Search Results (2,370)

Glomerulosclerosis is not an independent disease entity but rather a common histopathological endpoint shared by diverse glomerular diseases and chronic kidney disorders. It represents the final common pathway of progressive glomerular injury and is a major determinant of chronic kidney disease (CKD) progression. Accordingly, this review focuses on the shared cellular and molecular mechanisms that drive glomerulosclerosis, together with current diagnostic strategies, mechanism-based therapeutic approaches, and future directions toward precision nephrology. We begin by summarizing the structural and functional features of the glomerulus and outlining the key molecular mechanisms that drive sclerosis, including podocyte loss, mesangial matrix expansion, endothelial dysfunction, inflammation, and fibrosis-related signaling pathways. The clinical and pathological classifications of glomerular diseases associated with glomerulosclerosis—ranging from primary and secondary focal segmental glomerulosclerosis (FSGS) to diabetic, hypertensive, and immune-mediated forms—are discussed in detail. We further review current diagnostic approaches, including renal biopsy patterns, emerging biomarkers, and novel imaging and digital pathology tools that enable earlier and more precise assessment of disease severity. Recent advances in treatment are summarized across conservative, immunologic, and targeted therapeutic categories, with emphasis on SGLT2 inhibitors, endothelin receptor antagonists, immunomodulatory agents, and antifibrotic compounds. Finally, we highlight rapidly evolving therapeutic and technological advances, including podocyte-directed interventions, APOL1-targeted therapies, RNA- and gene-based therapeutics, and artificial intelligence-driven precision nephrology. These emerging approaches are reshaping the management paradigm of glomerular diseases by enabling molecular disease stratification and personalized treatment strategies. Despite substantial progress, significant unmet needs remain, particularly concerning early detection, individualized treatment selection, and the marked heterogeneity of disease mechanisms across patient populations. Overall, this review provides an integrated framework for understanding glomerulosclerosis as a shared pathological endpoint of diverse glomerular diseases and highlights emerging mechanism-based therapeutic strategies that support the transition toward precision nephrology. Full article

Background: Skull base plasmacytomas are rare plasma cell neoplasms arising from the clivus, sphenoid bone, and petrous apex, presenting with cranial neuropathies and bearing a high risk of progression to multiple myeloma. Optimal management remains poorly defined due to their rarity. Objective: The objectives of this study are to comprehensively characterize the clinical presentation, management strategies, and outcomes of skull base plasmacytomas and identify evolving trends in the literature. Methods: A systematic search of PubMed, EMBASE, Web of Science, and Cochrane databases was conducted, yielding 92 studies (18 case series and 74 case reports) encompassing 118 patients. Data on the demographics, symptoms, imaging, histopathology, treatment, and outcomes were extracted and analyzed. Results: The median patient age was 56 years; visual disturbances (66.1%) and headache (54.2%) were the most common presenting symptoms. The middle and posterior cranial fossae were most frequently involved, and cranial nerve VI was most affected (65.7%). Surgical resection was performed in 63.6% of cases with a gross total resection in 36%. At a median follow-up of 12 months (calculated across the entire cohort of 118 patients, including the 29 who presented with a prior diagnosis of multiple myeloma), 81.4% were alive, with symptom resolution at 38.1% or improvement at 26.2%. Recurrence occurred in 19.4% of patients, and multiple myeloma developed in 25.8% of patients without a prior diagnosis. Multiple myeloma status was the only independent predictor of survival on multivariate analysis (OR = 10.14, 95% CI: 1.63–63.04, p = 0.013). Conclusions: Skull base plasmacytomas show consistent clinical patterns but variable management strategies. Surgery is increasingly utilized; yet, its survival benefit remains unclear. Prospective multicenter studies with standardized outcome reporting and molecular profiling are needed to optimize individualized care. Full article

