Search Results (806)

Pediatric congenital right heart obstructive lesions encompass a spectrum of diseases that obstruct blood flow from the right atrium to the pulmonary artery. Right ventricular inflow obstructions include tricuspid valve abnormalities, such as Ebstein anomaly, tricuspid valve dysplasia, and tricuspid atresia. Right ventricular outflow obstructions include pulmonary valve stenosis, pulmonary atresia, and tetralogy of Fallot. Cardiac computed tomography angiography (CCTA) is a valuable tool for the diagnosis, treatment planning, and follow-up of these lesions. In this pictorial review, we highlight the diagnostic utility of CCTA in congenital right heart obstructive lesions, emphasizing its role in preoperative planning. Full article

Background/Objectives: Robotic-assisted bronchoscopy has emerged as an advanced technique for the evaluation of peripheral pulmonary lesions, offering improved navigation and targeting accuracy. While several studies investigating other diagnostic modalities have identified factors associated with higher diagnostic yield, such determinants remain poorly defined for shape-sensing robotic-assisted bronchoscopy (ssRAB). This study therefore aimed to identify predictors of diagnostic yield in robotic bronchoscopy. Methods: This retrospective single-center study included all consecutive patients who underwent ssRAB (ION^TM system, Intuitive Surgical, Sunnyvale, CA, USA) between August 2024 and March 2026. Lung nodules undergoing marker placement only or procedures performed without cone-beam CT (CBCT) guidance were excluded. Collected variables included demographic characteristics, lesion size, lesion density (solid, part-solid, ground-glass), biopsy modality, and number of biopsy samples obtained. Diagnostic yield was defined as a definitive pathological diagnosis of the target lesion. Predictors of diagnostic success were assessed using univariable logistic regression. Results: In total, 111 pulmonary nodules were included in the analysis. The overall diagnostic yield was 88.3% (98/111). The mean patient age was 64.94 ± 7.9 years, with a predominance of female patients (58.4%). No significant associations were observed between diagnostic yield and lesion size (odds ratio [OR] 1.014 per mm; p = 0.764), lesion density (p = 0.892), or biopsy instrument (p = 0.835). However, an increased number of biopsy samples showed a positive association with diagnostic yield, showing a statistical trend (OR 1.22 per additional sample; p = 0.084). Conclusions: Robotic-assisted bronchoscopy provides a high diagnostic yield for peripheral pulmonary lesions. The number of biopsy samples appears to be the most relevant modifiable factor influencing diagnostic success, underscoring the importance of adequate tissue acquisition. In contrast, lesion characteristics and biopsy modality did not significantly affect outcomes in this cohort. Full article

Background/Objectives: Chest X-ray (CXR) images are a widely used first-line screening tool for pulmonary tuberculosis (TB) detection but are difficult to interpret, which has increased demand for an automated screening tool. Deep-learning-based computer-aided diagnosis systems have demonstrated a classification performance comparable to that of trained radiologists, but they rely on dense annotations such as lesion-level or pixel-level labels, which are costly and difficult to obtain in routine clinical workflows. We developed CPM-XNet, an annotation-efficient framework for lesion-annotation-free downstream TB classification in CXR images. Methods: CPM-XNet incorporates a compressing–projecting mask (CPM) to provide soft lung-aware modulation while preserving global contextual information. The CPM-modulated images are then used for downstream classification with multiple convolutional neural network backbones and a vision transformer baseline. Results: Experiments were conducted using an internal hospital dataset and public TB datasets, and CPM-XNet showed improved performance compared with baseline models trained on unmodulated images. In a repeated-seed evaluation of the main ResNet-101 configuration on the Tung cohort, CPM-ResNet101 showed higher and more stable performance than the non-CPM counterpart and demonstrated significant paired improvement using McNemar’s exact test. An ablation analysis indicated that CPM modulation was the main contributor to performance improvement while data augmentation and the classifier architecture further influenced the overall robustness. Conclusions: CPM-XNet provides an annotation-efficient strategy for lesion-annotation-free downstream TB classification in CXR images. The findings support preliminary technical feasibility, although larger, naturally imbalanced, cross-institutional validation is required before clinical deployment can be inferred. Full article

