Background: Invasive lobular cancer is the second most common subtype of invasive breast cancer. Due to the wide diversity of histopathological, clinical, and radiological presentations, it can provide diagnostic and therapeutic challenges. Magnetic resonance imaging (MRI) has the highest sensitivity for its detection and the most accurate determination of invasive lobular cancer extent. The aim of our pictorial review was to demonstrate the different presentations of invasive lobular cancer on MRI and thus facilitate the interpretation of imaging findings for radiologists. Main body of the The pictorial essay carefully extracted six different MRI presentations of an invasive lobular cancer with brief histopathological and clinical patient data. We showed that invasive lobular cancer presentation on MRI varied, ranged from a single focus to single and multiple lesions, non-mass enhancements of various distributions, and in some cases with nonspecific enhancement curves. Conclusions: This pictorial essay presented a spectrum of MRI findings of invasive lobular cancer, showing the variety of their appearances. Considering the variety of MRI imaging, the radiologist sometimes has to look for other diagnostic methods for the final interpretation of the imaging findings. We believe that the presentation of different cases will educate radiologists and help in making appropriate diagnostic and therapeutic decisions.
Background: Chronic obstructive pulmonary disease has extrapulmonary manifestations, such as cardiovascular diseases and osteoporosis. The purpose of this research was to determine the relationship between the type and extent of emphysema with thoracic aorta calcification (TAC) and bone mineral density (BMD) at Th4, Th8, and L1 vertebrae. Methods: Emphysema was described by computed tomography parameters (both Fleischner classification and low attenuation value percentage, LAV%) and the clinical FEV1/FVC ratio (Tiffeneau–Pinelli index, TI, TI < 0.7; TI > 0.7). Results: Of 200 included patients (median age 64, 33% women), signs of clinical obstruction (TI) were observed in 104 patients, which had significantly lower BMD and more heavy TAC. BMD correlated negatively with LAV%, Rho = −0.16 to −0.23, while a positive correlation of aortic calcification with LAV% was observed, Rho = 0.30 to 0.33. Multiple linear regression showed that age and TI < 0.7 were independent predictors of BMD, β = −0.20 to −0.40, and β = −0.21 to −0.25; age and hypercholesterolemia were independent predictors of TCA, β = 0.61 and β = 0.19. Conclusions: Clinical TI and morphological LAV% parameters correlated with BMD and TAC, in contrast to Fleischer-graded emphysema, which showed no correlation. However, only TI was an independent predictor of BMD, while the morphologically described type and extent of emphysema could not independently predict any extrapulmonary manifestation.
Interstitial lung abnormalities (ILAs) are incidentally found nondependent parenchymal abnormalities affecting more than 5% of any lung zone and are potentially related to interstitial lung disease and worsening post-treatment outcomes in malignancies and infectious diseases. The aim of this study was to determine the prevalence and type of ILA changes in patients with head and neck squamous cell carcinoma (HNSCC) and their change in the follow-up period. This retrospective single-center study included 113 patients with newly diagnosed HNSCC who underwent lung MSCT prior to treatment. ILAs were reported in 13.3% of patients on pretreatment MSCT. Patients with ILAs were significantly older (median 75 vs. 67 years). ILAs were most prevalent in lower zones (73.3%) (p = 0.0045). The most reported ILA subtype was subpleural non-fibrotic (60%) (p = 0.0354). Reticulations were the most frequently described pattern (93.3%) (p < 0.0001). Progression of ILAs was reported in almost 30% of patients after receiving therapy. Patients with pre-existing ILAs were more likely to develop radiation-induced lung fibrosis after adjuvant radiotherapy (p = 0.0464). In conclusion, ILA’s incidence, distribution and presentation were similar to previous research conducted in other special cohorts. Our research suggests a possible association of more frequent radiation pneumonitis with ILA changes in patients with HNSCC, which should be further investigated.
