potential therapeutic option. Given the possibility of age-dependent penetrance, lifelong cardiac surveillance is for the affected individuals suggested. To emphasize cardiomyopathy as a critical and underrecognized component of the syndrome, we propose the consideration of modifying the acronym to PLACK-C. Full article

Aims: The purpose of this study was to evaluate survival outcomes and recurrence patterns following curative-intent resection of pancreatic neuroendocrine tumours (PNETs) at a UK tertiary centre. The secondary aims included identifying prognostic clinicopathological factors that influenced survival. Methods: Patients undergoing curative-intent surgical resection for PNETs between August 2010 and March 2024 were retrospectively reviewed. The data collated included demographics, histopathology, recurrence, and survival outcomes. Results: Eighty-six patients were included, with a median age of 61.5 years (IQR: 50–71) and an equal sex distribution. Most tumours were solitary (88.4%) and located in the pancreatic tail (57%), with distal pancreatectomy performed in 75% of cases. The median tumour size was 25 mm (IQR: 13–40). Lymph node metastases were observed in 23.3% of patients, and R0 resection was achieved in 67%. Most of the PNETs resected were WHO grade 1 tumours (65.1%), followed by grade 2 tumours (26.7%). Postoperative morbidity occurred in 37.2% of cases, while the 30-day postoperative mortality rate was 1.5%. Recurrence was observed in 13.95% of patients, with a median time to recurrence of 36.3 months. The 5-year overall survival (OS) was 83.0%, with a median OS and disease-free survival (DFS) of 143.3 months and 147.0 months, respectively. Multivariable analysis revealed that poorer DFS was associated with larger tumours (p = 0.009), higher tumour grade (p = 0.006), male sex (p = 0.039), vascular invasion (p = 0.003), perineural invasion (p = 0.042) and lymph node metastases (p = 0.015). OS was significantly influenced by the Charlson Comorbidity Index (p < 0.001) and tumour grade (p = 0.025). Conclusions: PNETs are associated with excellent long-term survival following curative-intent resection. However, adverse pathological features are linked to an increased risk of recurrence and a poorer prognosis. Full article

Background: Line-field confocal optical coherence tomography (LC-OCT) is a non-invasive imaging technique providing high-resolution en-face and cross-sectional views of the epidermis and superficial dermis for in vivo characterisation of actinic keratosis (AK), Bowen’s disease (BD) and squamous cell carcinoma (SCC). Despite its promise, standardised imaging protocols are lacking. Objective: This systematic review aims to assess the utility of LC-OCT for diagnosing AK, BD and SCC, with particular emphasis on workflow optimisation and protocol standardisation. Methods: A systematic literature search was performed using PubMed, Embase, and Scopus databases (January 2018–October 2024). Two reviewers independently screened the records, extracted data and applied the Confidence in the Evidence from Reviews of Qualitative research (CERQual) framework to assess confidence in key findings. Results: Eleven studies met the inclusion criteria. LC-OCT reliably identified key histopathological correlates. Across studies, LC-OCT consistently visualised hyperkeratosis, keratinocytic atypia, parakeratosis, and acanthosis, as well as characteristic vascular alterations and dermal remodeling. LC-OCT also demonstrated its capacity to detect invasive features by revealing disruptions in the dermo-epidermal junction and the presence of tumour strands infiltrating the dermis. Multimodal imaging combined with technical optimisations such as minimal probe pressure, paraffin oil coupling, and dermoscopy-guided localisation, substantially improved image resolution and interobserver concordance. Conclusions: This systematic review provides a basis for establishing standardised LC-OCT imaging protocols in keratinocytic tumours. While LC-OCT shows promise as a non-invasive diagnostic tool, further multicenter studies are needed to refine imaging workflows and evaluate the integration of artificial intelligence-based analysis to improve diagnostic accuracy and reproducibility. Full article

