Primary pulmonary meningioma and minute pulmonary meningothelial-like nodules: Rare pulmonary nodular lesions requiring more awareness in clinical practice

In this editorial,we comment on an article by Ruan et al published in a recent issue of the World Journal of Clinical Case.Pulmonary meningothelial proliferative lesions,including primary pulmonary meningiomas,minute pulmonary meningothelial-like nodules,and metastatic pulmonary meningiomas are rare pulmonary lesions.These lesions are difficult to differentiate from lung cancers based on clinical and imaging manifestations.Herein,we briefly introduce the clinical,imaging,and pathological characteristics of these lesions and discuss their pathogenesis to strengthen the current understanding of pulmonary meningothelial proliferative lesions in clinical diagnosis and therapy.

Nodular Pulmonary Amyloidosis with Interstitial Lung Disease—Case Report and Literature Review

Amyloidosis is a rare spectrum of disease which involves deposition of misfolded extracellular proteins (amyloids) in various body organs leading to progressive organ dysfunction. Clinical presentation can be variable depending on the organ involved and type of protein. Amyloidosis can be classified based on quantity, type, and location of these proteins. Amyloid light-chain amyloidosis develops in the bone marrow, producing abnormal forms of light-chain proteins, which cannot be broken down. These proteins transform into amyloid fibrils and form amyloid deposits in different organs. Pulmonary amyloidosis is uncommonly diagnosed since it is rarely symptomatic. Diagnosis of pulmonary amyloidosis is usually made in the setting of systemic amyloidosis;however, it may present as localised pulmonary disease. Localized pulmonary Amyloidosis can present as nodular, cystic, or tracheobronchial amyloidosis. Depending on the degree of the interstitial involvement, it may affect alveolar gas exchange and cause respiratory symptoms. This is a case of a 47-year-old female with background history of interstitial lung disease presenting with progressive shortness of breath. Computed tomography scan revealed bilateral pulmonary nodules. The patient was referred to our thoracic surgery team with the suspicion of bronchogenic malignancy with metastasis. Diagnostic video assisted wedge resection was performed for this patient, and histology confirmed pulmonary amyloidosis of nodular type. Amyloid deposition simulates both inflammatory and neoplastic conditions. Definitive diagnosis requires biopsy confirmation therefore early detection and commencing the patient on appropriate treatment pathway may help in symptomatic relief and better outcome.

SIZE DISTRIBUTION AND BEHAVIOUR OF VC PARTICLES IN FERRITIC NODULAR CAST IRON

Size distribution and precipitation of VC particles in ferritic nodular cast iron have been examined by techniques of ultrasonic screening,small angle X-ray scattering and chemical dissolution.The VC particles are sized over a wide range.The superfine ones, dispersed in the ferritic matrix,are the majority.A saturated dispersion with ultrafine VC particles may be approached as the V content increasing in the iron.Thi5 seems to play an important role in the precipitation strengthening for ferritic nodular cast iron.

CAUSE OF FORMATION OF NODULAR COPPER PARTICLES ON ELECTROREFINED COPPER SUBSTRATE

ＣＡＵＳＥＯＦＦＯＲＭＡＴＩＯＮＯＦＮＯＤＵＬＡＲＣＯＰＰＥＲＰＡＲＴＩＣＬＥＳＯＮＥＬＥＣＴＲＯＲＥＦＩＮＥＤＣＯＰＰＥＲＳＵＢＳＴＲＡＴＥ￥Ｌｉｎ，Ｊｉａｎｘｉｎ；Ｌｉ，Ｘｕｅｌｉａｎｇ；Ｃｈｅｎ，Ｈａｎｈｅ；Ｈｅ，Ｊｉａｎｂｏ（ＨｅｆｅｉＰｏｌ...

Nodular fasciitis of the external auditory canal: Clinical case report and review of the literature

Nodular fasciitis is a benign reactive soft tissue tumor arising from fibroblasts and myofibroblasts.Its incidence is low and misdiagnosis is frequent especially for malignant lesions.This can lead to inappropriate and unnecessary invasive treatment.Nodular fasciitis of the external auditory canal is extremely rare.So far,around fifteen cases have been reported.We present here the case of a 90-year-old patient with nodular fasciitis of the right external auditory canal.The lesion extends anteriorly for 6.5 cm and reaches the posterior wall of the maxillary sinus.To our knowledge,this is the first case in the literature of an external auditory canal nodular fasciitis presenting as an inflammatory ear polyp with such a wide extension.