Acquired cardiovascular diseases are recognized as a major age-related cause of morbidity and mortality in captive squirrel monkeys (Saimiri spp.). An 11-year-old intact male black-capped squirrel monkey (Saimiri boliviensis boliviensis) was presented following a syncopal episode associated with respiratory distress, abdominal distension, and peripheral edema. Upon presentation, the animal appeared thin and debilitated. Physical examination revealed respiratory distress with paradoxical breathing, abdominal distension, peripheral edema of the hind limbs, and hypothermia. Thoracic auscultation identified a loud systolic murmur over the left hemithorax and diffuse pulmonary crackles. Thoracic radiographs demonstrated severe cardiomegaly and perihilar pulmonary interstitial pattern consistent with cardiogenic pulmonary edema. Two-dimensional echocardiography revealed hyperechoic papillary muscles, thickened and restricted mitral valve leaflets, and shortened chordae tendineae with secondary severe left atrial and ventricular dilation. Doppler echocardiography demonstrated severe mitral regurgitation. Congestive heart failure secondary to mitral valve dysplasia was diagnosed. Treatment with diuretics and vasodilators resulted in transient clinical improvement followed by rapid deterioration of the patient’s condition; therefore, euthanasia was elected. Gross pathological and histopathological examinations revealed thickened and irregular mitral valve leaflets with hypoplastic chordae tendineae associated with severe left-sided cardiac enlargement. To the authors’ knowledge, this is the first report describing mitral valve dysplasia in an adult squirrel monkey. This report expands the spectrum of cardiovascular diseases described in squirrel monkeys and highlights the importance of advanced cardiac imaging in the diagnosis of rare congenital cardiac defects in non-human primates. Full article

Background and Clinical Significance: Dupuytren’s disease (DD) is characterized by abnormal myofibroblast proliferation and excessive collagen deposition, leading to the formation of pathological fibrous cords. It typically affects the palmar surface of the hand, where these contractile cords cause progressive flexion contractures of the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints. Lesions involving the proximal interphalangeal (PIP) joint without significant flexion contracture may be misdiagnosed as soft-tissue tumors or inflammatory lesions based on imaging findings, including magnetic resonance imaging (MRI) and ultrasound; Case Presentation: We present a case of a soft-tissue mass located on the volar aspect of the proximal phalanx of the little finger, associated with a mild PIP joint contracture. The initial MRI findings suggested a giant-cell tumor of the tendon sheath; however, the diagnosis of Dupuytren’s disease was established only after histopathological examination; Conclusions: This case highlights the importance of considering DD in the differential diagnosis of peripheral soft-tissue lesions of the finger, particularly when presenting with only mild PIP joint contracture and atypical imaging features. Full article

Angioleiomyoma is a benign soft tissue tumor originating from the smooth muscle of vascular structures. Though relatively uncommon, it frequently occurs in the lower extremities and is often misdiagnosed due to its nonspecific clinical presentation. We report the case of a 54-year-old female with chronic posterolateral heel pain initially attributed to insertional Achilles tendinopathy and Haglund’s deformity. After failure of conservative management, MRI revealed a well-circumscribed subcutaneous lesion with signal characteristics concerning for a soft tissue neoplasm. Surgical excision was performed, and histopathologic analysis confirmed a venous-type angioleiomyoma, characterized by thick-walled vascular channels and smooth muscle proliferation without atypia. Immunohistochemistry was positive for SMA, weakly positive for desmin, and ERG-positive in the vascular endothelium. The patient experienced complete symptom resolution postoperatively. Although not exceedingly rare, angioleiomyomas remain underrecognized in clinical practice, particularly in the foot and ankle, resulting in diagnostic delays averaging over five years. MRI demonstrated characteristic features described in recent literature, validating its utility in preoperative assessment. This case reinforces the importance of maintaining a broad differential when evaluating chronic, focal heel pain and supports the use of advanced imaging and histopathologic confirmation in atypical cases. Greater awareness of angioleiomyomas can help reduce diagnostic delays and improve outcomes in patients with chronic, unexplained soft tissue pain in the foot and ankle. Full article