Ovine pulmonary adenocarcinoma (OPA), caused by the exogenous Jaagsiekte sheep retrovirus (JSRV), shares several pathological and molecular features with human lung adenocarcinoma, providing an important model for comparative oncology. JSRV pathogenesis is mostly studied at the transcriptome level, with systematic proteomic and metabolomic studies remaining insufficient. Therefore, this study aimed to systematically characterise the molecular alterations associated with JSRV-induced OPA by integrating direct data-independent acquisition proteomics and untargeted metabolomics. We established an OPA model by infecting lambs with JSRV and performed multi-omics analyses on the lesion and control lung tissues (n = 3 per group for both proteomic and metabolomic analyses). In total, 1631 differentially expressed proteins and 748 differential metabolites were identified, and the two omics datasets exhibited highly coordinated variations. Integrated analyses suggested that adhesion remodelling (with downregulated LIMCH1), endoplasmic reticulum stress (with upregulated HYOU1), and metabolic and immune-related alterations (accompanied by elevated GFPT1 and PTGS2) represent major biological processes associated with JSRV infection. Western blot analysis confirmed the expression changes in these proteins. Overall, this study provides a multidimensional molecular landscape of OPA and expands current understanding of the molecular alterations associated with JSRV infection. These findings provide candidate pathways and molecular targets for future mechanistic studies and comparative investigations of lung adenocarcinoma. Full article

Background/Objectives: Accurate tissue diagnosis of small pulmonary nodules remains technically challenging with conventional bronchoscopic techniques. Radial probe endobronchial ultrasound-guided transbronchial lung cryobiopsy (RP-EBUS–guided TBLC) with a guide sheath (GS) may improve diagnostic yield; however, target instability during cryobiopsy remains a limitation. We aimed to evaluate the diagnostic yield of RP-EBUS-guided TBLC with a GS for pulmonary nodules < 3 cm that were suspected of malignancy. Methods: This retrospective observational study included patients who underwent RP-EBUS-guided TBLC with a GS for lung lesions suspected of malignancy on computed tomography between 1 February 2024 and 31 December 2025 in South Korea. After the target lesion was identified, the bronchoscope was inserted and fixed within the segment; its position was maintained while RP-EBUS was withdrawn, and lesion stability during respiration was confirmed. Results: A total of 99 patients were included in the final analysis. After patients with an indeterminate diagnosis were excluded, the final diagnostic yield was 83.2%. The sensitivity and specificity were 78.9% and 100.0%, respectively. Pneumothorax occurred in 6.0% (6/99) of patients. Bleeding of grade 3 or higher was observed in two patients, and a Fogarty balloon catheter was preemptively used in five patients at the operator’s discretion. In multivariable logistic regression analysis, the computed tomography bronchus sign was identified as the only significant factor associated with pathological confirmation (odds ratio, 6.090; p = 0.005). Conclusions: RP-EBUS-guided TBLC with a GS provided an acceptable diagnostic yield and safety profile, even in small pulmonary nodules < 3 cm. Full article