Development of preoperative prognostic models including radiological features for survival of singular nodular HCC patients

Background:Early singular nodular hepatocellular carcinoma(HCC)is an ideal surgical indication in clinical practice.However,almost half of the patients have tumor recurrence,and there is no reliable prognostic prediction tool.Besides,it is unclear whether preoperative neoadjuvant therapy is necessary for patients with early singular nodular HCC and which patient needs it.It is critical to identify the patients with high risk of recurrence and to treat these patients preoperatively with neoadjuvant therapy and thus,to improve the outcomes of these patients.The present study aimed to develop two prognostic models to preoperatively predict the recurrence-free survival(RFS)and overall survival(OS)in patients with singular nodular HCC by integrating the clinical data and radiological features.Methods:We retrospective recruited 211 patients with singular nodular HCC from December 2009 to January 2019 at Eastern Hepatobiliary Surgery Hospital(EHBH).They all met the surgical indications and underwent radical resection.We randomly divided the patients into the training cohort(n=132)and the validation cohort(n=79).We established and validated multivariate Cox proportional hazard models by the preoperative clinicopathologic factors and radiological features for association with RFS and OS.By analyzing the receiver operating characteristic(ROC)curve,the discrimination accuracy of the models was compared with that of the traditional predictive models.Results:Our RFS model was based on HBV-DNA score,cirrhosis,tumor diameter and tumor capsule in imaging.RFS nomogram had fine calibration and discrimination capabilities,with a C-index of 0.74(95%CI:0.68-0.80).The OS nomogram,based on cirrhosis,tumor diameter and tumor capsule in imaging,had fine calibration and discrimination capabilities,with a C-index of 0.81(95%CI:0.74-0.87).The area under the receiver operating characteristic curve(AUC)of our model was larger than that of traditional liver cancer staging system,Korea model and Nomograms in Hepatectomy Patients with Hepatitis B VirusRelated Hepatocellular Carcinoma,indicating better discrimination capability.According to the models,we fitted the linear prediction equations.These results were validated in the validation cohort.Conclusions:Compared with previous radiography model,the new-developed predictive model was concise and applicable to predict the postoperative survival of patients with singular nodular HCC.Our models may preoperatively identify patients with high risk of recurrence.These patients may benefit from neoadjuvant therapy which may improve the patients’outcomes.

Advances in the Intervention of Prunella Spica Capsules on Postoperative Recurrence of Nodular Goiter

As important drugs for the treatment of nodular goiter(NG),Prunella Spica preparations are widely used clinically,and have a significant effect on NG.Various active ingredients in the preparations intervene in the formation of NG by inhibiting the proliferation of thyroid follicular cells,promoting cell apoptosis,regulating immunity,improving the microcirculation of thyroid tissue and other mechanisms,and can reduce the postoperative recurrence of NG.

Papillary thyroid carcinoma with nodular fasciitis-like stroma-an unusual variant with distinctive histopathology:A case report

BACKGROUND Papillary thyroid carcinoma(PTC)is regarded as a fairly common endocrine malignancy,which can be divided into different multiple variants due to wide morphologic differences.The majority of PTC variants have been reported,but PTC with nodular fasciitis-like stroma(NFS)is a rare pathological variant and has been infrequently reported in the relevant literature.This condition involves abundant reactive stromal components rich in spindle cells,which may account for 60%-80%of the tumor along with a typical papillary carcinoma.CASE SUMMARY A 44-year-old man presented with a 4-mo history of a palpable mass over the anterior aspect of the left neck,the tumor demonstrated gradual enlargement but was painless during the 4 mo prior to discovery.Thyroid function test results were normal.Physical examination showed an enormous and firm nodular mass in the left lobe of the thyroid gland extending to the level of the hyoid bone.Ultrasonography of the neck revealed a well-defined heterogeneous lesion measuring around 5.0 cm×4.0 cm with a hypoechoic complex nodule,decreased vascularity and speckles of microcalcification.The patient underwent left thyroidectomy with central compartment lymph node dissection.Final histopathological examination confirmed the diagnosis of PTC with extensive fibromatosis-like stroma combined with typical PTC.The patient was asymptomatic at the 3-mo follow-up.CONCLUSION PTC-NFS is a rare pathological variant and its diagnosis and prognosis may be similar to typical papillary carcinoma.