Artificial intelligence (AI) has emerged as a promising tool for inferring molecular biomarkers directly from digitized histopathologic slides. However, the current evidence in gastrointestinal and hepatobiliary cancers remains fragmented across tumor types and biomarker categories. Relevant studies were systematically identified and screened according to the PRISMA 2020 statement. PubMed, Embase, Web of Science Core Collection, Scopus, and IEEE Xplore were searched from 1 January 2015 to the date of search. Eligible studies involved gastrointestinal or hepatobiliary malignancies, used histopathology images, applied AI-based methods, and reported molecular biomarker prediction or inference. A total of 110 studies were included. Most studies focused on colorectal, gastric, liver, and pancreatic cancers, with microsatellite instability, mutation status, molecular subtypes, and tumor mutational burden being the most commonly investigated targets. Model architectures evolved from conventional convolutional neural networks to multiple-instance learning and transformer-based methods. While many studies reported promising predictive performance, direct comparison across studies remained challenging because of substantial heterogeneity in datasets, model architectures, and validation strategies. AI-based molecular biomarker identification from pathologic slides shows substantial promise in gastrointestinal and hepatobiliary cancers, but current evidence is constrained by heterogeneity and limited validation. Standardized, multicenter studies are needed before routine clinical implementation. Full article

Background: Ultrasound-guided radiofrequency ablation (RFA) has become an established minimally invasive treatment for selected benign and autonomously functioning thyroid nodules. Although clinical outcomes are well documented, the biological mechanisms underlying tissue remodeling after ablation remain incompletely characterized. The integration of imaging, molecular, and histopathological data may provide a more comprehensive understanding of treatment response. Methods: We conducted a prospective monocentric observational translational cohort study including 60 patients undergoing ultrasound-guided RFA for benign or autonomously functioning thyroid nodules between November 2024 and December 2025. Patients underwent standardized pre-procedural assessment including high-resolution ultrasound with volumetric evaluation, three-dimensional reconstruction, and collection of peripheral blood samples for exploratory extracellular vesicle (EV)-derived microRNA (miRNA) profiling. Clinical outcomes, volumetric changes, vascular remodeling, and procedural complications were assessed during scheduled follow-up visits (mean follow-up duration: 11 months; range: 5–17 months). A subgroup of patients who subsequently required surgery because of insufficient volumetric response underwent thyroidectomy, allowing histopathological evaluation of post-ablation tissue changes. Clinical, imaging, molecular, and pathological data were integrated within a multimodal translational framework. Results: RFA resulted in a mean nodule volume reduction of 56% at early follow-up, with progressive volumetric reduction observed during longitudinal ultrasound evaluation. A clinically relevant improvement in compressive symptoms was observed, with a 44% reduction in symptom burden. Doppler ultrasound demonstrated progressive changes in vascular patterns consistent with post-ablation devascularization and tissue remodeling. Ten patients underwent thyroidectomy after RFA because of insufficient volumetric response, providing histological validation of treatment-induced tissue alterations, including coagulative necrosis, fibrosis, inflammatory changes, and architectural remodeling. Exploratory EV-derived miRNA profiling was incorporated into the translational workflow to investigate potential molecular correlates of treatment response; however, molecular findings require further validation in larger cohorts. Conclusions: This study provides a multimodal translational characterization of tissue response after thyroid RFA by integrating clinical outcomes, ultrasound imaging, histopathology, and exploratory EV-derived miRNA analysis. The proposed framework may contribute to a deeper understanding of biological changes following thermal ablation and support future investigations aimed at identifying reliable biomarkers of treatment response. Full article