Breast cancer is one of the most prevalent malignant tumors among women worldwide, underscoring the urgent need for early and accurate diagnosis to reduce mortality. To address this, A Multi-Feature Fusion Classification Network (MFF-ClassificationNet) is proposed for breast histopathological image classification. The network adopts a two-branch parallel architecture, where a convolutional neural network captures local details and a Transformer models global dependencies. Their features are deeply integrated through a Multi-Feature Fusion module, which incorporates a Convolutional Block Attention Module—Squeeze and Excitation (CBAM-SE) fusion block combining convolutional block attention, squeeze-and-excitation mechanisms, and a residual inverted multilayer perceptron to enhance fine-grained feature representation and category-specific lesion characterization. Experimental evaluations on the BreakHis dataset achieved accuracies of 98.30%, 97.62%, 98.81%, and 96.07% at magnifications of 40×, 100×, 200×, and 400×, respectively, while an accuracy of 97.50% was obtained on the BACH dataset. These results confirm that integrating local and global features significantly strengthens the model’s ability to capture multi-scale and context-aware information, leading to superior classification performance. Overall, MFF-ClassificationNet surpasses conventional single-path approaches and provides a robust, generalizable framework for advancing computer-aided diagnosis of breast cancer. Full article

We present a case of a 72-year-old woman with four amelanotic tumors on the left arm, without a history of skin cancer or sun exposure. Dermoscopy showed polymorphic and arborizing vessels, with some lesions displaying non-specific malignant features. Histopathology confirmed basal cell carcinoma (BCC) in all lesions. No signs of recurrence were observed during 3-year follow-up. Segmental/agminated basal cell carcinoma is a rare differential diagnosis of multiple clustered, painless pink tumors. To the best of our knowledge, this is the first report describing their dermoscopic features. Full article

Objectives: This study aimed to develop and validate a biparametric MRI (bpMRI)-based radiomics model for the noninvasive prediction of tumor–stroma ratio (TSR) in prostate cancer (PCa). Additionally, we sought to explore lesion distribution patterns in the peripheral zone (PZ) and transition zone (TZ) to provide deeper insights into the biological behavior of PCa. Methods: This multicenter retrospective study included 223 pathologically confirmed PCa patients, with 146 for training and 39 for internal validation at Center 1, and 38 for external testing at Center 2. All patients underwent preoperative bpMRI (T2WI, DWI acquired with a b-value of 1400 s/mm², and ADC maps), with TSR histopathologically quantified. Regions of interest (ROIs) were manually segmented on bpMRI images using ITK-SNAP software (version 4.0.1), followed by high-throughput radiomic feature extraction. Redundant features were eliminated via Spearman correlation analysis and least absolute shrinkage and selection operator (LASSO) regression. Five machine learning (ML) classifiers—Logistic Regression (LR), Support Vector Machine (SVM), BernoulliNBBayes, Ridge, and Stochastic Gradient Descent (SGD)—were trained and optimized. Model performance was rigorously evaluated using receiver operating characteristic (ROC) curves and decision curve analysis (DCA). Results: The Ridge demonstrated superior diagnostic performance, achieving AUCs of 0.846, 0.789, and 0.745 in the training, validation, and test cohorts, respectively. Lesion distribution analysis revealed no significant differences between High-TSR and Low-TSR groups (p = 0.867), suggesting that TSR may not be strongly associated with zonal localization. Conclusions: This exploratory study suggests that a bpMRI-based radiomic model holds promise for noninvasive TSR estimation in prostate cancer and may provide complementary insights into tumor aggressiveness beyond conventional pathology. Full article

Purpose: Gastrointestinal (GI) illness demands precise and efficient diagnostics, yet conventional approaches (e.g., endoscopy and histopathology) are time-consuming and prone to reader variability. This work presents GID-Xpert, a deep learning framework designed to improve feature learning, accuracy, and interpretability for GI disease classification. Methods: GID-Xpert integrates a hierarchical, multi-stage attention-driven mixture of experts with dynamic routing. The architecture couples spatial–channel attention mechanisms with specialized expert blocks; a routing module adaptively selects expert paths to enhance representation quality and reduce redundancy. The model is trained and evaluated on three benchmark datasets—WCEBleedGen, GastroEndoNet, and the King Abdulaziz University Hospital Capsule (KAUHC) dataset. Comparative experiments against state-of-the-art baselines and ablation studies (removing attention, expert blocks, and routing) are conducted to quantify the contribution of each component. Results: GID-Xpert achieves superior performance with 100% accuracy on WCEBleedGen, 99.98% on KAUHC, and 75.32% on GastroEndoNet. Comparative evaluations show consistent improvements over contemporary models, while ablations confirm the additive benefits of spatial–channel attention, expert specialization, and dynamic routing. The design also yields reduced computational cost and improved explanation quality via attention-driven reasoning. Conclusion: By unifying attention, expert specialization, and dynamic routing, GID-Xpert delivers accurate, computationally efficient, and more interpretable GI disease classification. These findings support GID-Xpert as a credible diagnostic aid and a strong foundation for future extensions toward broader GI pathologies and clinical integration. Full article