Background/Objectives: Given rising lung cancer incidence and limited data on pulmonologist-performed ultrasound-guided transthoracic core biopsy (US-TTCB), in this study, we evaluated diagnostic yield and safety for pleural or pulmonary lung masses, using Clavien–Dindo classification to standardize complication reporting. Methods: We retrospectively reviewed single-center pulmonologist-performed US-TTCB using a MEDONE biopsy gun with a 16 G/18 G Tru-Cut needle between January 2019 and December 2025. The primary endpoints were diagnostic yield, defined as specific malignant or benign histology, and complication rate. Non-diagnostic results were assessed using available clinical/imaging follow-up. Univariate analyses screened candidate correlates, and a prespecified computer tomography (CT)-completed subanalysis (n = 67) used multivariable logistic regression and receiver operating characteristic (ROC) analysis to assess CT lesion size discrimination. Results: Diagnostic yield was 84.2% (202/240); complications occurred in 12.1% (29/240), including one Clavien–Dindo Grade III event (0.4%). In the CT-completed subset (n = 67), diagnostic yield was independently associated with CT lesion size (aOR 1.03/mm, 95% CI 1.00–1.05; p = 0.022) and Chronic Obstructive Pulmonary Disease (COPD) (aOR 2.30, 95% CI 1.06–4.96; p = 0.034); CT lesion size showed an area under the curve (AUC) of 0.717 for predicting yield. Diagnostic yield remained stable over time (84.2% in first vs. second half; p = 1.00), with no association between case order and yield (OR 0.999; p = 0.64). Conclusions: US-TTCB of pleural/pulmonary masses achieved a high diagnostic yield with minimal major complications. Large CT dimension and COPD were associated with higher diagnostic success, and CT size provided fair discrimination for predicting yield; findings should be interpreted in the context of the retrospective single-center design and the restricted CT-completed subset. Full article

Background/Objectives: With increasing frequency in sublobar resections, accurate intraoperative localization has become essential to ensure adequate resection margins and spare lung parenchyma. Our study evaluates the efficacy of shape-sensing robotic bronchoscopy (SS-RAB) with integrated mobile cone-beam CT (mCBCT) for intraoperative localization of lung tumors using indocyanine green (ICG). We further aimed to explore the feasibility of a single intubation-single positioning technique for bronchoscopy and surgery. Methods: We retrospectively reviewed patients who underwent SS-RAB with integrated mCBCT for ICG marking, followed by minimally invasive sublobar resection. ICG marking was deemed successful when it allowed the operative team to localize and resect the lesion with adequate pathology margins. Results: A total of 28 patients with 30 pulmonary lesions from a single institution were included. Median tumor size was 10.5 mm (IQR, 8.7–14.6 mm) and distance from pleura 7.8 mm (IQR, 2.45–13.8 mm). Twenty lesions (66.6%) were solid, 5 lesions (16.6%) semi-solid, and 5 lesions (16.6%) ground-glass. ICG localization was successful in 28 lesions (93%). Nineteen patients (68%) were intubated only with a double-lumen endotracheal tube (DL-ETT), used for bronchoscopy and surgery, and in 10 patients (36%) ICG marking and surgery were both performed in lateral decubitus. One patient developed a small pneumothorax during bronchoscopy which did not prevent ICG injection. Conclusions: SS-RAB with integrated mCBCT for ICG marking is successful and safe. Single intubation with DL-ETT and lateral decubitus positioning for both bronchoscopy and surgery are feasible. Further studies are needed to prove a potential increase in efficiency with this technique. Full article