Background/Objectives: Three-dimensional (3D) reconstruction of contrast-enhanced computed tomography (CT) data has shown value in elective hepato-pancreato-biliary (HPB) surgery, but its role in complex abdominal emergencies remains poorly defined. Complex emergency HPB operations are high-acuity procedures in which precise preoperative anatomical knowledge directly influences outcome, because inadequate characterization of vascular relationships in these operations may lead to intraoperative catastrophe, unrecognized vascular injury, incomplete resection, or perioperative death. We report a retrospective proof-of-concept case series designed to test whether 3D reconstructions generated from preoperative CT datasets, when read by an operator blinded to the intraoperative findings, correspond to the intraoperative findings used as ground truth and provide anatomical information beyond the original conventional CT report. Methods: Single-center retrospective consecutive case series of five patients who underwent complex emergency HPB surgery at the Regional Institute of Gastroenterology and Hepatology “Prof. Dr. O. Fodor,” Cluj-Napoca, Romania, between July 2018 and July 2022. All operations were guided by conventional contrast-enhanced CT. Three-dimensional reconstructions were generated after surgery, from the archived preoperative CT datasets by a single reader who was blinded to the intraoperative findings, to the operative note, and to the histopathological diagnosis. The 3D reconstructions were compared qualitatively with the intraoperative findings (ground truth) and with the original radiological report. Results: Five patients (3 women, 2 men; mean age 62.2 years) were analyzed: a right colonic flexure tumor with duodenal invasion, a duodenal gastrointestinal stromal tumor (GIST), an aortoduodenal fistula, a complex bilioduodenal fistulization with right hepatic artery pseudoaneurysm, and a periampullary tumor in contact with the inferior vena cava (IVC). In all five cases the blinded 3D reconstruction corresponded closely with the intraoperative findings, whereas the original conventional CT report did not match the intraoperative ground truth as precisely—particularly with respect to the exact location, the longitudinal and circumferential extent, and the local topography of vascular involvement and of fistulous tracts. Conclusions: Under blinded retrospective comparison, post hoc 3D reconstructions—generated through independent reassessment of the archived CT imaging by a reader blinded to the intraoperative findings—corresponded more closely with intraoperative findings than the original same-day emergency CT report in depicting vascular topography across five complex emergency HPB operations. These hypothesis-generating findings motivate a prospective study of preoperative 3D reconstruction within the emergency imaging pathway. Full article

This report presents a within-patient comparison of ¹⁸F-rhPSMA-7.3 and ¹⁸F-PSMA-1007 PET/CT in a 71-year-old man with Gleason score 4 + 3 = 7, pT3bN1 metastatic castration-resistant prostate cancer after robot-assisted radical prostatectomy, multiple androgen-deprivation and androgen receptor-directed treatments, and radiotherapy for para-aortic nodal metastases. The scans showed concordant PSMA-avid cervical-to-mediastinal lymphadenopathy and an ill-defined right lower-lobe pulmonary lesion with a recorded SUVmax > 15, despite distinct physiologic biodistributions. Infection or inflammation remained a relevant differential diagnosis, and the patient declined biopsy. Antibiotics did not improve the CT findings. After enrollment in a clinical trial of systemic therapy, the last available pretreatment prostate-specific antigen (PSA) level of 42.4 ng/mL decreased to 3.1 ng/mL, with marked disease regression. The concordant dual-tracer findings, lack of response to antibiotics, and subsequent radiographic and biochemical response to systemic therapy favored nodal and pulmonary metastases from prostate cancer. However, without histopathologic confirmation, the diagnosis remains presumptive, highlighting the need to integrate PET biodistribution, semiquantitative uptake, anatomic imaging, and longitudinal clinical findings. Full article