Introduction: Ductal carcinoma in situ (DCIS) is a non-invasive precursor of breast cancer, usually detected on mammography as clustered microcalcifications. Many cases, however, lack calcifications and require complementary imaging. This study aimed to describe the multimodal imaging features of DCIS and evaluate the radiology–pathology correlation. Methods: We retrospectively reviewed 75 women (aged 36–52 years) with biopsy-proven DCIS (January 2023–June 2025). All underwent mammography, targeted ultrasound, and dynamic contrast-enhanced 1.5T MRI. Imaging findings were correlated with histopathology, and logistic regression was used to explore predictors of MRI kinetics. Results: Mammography detected microcalcifications in 53.8% of patients, while 46.2% showed no calcifications. Ultrasound frequently revealed non-mass, duct-oriented hypoechoic abnormalities in non-calcified cases. MRI consistently demonstrated non-mass enhancement, with weak or persistent kinetics without washout in 69.2% and washout in 30.8%. A moderate correlation between MRI and histological extent was found (r = 0.62, p < 0.001), with MRI tending to overestimate lesion size. Oral contraceptive use was common (61.5%) but not significantly associated with kinetic pattern or grade. Conclusions: Mammography remains essential for calcified DCIS, whereas MRI enhances detection of non-calcified lesions. Persistent kinetics without washout may represent a typical imaging feature of DCIS. However, moderate radiology–pathology concordance and frequent overestimation highlight the need for careful interpretation. These findings support a multimodal diagnostic approach that can improve detection accuracy and assist in more tailored surgical planning. Full article

Malignant peripheral nerve sheath tumors (MPNSTs) are rare sarcomas with an extremely rare perineurial subtype. Herein, we present a case of a perineurial MPNST in the cauda equina. Clinically and radiologically, a mass extending from within the spinal canal at the L5 level to outside the intervertebral foramen was identified, raising suspicion of a neurogenic tumor as the primary diagnosis. Computed tomography-guided biopsy suggested an intermediate- to low-grade malignancy; however, a definitive diagnosis could not be established. Two years later, worsening neurological symptoms prompted further imaging, which revealed significant tumor growth and bone invasion. Open biopsy was performed to obtain a definitive diagnosis of perineurial MPNST. MPNSTs lack distinctive imaging features and are generally diagnosed based on a combination of radiological and histopathological findings. Although MPNSTs have a poor prognosis, the perineurial subtype is considered to have a relatively favorable outcome. Given these factors, early diagnosis followed by surgical resection or radiation therapy is recommended. Full article

Background: Salivary gland sarcoidosis is a rare manifestation of systemic sarcoidosis that poses a challenge in terms of its diagnosis due to its similarities to disorders such as Sjögren’s syndrome, other granulomatous diseases, and infections. Objective: To systematically review reported cases of salivary gland sarcoidosis and summarize clinical presentation, diagnostic methods, treatments, and outcomes. Methods: We conducted a systematic search of PubMed, Scopus, Embase, ScienceDirect, and Medline for case reports and case series published up to April 2025. This review was registered with PROSPERO (CRD42024629263) and was conducted following PRISMA guidelines. Variables assessed included age, sex, presenting symptoms, location, duration of symptoms, treatment approaches, and outcomes. Study quality assessment was assessed using The Joanna Briggs Institute (JBI) Critical Appraisal tools. Results: A total of 28 articles involving 39 participants met the inclusion criteria, with a mean age of 42.7 years. Salivary gland sarcoidosis predominantly affected female patients (66.7%). The parotid gland was the most frequently involved site (82.1%). Common presenting features included glandular swelling that is usually painless, xerostomia, and facial palsy. Sarcoidosis was newly diagnosed in 82.1% of cases, primarily through histopathological examination revealing non-caseating granulomas. Systemic corticosteroids were the most common treatment. Outcomes were favorable in nearly all cases, with complete resolution post treatment or spontaneous remission without treatment. Conclusions: Salivary gland sarcoidosis predominantly affects middle-aged women, typically presenting as a painless parotid swelling and often serving as the initial sign of systemic disease. Diagnosis requires histopathological confirmation via biopsy, as serum ACE levels are insufficient alone. The prognosis is excellent, with most patients responding favorably to corticosteroids or even experiencing spontaneous resolution. This condition must be considered in differential diagnoses for persistent salivary gland swellings to ensure accurate diagnosis and prevent unnecessary interventions. Full article