基于粒子图像测速技术的节状地下连续墙变形特性与破坏模式研究

节状地下连续墙(简称节状墙)是一种新型的地基基础形式,具备良好的工程特性,相对于传统地下连续墙而言,由于节部的存在,其抗拔承载力得到了有效地提升。目前,节状墙的应用及研究尚处于起步阶段,其变形特性与破坏模式亟待摸清。通过室内模型试验辅以粒子图像测速(particle image velocimetry,简称PIV)技术对节状墙基础竖向受拉下的位移和破坏形态开展了分析,研究结果表明:端部与中部节的设置扩大了深部与浅部土体的影响范围,多部节的设置相对于单部节有利于调动更广范围的土体。节状墙的破坏模式包括垂直滑移面、倒金字塔状或正切曲线和花瓶状曲线(即曲线滑移面)相连接的滑移面。总体而言,与抗拔桩相比,节状墙的抗拔破坏面受到节部数量和位置的影响而表现为复合型,且部分滑移面的走向与土体内摩擦角有关。

Microstructure and properties of LZQT600-3 HCCDIBs for plunger pump cylinder

It is important to improve the comprehensive performance of the ductile iron bars(DIBs)for the cylinder block of the extra high pressure hydraulic plunger pump and accelerate the industrial application.In this work,the LZQT600-3 DIBs with the diameter of 145 mm were prepared by the horizontal continuous casting(HCC)process,that is,LZQT600-3 HCCDIBs.The microstructure and room temperature tensile properties of different sections[left-edge(surface layer),left-1/2R(left half of the radius),and the center of the HCCDIBs]were studied.The results show that the spheroidization of LZQT600-3 HCCDIBs matrix from the left-edge,left-1/2R to the center is at nodulizing grade II and above.As the cooling rate gradually decreases from surface to the center of the HCCIBs,the number of spheroidized graphite is gradually reduced,the size is gradually increased,the shape factor is decreased,and the pearlite content and lamellate spacing are increased.Along the horizontal direction of the section,the hardness of the material is distributed symmetrically around the center of the HCCDIBs.In the vertical direction,the hardness distribution in the center of the HCCDIBs is asymmetrical due to the gravity during the solidification process.Therefore,the microstructure in the lower part of the section solidifies relatively quickly.The left-edge has the best tensile mechanical properties,and the ultimate tensile strength,yield tensile strength and elongation are 597.3 MPa,418.5 MPa and 9.6%,respectively.The tensile fracture belongs to the ductile-brittle hybrid fracture.The comprehensive performances of LZQT600-3 HCCDIBs meet the actual application requirements of ultra-high pressure hydraulic plunger pump cylinder.

球墨铸铁轨道垫板在垂直生产线上的工艺改进

介绍了采用垂直分型线生产的球墨铸铁轨道垫板的原生产工艺及存在密集的砂眼、渣眼缺陷,通过对浇注系统和冒口进行改进,有效解决了大平面存在的砂眼、渣眼问题,最后指出:(1)在垂直线上生产板类铸件,可以实现液面的快速上升,避免高温铁液对砂型平面的烘烤变形,但上下部同时引入铁液且上部流量大于下部流量的浇注系统不可取,会导致型腔内铁液的严重紊流,不利于夹渣、砂粒的稳定上浮;(2)内浇道充型铁液的速度较高,不应正对砂芯或砂胎,会导致冲砂风险;(3)对于板类铸件,采用半开放式阶梯浇注系统很好地解决了原工艺存在的密集型砂眼、渣眼问题。

Nodular regenerative hyperplasia:Evolving concepts on underdiagnosed cause of portal hypertension

Nodular regenerative hyperplasia(NRH)is a rare liver condition characterized by a widespread benign transformation of the hepatic parenchyma into small regenerative nodules.NRH may lead to the development of non-cirrhotic portal hypertension.There are no published systematic population studies on NRH and our current knowledge is limited to case reports and case series.NRH may develop via autoimmune,hematological,infectious,neoplastic,or drug-related causes.The disease is usually asymptomatic,slowly or nonprogressive unless complications of portal hypertension develop.Accurate diagnosis is made by histopathology,which demonstrates diffuse micronodular transformation without fibrous septa.Lack of perinuclear collagen tissue distinguishes NRH from typical regenerative nodules in the cirrhotic liver.While the initial treatment is to address the underlying disease,ultimately the therapy is directed to the management of portal hypertension.The prognosis of NRH depends on both the severity of the underlying illness and the prevention of secondary complications of portal hypertension.In this review we detail the epidemiology,pathogenesis,diagnosis,management,and prognosis of NRH.