Background/Objectives: Breast cancer biomarker detection through immunohistochemistry (IHC) is essential for treatment planning but faces challenges including turnaround time, variability, and laboratory resource constraints. Large open-source vision-language foundation models offer a potential avenue for inferring biomarker status directly from hematoxylin-and-eosin (H&E)-stained whole-slide images (WSIs). Methods: We evaluated two open-source pathology foundation models—TITAN (Transformer-based Pathology Image and Text Alignment Network, approximately 48.5 M parameters) and CHIEF (Clinical Histopathology Imaging Evaluation Foundation Model, approximately 1.2 M parameters)—for predicting estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status from H&E-stained breast cancer WSIs. WSI data were obtained from The Cancer Genome Atlas Breast Invasive Carcinoma collection (TCGA-BRCA) via the NCI Imaging Data Commons, with biomarker labels from the NCI Genomic Data Commons. In total, 937 cases (995 WSIs; 78.3% ER-positive) were evaluated for ER, 934 cases (992 WSIs; 68.4% PR-positive) for PR, and 646 cases (691 WSIs; 21.1% HER2-positive) for HER2. All evaluation was performed under a strict patient-level 50/25/25 split with 10 independent random partitions; metrics are reported as the mean across partitions with percentile-based 95% confidence intervals. Performance was assessed using area under the receiver operating characteristic curve (AUROC), area under the precision-recall curve (AUPRC), sensitivity, specificity, and positive predictive value (PPV). Results: TITAN and CHIEF achieved comparable performance for ER (TITAN AUROC: 0.885 [95% CI: 0.848, 0.921], AUPRC: 0.954 [0.940, 0.964]; CHIEF AUROC: 0.877 [0.831, 0.914], AUPRC: 0.955 [0.938, 0.969]) and PR (TITAN AUROC: 0.799, AUPRC: 0.868; CHIEF AUROC: 0.791, AUPRC: 0.864). At the default 0.5 operating point, ER PPV was 0.90 and PR PPV was 0.79–0.81. For HER2, both models achieved AUROC values of 0.71–0.74 and AUPRC values of 0.41–0.45—well above the prevalence-based random baseline (approximately 0.211)—but default-threshold sensitivity was very low (approximately 0.07–0.08), reflecting class imbalance and the use of an uncalibrated default threshold rather than a categorical absence of morphologic signal. Conclusions: Under retrospective evaluation, both models demonstrate strong discriminative performance for ER and moderate performance for PR; HER2 prediction at the default operating point is limited and motivates threshold-calibration and multimodal extensions before any clinical use. AUPRC summarizes precision−recall behavior across thresholds and is distinct from threshold-specific precision (PPV); the two should be reported together for clinical-utility assessment in pathology AI. The findings are hypothesis-generating and motivate prospective external validation across independent institutional cohorts before any clinical deployment is considered. Full article

Background/Objectives: Distinguishing melanoma from benign melanocytic nevi remains a central diagnostic challenge, and vascular features may provide additional information beyond surface morphology. Super-resolution ultrasound using the erythrocytes (SURE) is a contrast-free imaging technique that uses endogenous erythrocyte scattering signals to reconstruct microvascular architecture beyond the conventional diffraction limit. This study evaluated the feasibility of SURE for in vivo visualization and quantitative assessment of dermal microvasculature in clinically benign nevi. Methods: Eleven participants with 35 clinically benign dermal nevi were included. All lesions underwent clinical and dermoscopic assessment, conventional B-mode ultrasound, color and power Doppler imaging, and SURE imaging. Eight larger nevi were imaged in two imaging planes, resulting in 43 SURE acquisitions. SURE reconstructions were assessed qualitatively for microvascular morphology and quantitatively for vessel diameter and erythrocyte flow velocity in proximal, intermediate, and distal visible intralesional vessel segments. Results: Dermoscopic and conventional ultrasound images were acquired for all lesions. SURE reconstructions of sufficient quality for quantitative analysis were obtained for all included acquisitions, yielding 129 vessel diameter measurements and 129 corresponding velocity measurements. Conventional Doppler demonstrated absent or minimal detectable vascular signal in the majority of lesions, whereas SURE visualized branching structures consistent with dermal microvascular networks in all the lesions. The mean vessel diameter was 85.0 ± 20.2 µm, with measured diameters ranging from 48.1 to 173.0 µm. The median flow velocity was 1.80 [1.30–2.50] mm/s. No significant differences in vessel diameter or velocity were observed between proximal, intermediate, and distal intralesional segments. Conclusions: SURE enabled contrast-free in vivo visualization and quantitative assessment of low-velocity dermal microvasculature in clinically benign nevi. These findings support the feasibility of SURE for microvascular mapping of melanocytic lesions and provide a basis for future studies including malignant lesions, volumetric imaging, and histopathological validation. Full article