Background: Spread through air spaces (STAS) is a recognized histologic pattern of invasion associated with poor prognosis in non-small-cell lung cancer (NSCLC), particularly adenocarcinoma. However, its presence in pulmonary squamous cell carcinoma (SCC), whether primary or metastatic, remains largely unexplored. Given the limited available evidence, this study was designed as an exploratory analysis to evaluate the prevalence and potential prognostic significance of STAS in pulmonary SCC. Material and Methods: In this exploratory retrospective study, we analyzed 57 patients who underwent surgical resection for pulmonary squamous cell carcinoma (P-SCC) at the Department of Thoracic Surgery at the University Hospital Erlangen between 2008 and 2020. The cohort included both primary lung SCC and metastatic SCC to the lung from extrapulmonary sites, primarily from ear, nose, and throat (ENT) tumors. Histological slides were reviewed to assess the presence of STAS, as defined by established morphological criteria. The Chi-square test was used to investigate the presence of STAS. Disease-free survival (DFS) and overall survival (OS) was evaluated using Kaplan–Meier analysis, and the prognostic impact of STAS along other variables were assessed using Cox proportional hazards regression. Results: A total of 57 patients with squamous cell carcinoma (SCC), 22 (39%) had primary lung SCC and 35 (61%) had metastatic SCC from head and neck tumours (ENT). Spread through air spaces (STAS) was detected in 20 patients (35%). Disease-free survival (DFS) differed according to primary tumour location (p-value of 0.009), with higher 1-, 3-, and 5-year DFS in patients with primary lung SCC (86.4%, 77.3%, 63.3%) than in those with head and neck SCC (54.3%, 31.4%, 22.2%). DFS was also significantly higher in patients undergoing solitary resections compared with multiple resections (78.6%, 64.3%, 49.5% vs. 33.3%, 6.7%, not estimable; p-value < 0.001). DFS was slightly longer in STAS-negative patients compared with STAS-positive patients (1-, 3-, 5-year DFS: 64.9%, 51.4%, 40.5% vs. 70%, 45%, not estimable), (median DFS 36 vs. 25 months; p-value of 0.776). Overall survival (OS) was significantly longer in patients with primary lung SCC (median OS 125 months) than in those with head and neck SCC (27 months; p-value of 0.039). STAS-negative patients had also a longer OS than STAS-positive patients (median OS 46 vs. 38 months; HR = 1.11, 95% CI 0.56–2.20; p-value of 0.771). Conclusions: STAS was identified in metastatic pulmonary SCC lesions as well as in primary lung SCC, occurring in approximately one-third of cases. However, due to the limited cohort size and the exploratory univariate design of the study, the prognostic significance of STAS could not be definitively established and requires further investigation in larger, adequately powered studies. Full article

Background/Objectives: CT-guided transthoracic core needle biopsy (CT-TTNB) is the standard technique for histological characterization of pulmonary lesions, yet it carries a 15–42% rate of pneumothorax and a 5–27% rate of alveolar hemorrhage. Accurate identification of modifiable and non-modifiable procedural determinants is essential for pre-procedural risk stratification, technique optimization, and post-procedural care. Methods: We conducted a single-centre retrospective cohort study of 240 consecutive CT-TTNB procedures performed between November 2023 and January 2025. The variables were extracted from medical records and PACS and entered into univariate and multivariate analysis models. Model performance was assessed by AUC-ROC, Nagelkerke R², and the Hosmer–Lemeshow test. Results: Pneumothorax occurred in 79 patients (32.9%), with chest tube drainage required in 14 (5.8%). Alveolar hemorrhage was identified in 49 patients (20.4%). Four independent predictors for pneumothorax were identified: needle–pleural angle (OR 0.837/1°; p < 0.001), pleura-to-lesion distance (OR 1.675/10 mm; p < 0.001), fissure traversal (OR 26.718; p = 0.003), and patient age (OR 1.076/year; p = 0.002); AUC-ROC 0.927. The alveolar hemorrhage model identified pleura-to-lesion distance (OR 1.768/10 mm; p < 0.001), RUL apical segment (OR 4.281; p < 0.001), and carcinomatous lymphangitis as protective factors (OR 0.359; p = 0.030); AUC-ROC 0.822. The needle–pleural angle was not independently associated with alveolar hemorrhage, confirming mechanistically distinct complication pathways. Conclusions: Needle–pleural angle is the dominant modifiable determinant of pneumothorax and pneumothorax-related complications. Optimizing the trajectory towards perpendicularity does not increase hemorrhage risk. These findings support the implementation of angle-based trajectory planning protocols and risk-stratified post-procedural monitoring. Full article