Focal nodular hyperplasia of the liver in 86 patients

BACKGROUND: Focal nodular hyperplasia (FNH), the second most common benign hepatic tumor after hemangioma, is characterized by a stellate central scar and hyperplastic nodules. Although some large FNH may be associated with significant symptoms, more frequently they are discovered incidentally on physical examination or the work-up of unrelated symptoms. Since its nature and pathogenesis are still controversial, accurate diagnosis of FNH based on clinical presentation and radiographic studies is difficult. The purpose of this study was to explore the diagnosis and treatment of FNH. METHODS: Eighty-six FNH patients confirmed pathologically were treated at the Liver Cancer Institute in our hospital from 1996 to 2006. Their clinical manifestions, imaging presentation, pathological findings, and surgical results were analyzed retrospectively. RESULTS: Of the 86 patients with 99 foci, 54 were male and 32 female, with a mean age of 37 years. Eighty patients had a single solitary focus and 6 had multiple foci. Tumor diameter was less than 5 cm in 69 patients, 5-10 cm in 15, and more than 10 cm in 2. The overall rate of correct preoperative diagnosis was 59.3% (51/86) including 32.9% (26/79) by color Doppler flow imaging (CDFI), 60.3% (35/58) by CT, and 77.4% (24/31) by MRI. All the 86 patients underwent resection with good curative effect. CONCLUSIONS: CT and MRI are important diagnostic methods for FNH but it is difficult to make a definite preoperative diagnosis for partial classical and all non-classical FNH patients. We suggest that patients with clinical symptoms or with indefinite diagnosis should accept surgical removal.

Hepatic focal nodular hyperplasia in children:Imaging features on multi-slice computed tomography

AIM:To retrospectively analyze the imaging features of hepatic focal nodular hyperplasia(FNH) in children on dynamic contrast-enhanced multi-slice computed tomography(MSCT) and computed tomography angiography(CTA) images.METHODS:From September 1999 to April 2012,a total of 218 cases of hepatic FNH were confirmed by either surgical resection or biopsy in the Sun Yat-sen Memorial Hospital of Sun Yat-sen University and the Cancer center of Sun Yat-sen University,including 12 cases(5.5%) of FNH in children(age ≤ 18 years old).All the 12 pediatric patients underwent MSCT.We retrospectively analyzed the imaging features of FNH lesions,including the number,location,size,margin,density of FNH demonstrated on pre-contrast and contrastenhanced computed tomography(CT) scanning,central scar,fibrous septa,pseudocapsule,the morphology of the feeding arteries and the presence of draining vessels(portal vein or hepatic vein).RESULTS:All the 12 pediatric cases of FNH had solitary lesion.The maximum diameter of the lesions was 4.0-12.9 cm,with an average diameter of 5.5 ± 2.5 cm.The majority of the FNH lesions(10/12,83.3%) had well-defined margins.Central scar(10/12,83.3%) and fibrous septa(11/12,91.7%) were commonly found in children with FNH.Central scar was either isodense(n = 7) or hypodense(n = 3) on pre-contrast CT images and showed progressive enhancement in 8 cases in the equilibrium phase.Fibrous septa were linear hypodense areas in the arterial phase and isodense in the portal and equilibrium phases.Pseudocapsule was very rare(1/12,8.3%) in pediatric FNH.With the exception of central scars and fibrous septa within the lesions,all 12 cases of pediatric FNH were homogenously enhanced on the contrast-enhanced CT images,significantly hyperdense in the arterial phase(12/12,100.0%),and isodense in the portal venous phase(7/12,58.3%) and equilibrium phase(11/12,91.7%).Central feeding arteries inside the tumors were observed on CTA images for all 12 cases of FNH,whereas no neovascularization of malignant tumors was noted.In 9 cases(75.0%),there was a spoke-wheel shaped centrifugal blood supply inside the tumors.The draining hepatic vein was detected in 8 cases of pediatric FNH.However,the draining vessels in the other 4 cases could not be detected.No associated hepatic adenoma or hemangioma was observed in the livers of the 12 pediatric cases.CONCLUSION:The characteristic imaging appearances of MSCT and CTA may reflect the pathological and hemodynamic features of pediatric FNH.Dynamic multi-phase MSCT and CTA imaging is an effective method for diagnosing FNH in children.

A case of hepatocellular carcinoma arising within large focal nodular hyperplasia with review of the literature

Focal nodular hyperplasia （FNH） is a relatively rare benign hepatic tumor, usually presenting as a solitary lesion; however, multiple Iocalizations have also been described. The association of FNH with other hepatic lesions, such as adenomas and haemangiomas has been reported by various authors. We herein report a case of a hepatocellular carcinoma arising within a large focal nodular hyperplasia, in a young female patient.