Resveratrol (RES) is a natural polyphenolic compound characterized by poor aqueous solubility and significant first-pass metabolism, resulting in extremely low oral bioavailability. Although resveratrol-loaded nanostructured lipid carriers (RES-NLCs) have shown potential in enhancing oral absorption, direct experimental evidence for their intestinal lymphatic transport mechanism remains limited, and existing explanations is largely based on indirect inference. RES-NLCs were prepared, and their pharmacokinetics and lymphatic transport characteristics were evaluated using a laboratory-established mesenteric lymph duct–jugular vein assisted reflux model in rats. Simultaneously, a 28-day repeated-dose toxicity study was conducted in ICR mice. Pharmacokinetic results showed that compared with RES-Sol, RES-NLCs increased Cmax by approximately 2.3-fold, improved relative bioavailability by 7-fold, and achieved an absolute bioavailability of 176%. The lymphatic transport model confirmed that RES-NLCs are absorbed via the intestinal lymphatic pathway. In the 28-day repeated-dose toxicity study, no mortality or obvious clinical symptoms were observed at a dose of 10 mg/kg. The RES-NLCs group exhibited increased liver coefficient and decreased spleen coefficient. Hematological analysis showed a mild increase in red blood cell count, along with decreases in mean corpuscular volume and red blood cell distribution width coefficient of variation. Serum biochemistry revealed significant elevations in aspartate aminotransferase and alanine aminotransferase (p = 9 × 10⁻⁵ and p = 4.02 × 10⁻⁷, respectively). However, no significant differences were observed in the organ coefficients of the heart, lungs, kidneys, or brain. Body composition and magnetic resonance imaging showed no abnormalities, and histopathological examination of major organs including the liver, stomach, and intestines revealed no structural damage. These findings provide direct evidence that RES-NLCs enhance the oral bioavailability by promoting intestinal lymphatic uptake, suggesting that this system may serve as an effective delivery platform for poorly soluble hydrophobic drugs. Full article

Ewing sarcoma is a highly malignant tumor whose histological appearance often overlaps with that of other undifferentiated round-cell and ovoid-cell tumors, making accurate diagnosis challenging. Selecting the most appropriate immunohistochemical and molecular tests is critical, particularly when only limited core biopsy material is available and tissue preservation for additional molecular or biomarker testing is required. Artificial intelligence (AI)-based histopathological image analysis is emerging as a promising diagnostic tool in oncology. This study evaluated the potential of AI-based histopathological analysis to assist pathologists in the morphologic classification of Ewing sarcoma and selected histological mimics using tissue microarrays (TMAs), rather than to identify or predict molecular alterations. We analyzed 1926 digitized histological cores, from 729 patients, assembled into 45 tissue microarrays. The dataset comprised 517 Ewing sarcomas (ESs), 367 rhabdomyosarcomas (RMSs), 187 chondrosarcomas (CHSs), 138 gastrointestinal stromal tumors (GISTs), and 124 synovial sarcomas (SSs). A weakly supervised multiple-instance learning (MIL) framework with transformer-based aggregation was developed using only core-level diagnostic labels. The model achieved classification accuracies of 97.1% for Ewing sarcoma, 80.0% for rhabdomyosarcoma, 85.7% for gastrointestinal stromal tumors, 80.0% for chondrosarcoma, and 76.0% for synovial sarcoma. The overall classification accuracy was 91.6%, with no misclassifications between Ewing sarcoma and rhabdomyosarcoma. These findings highlight the model’s robustness in distinguishing tumor entities that present a well-recognized diagnostic challenge in routine pathology. The AI algorithm demonstrated strong potential as a diagnostic adjunct for assisting pathologists in the morphologic classification of Ewing sarcoma and selected tumor entities based on histopathological features. Although these tumor entities are characterized by specific molecular alterations, the model was not designed to identify or predict molecular alterations directly. Instead, it supports clinical decision-making by recognizing morphologic patterns associated with diagnostically defined tumor entities. The integration of AI-based histopathological analysis with immunohistochemistry and contemporary molecular diagnostic techniques has the potential to improve diagnostic accuracy, optimize the use of ancillary testing, enhance our understanding of genotype–phenotype relationships, and ultimately support more effective patient management. Full article