Background: Scar carcinoma represents a distinct subtype of lung malignancy developing in areas of chronic pulmonary fibrosis, inflammation, and structural remodeling, frequently associated with previous pulmonary tuberculosis (TB). The present study aimed to evaluate the radiological, clinical, inflammatory, and histopathological characteristics associated with the scar carcinoma phenotype in patients with lung cancer (LC) and previous TB-related pulmonary abnormalities. Methods: A retrospective observational cohort study conducted between February 2020 and December 2025 included 844 patients diagnosed with lung cancer. The scar carcinoma phenotype was operationally defined by the coexistence of: (1) confirmed lung cancer, (2) post-tuberculous structural pulmonary abnormalities on thoracic imaging, and (3) clinical history compatible with prior pulmonary TB. Associations between the scar carcinoma phenotype and clinicopathological variables were evaluated using Pearson’s Chi-square and Fisher’s exact tests. Binary logistic regression analysis was performed to identify independent predictive factors associated with scar carcinoma. Receiver operating characteristic (ROC) curve and precision–recall curve analyses were additionally performed. Results: Post-TB sequelae were identified in 58.2% of patients, while active TB was present in 7.8% of cases. Adenocarcinoma represented the predominant histopathological subtype (63.3%). Fibrotic/interstitial/bronchial abnormalities (67.7%), cavitary/destructive lesions (69.0%), atelectatic/retractile changes (65.4%), and infectious/inflammatory pulmonary abnormalities (60.4%) were highly prevalent. Significant associations were identified between scar carcinoma and TB sequelae (χ² = 811.850, p < 0.001), adenocarcinoma histology (χ² = 655.545, p < 0.001), infectious/inflammatory changes (χ² = 635.168, p < 0.001), cavitary/destructive lesions (χ² = 508.347, p < 0.001), fibrotic/interstitial abnormalities (χ² = 539.895, p < 0.001), and atelectatic/retractile changes (χ² = 597.346, p < 0.001). Logistic regression identified haemoptysis (OR = 0.651 (95% CI: 0.486–0.871), p = 0.005) and pulmonary opacities and/or condensation (OR = 1.343 (95% CI: 1.014–1.779), p = 0.040) as independent predictive factors. ROC analysis demonstrated moderate predictive performance (AUC = 0.703). Conclusions: TB-associated pulmonary remodeling was strongly associated with the scar carcinoma phenotype, consistent with an associative role of chronic inflammation, fibrosis, and post-TB structural damage in lung carcinogenesis; however, causal inferences cannot be drawn from this retrospective observational design. Full article

Catamenial pneumothorax is a rare form of recurrent spontaneous pneumothorax occurring in women in temporal association with the menstrual cycle, most commonly within 72 h before or after the onset of menstruation, and is frequently encountered as part of thoracic endometriosis syndrome. Thoracic endometriosis represents an extrapelvic manifestation of endometriosis in which ectopic endometrial tissue may involve the pleura, diaphragm, lung parenchyma, or airways, leading to cyclic pleuropulmonary symptoms. The clinical spectrum includes catamenial pneumothorax, catamenial hemothorax, catamenial hemoptysis, and pulmonary endometriotic nodules. This narrative review critically analyzes the diagnostic challenges and limitations of imaging modalities in thoracic endometriosis, with particular emphasis on diagnostic delay, radiological pitfalls, and the discrepancy between morphological detection and etiological confirmation. Chest radiography and computed tomography are useful for documenting acute thoracic events, whereas magnetic resonance imaging may provide additional tissue characterization in selected cases, particularly when hemorrhagic or diaphragmatic lesions are suspected. However, imaging findings are often nonspecific, temporally variable, and insufficient to establish the diagnosis when interpreted in isolation. Recognition of thoracic endometriosis therefore requires correlation of imaging findings with menstrual cyclicity, gynecological history, clinical phenotype, and, when indicated, surgical and histopathological assessment. The available evidence remains limited by retrospective designs, small case series, inconsistent diagnostic criteria, and lack of validated thoracic-specific imaging pathways. Accordingly, an integrated clinical–radiological–surgical approach should be regarded as a pragmatic diagnostic framework rather than a validated algorithm. Such an approach may improve clinical suspicion, reduce diagnostic delay, and support more appropriate multidisciplinary management of this underrecognized condition. Full article