Rare case of an abdominal mass: Reactive nodular fibrous pseudotumor of the stomach encroaching on multiple abdominal organs

Reactive nodular fibrous pseudotumor(RNFP), which presents abdominal clinical manifestations and malignant radiographic results, usually requires radical resection as the treatment. However, RNFP has been recently described as an extremely rare benign postinflammatory lesion of a reactive nature, which typically arises from the sub-serosal layer of the digestive tract or within the surrounding mesentery in association with local injury or inflammation. In addition, a postoperative diagnosis is necessary to differentiate it from the other reactive processes of the abdomen. Furthermore, RNFP shows a good prognosis without signs of recurrence or metastasis. A 16-year-old girl presented with a 3-mo history of epigastric discomfort, and auxiliary examinations suggested a malignant tumor originating from the stomach; postoperative pathology confirmed RNFP, and after a 2-year follow-up period, the patient did not display any signs of recurrence. This case highlights the importance of preoperative pathology for surgeons who may encounter similar cases.

Clinical characteristics of a group of adults with nodular lymphoid hyperplasia:A single center experience

AIM： To describe the clinical and histological characteristics of a group of adults with small-bowel nodular lymphoid hyperplasia （NLH）. METHODS： Patients were searched for five years in pathology records of our institution. The biopsy material was reassessed using strict histopathological criteria. Clinical data were obtained from medical records. RESULTS： Small-bowel NLH was diagnosed in 18 cases. The female： male ratio was 2 ： 1. The most frequent symptoms were diarrhea （72%）, involuntary weight loss （72%） and abdominal pain （61%）. Nine patients （50%） had immunodeficiency. Small-bowel bacterial overgrowth was found in three （17%） cases. At small-bowel NLH diagnosis, three （17%） had associated lymphoma： two intestinal and one extra-intestinal lymphomas. In two patients with villous atrophy and anti-endomysial antibodies the diagnosis of celiac disease was established. Giardia larnblia infection was found in only one patient with hypogammaglobulinemia （Herman＇s syndrome）. CONCLUSIONS： NLH is uncommon in adult patients. Associated diseases are immunodeficiency and lymphoid tissue malignancies.

Complete spontaneous regression of giant focal nodular hyperplasia of the liver: Magnetic resonance imaging evaluation with hepatobiliary contrast media

Focal nodular hyperplasia(FNH) of the liver is a benign lesion occurring in 0.6%-3% of the general population that probably reflects a local hyperplastic response of hepatocytes to a vascular abnormality. Most lesions are diagnosed incidentally and the natural history of the disease remains largely unknown. It has been shown that most FNH remain stable, or even regress, over a long follow-up period. We present a patient with FNH of the liver who was followed up for 7 years. A 26-yearold woman with a 5-year history of oral contraceptive use was referred to our hospital in February 2005 for further examination of a liver tumour. The diagnosis of FNH was made using magnetic resonance(MR) imaging with hepatospecific contrast media; this technique allows a correct diagnosis, in particular distinguishing FNH from hepatic adenoma, avoiding an invasive procedure such as the lesion biopsy. After 7-year from the diagnosis, we observed the complete spontaneous regression of the lesion by enhanced MR scanning. In this patient, discontinuation of oral contraceptive use and two childbirths may have influenced the natural history of FNH. To our knowledge, in the English literature there is no report illustrating a complete regression of giant FNH but only studies of decreasing in size. The present case suggests that a young patient with giant FNH should be managed conservatively rather than by resection, because FNH has the potential for spontaneous regression.

Ultrasonography of sclerosing angiomatoid nodular transformation in the spleen

We report three rare cases of sclerosing angiomatoid nodular transformation(SANT) in the spleen.We compared the conventional and contrast-enhanced ultrasonographic appearance.The conventional sonographic examinations exhibited solitary lesions without common respects,while contrast-enhanced ultrasonography(CEUS) revealed nodular appearance mimicking its pathologic characteristics.It suggests that CEUS can provide morphologic information for diagnosing SANT.

Effect of scanning speed during PTA remelting treatment on the microstructure and wear resistance of nodular cast iron

The surface of nodular cast iron （NCI） with a ferrite substrate was rapidly remelted and solidified by plasma transferred arc （PTA） to induce a chilled structure with high hardness and favorable wear resistance. The effect of scanning speed on the microstructure, micro-hardness distribution, and wear properties of PTA-remelted specimens was systematically investigated. Microstructural characterization in-dicated that the PTA remelting treatment could dissolve most graphite nodules and that the crystallized primary austenite dendrites were transformed into cementite, martensite, an interdendritic network of ledeburite eutectic, and certain residual austenite during rapid solidifica-tion. The dimensions of the remelted zone and its dendrites increase with decreased scanning speed. The microhardness of the remelted zone varied in the range of 650 HV0.2 to 820 HV0.2, which is approximately 2.3-3.1 times higher than the hardness of the substrate. The wear re-sistance of NCI was also significantly improved after the PTA remelting treatment.