Background and Clinical Significance: Pulmonary crystal-storing histiocytosis (CSH) without an associated haematological malignancy, lymphoproliferative disorder, plasma cell disorder, or other identifiable underlying condition is exceptionally rare. Long-term radiological data from published cases remain limited, and this case, contextualised by a narrative review of the literature, may expand the recognised imaging spectrum of localised pulmonary CSH. Case Presentation: We report the case of a 59-year-old man with incidental multiple pulmonary lesions identified on CT thorax imaging. The lesions demonstrated an unusual combination of cystic change, cavitation, and surrounding ground-glass opacities. His medical history was significant for bipolar disorder treated with lithium and a 50-pack-year smoking history. Interval imaging showed progression, prompting further investigation and ultimately right upper lobectomy. Histopathological analysis confirmed pulmonary CSH; lesional cells contained crystalloid material and showed CD68 and PAS positivity, with dual kappa and lambda expression on immunohistochemistry. Markers for other differential diagnoses, including Congo red, birefringence, Langerin, and CD1a were negative. Following diagnosis and resection, serial imaging demonstrated fluctuating yet slowly progressive pulmonary abnormalities. No lymphoproliferative or plasma cell disorder has emerged after more than seven years of post-diagnostic surveillance and more than ten years since the initial imaging abnormality. Conclusions: This case demonstrates that the radiological spectrum of localised pulmonary CSH may include cystic, cavitary and ground-glass abnormalities, with subsequent fluctuating yet slowly progressive post-resection evolution. Pulmonary CSH should be considered in the differential diagnosis of unexplained or atypical pulmonary nodules, particularly when histiocyte-rich pathology with intracytoplasmic crystalloid material is identified. Long-term multidisciplinary surveillance is warranted. Full article

Background: Eosinophilic jejuno-duodenitis is a rare inflammatory disorder characterized by eosinophilic infiltration of the gastrointestinal tract, with highly variable clinical presentations. Mucosal eosinophilic duodenitis and jejunitis associated with ascites is uncommon and may mimic inflammatory or neoplastic conditions. Case Presentation: A 26-year-old male presented with persistent left-sided abdominal pain without bowel habit changes. Laboratory investigations revealed only slight inflammatory syndrome and peripheral eosinophilia. Contrast-enhanced abdominopelvic computed tomography demonstrated minimal ascites and circumferential wall thickening with contrast enhancement of duodenal and jejunal loops in the left flank. Given the nonspecific imaging findings, differential diagnoses included Crohn’s disease, intestinal lymphoma, and infectious enteritis. Endoscopic evaluation with histopathological analysis confirmed dense eosinophilic infiltration of the duodenal and jejunal mucosa, establishing the diagnosis of eosinophilic jejuno-duodenitis after exclusion of secondary causes. Management and Outcome: The patient was treated with budesonide, with rapid clinical improvement and resolution of inflammatory markers. Follow-up magnetic resonance enterography performed three months after initiation of treatment demonstrated complete resolution of bowel wall thickening and disappearance of the minimal ascites. Conclusions: Eosinophilic jejuno-duodenitis should be considered in young patients presenting with small bowel thickening, ascites, and peripheral eosinophilia. Awareness of this entity is essential to avoid misdiagnosis and unnecessary invasive procedures. Full article