Background/Objectives: CT-guided lung biopsy is an essential diagnostic procedure but is associated with complications such as pneumothorax and pulmonary hemorrhage. While patient- and lesion-related factors are well established, operator-modifiable parameters remain less clearly defined. This study aimed to evaluate complication rates and identify independent predictors, with a particular focus on modifiable procedural factors. Methods: This retrospective study included 309 consecutive patients undergoing CT-guided transthoracic lung biopsy. Patient, lesion, and procedural variables—including needle–pleura angle and patient positioning—were analyzed. Complications were classified according to the Society of Interventional Radiology (SIR) system. Multivariate logistic regression analyses were performed to identify independent predictors. Results: Complications occurred in 20.4% of patients, with pneumothorax (14.2%) and hemorrhage (4.9%) being the most frequent. A needle angle ≤ 65° was independently associated with major complications (OR = 8.12, p = 0.025). Perilesional emphysema (OR = 19.38, p = 0.004) and pleural effusion (OR = 30.72, p = 0.001) were also strong predictors. Supine positioning significantly increased hemorrhage risk (OR = 9.03, p = 0.043). Conclusions: Operator-modifiable factors, particularly needle angle and patient positioning, may influence complication risk. Optimization of these parameters may provide a practical approach to improving procedural safety in CT-guided lung biopsy. Full article

Background: Robotic-assisted bronchoscopy enables precise navigation to peripheral pulmonary lesions and expands minimally invasive diagnostic options in thoracic surgery. At our institution, the ION™ Endoluminal System (Intuitive Surgical, Sunnyvale, CA, USA) was introduced to improve diagnostic accuracy in challenging peripheral targets. It is widely recognized that a defined number of procedures is required to achieve procedural proficiency and optimal clinical outcomes when adopting a novel platform. Therefore, this retrospective single-center study aimed to evaluate the learning curve associated with the implementation of this technology in a thoracic surgery center. Methods: In this retrospective study, all consecutive patients who underwent robotic-assisted bronchoscopies performed using the ION™ Endoluminal System (Intuitive Surgical, Sunnyvale, CA, USA) for the diagnosis of peripheral pulmonary lesions between August 2024 and March 2026 were analyzed. A total of 128 lesions in 89 patients were initially identified. Cases involving marker placement without diagnostic biopsy, as well as procedures not performed by the primary operator, were excluded. After applying exclusion criteria, 109 procedures in 76 patients were included. The mean patient age was 65.4 ± 9.1 years, and 44 patients were female (57.9%). To assess the learning curve, procedures were chronologically divided into three groups: early (cases 1–36), intermediate (37–73), and late (74–109). Outcome measures included procedure time, number of biopsies per lesion, tumor size, and diagnostic yield. Group comparisons were performed using non-parametric and chi-square tests. Procedural learning was assessed by cumulative sum (CUSUM) analysis of procedure time. Results: The overall diagnostic yield was 85.3% (93/109). The diagnostic yield increased over time from 73.0% in the early phase to 83.3% in the intermediate phase and 94.6% in the late phase. The overall comparison was statistically insignificant (χ² p = 0.117); however, there was a significant linear trend across phases, indicating progressive improvement with exposure to the application of this technology. Procedure time decreased significantly from a median of 49.0 min in the early phase to 31.0 min in the intermediate phase and 30.0 min in the late phase (p < 0.001). At the same time, the number of biopsies per lesion increased significantly (p < 0.001). Tumor size did not differ significantly between groups (p = 0.170). Conclusions: Robotic-assisted bronchoscopy demonstrates a clear learning curve, characterized by increasing diagnostic yield and significantly reduced procedure time during the implementation phase. The technique can be effectively integrated into the thoracic surgical diagnostic workflow and represents a valuable addition to minimally invasive diagnostics for peripheral pulmonary lesions. Full article