Background/Objectives: Hidradenitis suppurativa (HS) is a chronic, immune-mediated inflammatory skin disease characterized by painful nodules, abscesses, sinus tracts, and progressive fibrosis. Vascular activation is becoming increasingly acknowledged as an important factor in HS pathogenesis; however, the effects of tumor necrosis factor alpha (TNF-α) blockade on vascular remodeling in HS remain poorly characterized. This study investigated the impact of TNF-α inhibition by adalimumab (ADA) on endothelial and fibroblast-associated markers in HS lesions. Methods: Formalin-fixed paraffin-embedded skin samples from 71 HS patients were analyzed, including treatment-naive (n = 38) and adalimumab-treated (n = 33) cases. Histopathology and immunofluorescence were performed using antibodies against CD31, von Willebrand factor (vWF), α-smooth muscle actin (αSMA), vimentin, Ki-67 (proliferation), and cleaved Caspase-3 (apoptosis). ImageJ software was used to determine the immunoexpression of selected markers and vascular density. Vascular density, assessed as vessel count per mm2, was designated as the primary endpoint. Sex-related differences were analyzed as exploratory endpoints. Results: Adalimumab-treated tissue exhibited significantly reduced vascular density (p < 0.01) compared to the treatment-naive group. Conversely, vimentin immunoexpression was significantly higher (p < 0.01) in the adalimumab-treated group. No significant differences were found in endothelial Ki-67 or cleaved Caspase-3 expression between treatment groups, indicating that the observed reduction in vascular density is not associated with direct effects on endothelial cell proliferation or apoptosis, but rather may occur indirectly through attenuation of the pro-angiogenic inflammatory milieu. Exploratory sex-stratified analysis revealed that treatment-naive males had significantly higher endothelial proliferation (Ki-67; p = 0.031) and vimentin expression (p = 0.017) compared to treatment-naive females. In the ADA-treated group, males exhibited significantly lower vascular density (p = 0.036) and higher endothelial apoptosis (p = 0.039) compared to females, whereas females showed a significant increase in vimentin expression following treatment (p = 0.008), suggesting possible sex-dependent differences in vascular remodeling. Conclusions: TNF-α blockade is associated with reduced vascular density, consistent with indirect anti-angiogenic effects, suggesting that adalimumab exerts disease-modifying effects on the microenvironment beyond inflammatory cytokine suppression. Sex-dependent differences in vascular regression underscore the importance of considering sex as a biological variable in HS pathogenesis and treatment response. These results highlight the significance of vascular interactions in HS and support adalimumab as a disease-modifying treatment. These exploratory findings require confirmation in longitudinal studies with paired biopsies.
Background/Objectives: The aim of this study was to assess the extent to which published abstracts of randomized controlled trials on diabetic foot complied with the Consolidated Standards of Reporting Trials for Abstracts (CONSORT-A) guidelines and to identify factors associated with the quality of reporting. Methods: A cross-sectional observational study was designed using the MEDLINE/PubMed database, and the timeframe from 1994 to 2026 was covered by this review. In total, 606 abstracts of randomized controlled trials (RCTs) focusing on diabetic foot were assessed for compliance with the CONSORT-A checklist criteria. Results: Ratio of non-pharmacological and pharmacological studies was approximately 1:1. Most of the included abstracts did not report a multicenter design (84.3%) and reported less than one hundred participants included (78.9%). The median total score was six of 17 items (35.29%, IQR 29.41–47.06%). The objective of the study, conclusion and intervention had been reported by over ninety percent of the studies. Randomization method (3.6%), funding (4.8%), recruitment process (6.8%) and numbers of analyzed participants in the study (7.4%) were all reported by less than ten percent of the abstracts. Following CONSORT-A, in 2008, median abstract reporting score improved from 35.29% to 41.18% (p < 0.001). Conclusions: However, segmented regression showed a secular trend of +0.63 percentage points per year (95% CI 0.14–1.12, p = 0.012) with no change in level (p = 0.261) or slope (p = 0.278) at 2008, indicating that the improvement is not attributable to the guideline itself.