Aphasia is a complex neurological syndrome that includes a multitude of signs and symptoms that describe a patient’s inability to use language (understanding and producing spoken and/or written language) after it has already been acquired, which is caused by cerebral lesions situated in the dominant (left) cerebral hemisphere in right-handed people. Aphasia has a prevalence of 25–30% in acute ischemic stroke (especially in arterial infarcts). In patients who suffered cerebral venous and dural sinuses thrombosis (CVST), aphasia has been noticed in almost 20% of cases, its presence being considered a negative predictive factor. We report the case of a 22-year-old right-handed woman with obesity and active smoking (10 cigarettes/day), undergoing treatment with oral contraceptives who presented to the Emergency Department with an intense headache, resistant to usual analgesic treatment, accompanied by language disorders onset within 24 h. The neurological examination was normal, except for language assessment, which revealed the severe impairment of the repetition domain (she was unable to repeat simple words), and difficulty in naming objects with some hesitations and mild comprehension difficulties (especially in complex orders). She underwent neuroimaging examinations at admission. Native Head Computed Tomography revealed spontaneous hyperdensity (parenchymatous hematoma) in the left temporal lobe. Cranial magnetic resonance imaging (MRI) confirmed venous infarction in the left temporal area and a hypointense signal on MRI T2*SW (susceptibility-weighted) in the region of the left lateral sinus and left jugular vein bulb, which confirmed the thrombosis at this level. Associated cortical vein thrombosis was diagnosed on indirect radiological grounds, since hemorrhagic transformation obscured the direct visualization of the adjacent cortical veins. MR venography was not performed at that time, but instead at the 1-month follow-up, MR venography confirmed the chronic, partial thrombosis of the left lateral sinus and left jugular vein bulb. Laboratory data demonstrated an elevated D-dimer and the presence of homozygosity for MTHFR C677T and PAI-1 4G/4G. Anticoagulation in the form of low-molecular-weight heparin was immediately started, followed by chronic treatment with oral anticoagulant (apixaban) and folic acid. The headaches resolved within three days, and her neurological examination was almost normal: the repetition continued being altered for complex phrases. We did not observe any left lateral sinus thrombosis recurrence, or other extra-cerebral embolic events (deep vein thrombosis or pulmonary embolism) during the follow-up year. The immediate anticoagulation since the admission resulted in a favorable outcome. Taking into consideration our interest in monitoring patients with aphasia secondary to CVST, we also analyzed data from the literature regarding the incidence of conduction aphasia and other aphasic syndromes in this CVST. Due to the limited number of articles identified in the last 21 years (2005–2026) in the literature, we concluded that conduction aphasia is an extremely rare clinical presentation in this kind of pathology and further studies should be conducted in order to identify significant statistical data. Full article

Garlic (Allium sativum) contains organosulfur compounds capable of inducing oxidative damage to erythrocytes in dogs, leading to hemolytic anemia and methemoglobinemia. Although Allium toxicosis is relatively common, fatal cases with detailed histopathological characterization are rarely reported. This case report describes a fatal episode of garlic toxicosis in a 3-year-old female mixed-breed dog. At necropsy, gastric contents included food material and raw garlic cloves (16 g). Gross findings included pulmonary hyperemia and thoracic hemorrhagic effusion. Histopathological examination revealed multifocal myocardial hemorrhages, diffuse pulmonary capillary congestion, hepatic sinusoidal dilation with hemorrhagic areas, splenic hemorrhage, and renal glomerular capillary dilation. These lesions were consistent with systemic hypoxic and vascular injury secondary to oxidative erythrocyte damage. The lower quantity of garlic recovered compared with reported toxic doses suggests possible individual susceptibility or incomplete recovery of ingested material. This case highlights the diagnostic value of histopathology in suspected Allium fatal toxicosis and contributes to increasing the limited literature describing these outcomes in dogs. Full article