Inflamed Non-Limbal Scleral Dermoid Masquerading as Nodular Scleritis

Background: Dermoid cysts are one of the most common orbital lesions in childhood. They typically present as a palpable subcutaneous mass in the superotemporal region along the frontozygomatic suture. When involving the eye, ocular dermoids typically present as visible lesions at the limbus. Clinical Case Report: A five-year-old male presented with focal injection of the left nasal conjunctiva sparing the limbus that progressed to a non-mobile scleral nodule with overlying 3+ injection, tenderness to palpation, and minimal blanching with phenylephrine suspicious for nodular scleritis versus abscess. The inflammation improved, but the nodule persisted despite treatment with topical antibiotics, steroids, and oral NSAIDs. Superonasal subconjunctival excisional biopsy revealed an 8mm mass with a visible hair protruding from lesion, with pathological analysis revealing findings of acutely inflamed dermoid cyst. Discussion: To our knowledge, this is the first documented case of a non-limbal ocular dermoid masquerading as nodular scleritis.https://scholarlycommons.henryford.com/merf2020caserpt/1048/thumbnail.jp

Search for gravitational-lensing signatures in the full third observing run of the LIGO-Virgo network

Gravitational lensing by massive objects along the line of sight to the source causes distortions of gravitational wave-signals; such distortions may reveal information about fundamental physics, cosmology and astrophysics. In this work, we have extended the search for lensing signatures to all binary black hole events from the third observing run of the LIGO--Virgo network. We search for repeated signals from strong lensing by 1) performing targeted searches for subthreshold signals, 2) calculating the degree of overlap amongst the intrinsic parameters and sky location of pairs of signals, 3) comparing the similarities of the spectrograms amongst pairs of signals, and 4) performing dual-signal Bayesian analysis that takes into account selection effects and astrophysical knowledge. We also search for distortions to the gravitational waveform caused by 1) frequency-independent phase shifts in strongly lensed images, and 2) frequency-dependent modulation of the amplitude and phase due to point masses. None of these searches yields significant evidence for lensing. Finally, we use the non-detection of gravitational-wave lensing to constrain the lensing rate based on the latest merger-rate estimates and the fraction of dark matter composed of compact objects

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M>70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0<e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level

Ultralight vector dark matter search using data from the KAGRA O3GK run

Among the various candidates for dark matter (DM), ultralight vector DM can be probed by laser interferometric gravitational wave detectors through the measurement of oscillating length changes in the arm cavities. In this context, KAGRA has a unique feature due to differing compositions of its mirrors, enhancing the signal of vector DM in the length change in the auxiliary channels. Here we present the result of a search for U(1)B−L gauge boson DM using the KAGRA data from auxiliary length channels during the first joint observation run together with GEO600. By applying our search pipeline, which takes into account the stochastic nature of ultralight DM, upper bounds on the coupling strength between the U(1)B−L gauge boson and ordinary matter are obtained for a range of DM masses. While our constraints are less stringent than those derived from previous experiments, this study demonstrates the applicability of our method to the lower-mass vector DM search, which is made difficult in this measurement by the short observation time compared to the auto-correlation time scale of DM

Clinical-pathological correlation in a case of idiopathic eruptive macular pigmentation (IEMP)

Idiopathic Eruptive Macular Pigmentation (IEMP) is a rare conditioncharacterized by asymptomatic macular pigmentation. We present a casereport of an 8-year-old white girl presenting with diffuse brown non-scalymacules on neck, chest, back, arms and legs with no other symptoms. Theonset was abrupt and no suspicious contact with similar rash is stated. Patienthas history of asthma; however, she had no recent dermal inflammatoryincident. Family history is negative. With clinical suspicion of Lichen Planus(LP), a 4-mm punch biopsy of skin lesion was performed. The histopathological examination revealed increased superficial dermal melanophages withpigment incontinence with no epidermal changes and no increased mast cellcount, consistent with IEMP. No definite features of LP, LP variant or LPPigmentosus were identified. Since IEMP is a self-limiting disease, shereceived no treatment; however, parents were advised to follow up in case ofthe eruption of new lesions. After one year of follow up, the pigments hasdecreased marginally; which is consistent with natural course of IEMP

Methimazole induced cutaneous leukocytoclastic vasculitis (LCV) in Anca negative patient

A 64 y.o. Caucasian female with past medical history of hypertension, diabetes, asthma, and Graves\u27 disease with progressive dyspnea secondary to exudative large pleural effusion with a differential diagnosis of neoplastic, collagen vascular or drug induced lung disease. The patient was admitted with uncontrolled hypertension and Graves\u27 disease and started on metopro-lol, lisinopril and methimazole. One week later she developed small red macules on her forearms, hands, and ankles (Figures 1 and 2). ANA was positive but ANCA was negative. Left forearm punch biopsy showed prominent superficial perivascular neutrophilic leukocytoclasia and purpura with abundant eosinophils (Figures 3 and 4) and accompanying positive DIF findings (IgG and C3: 3+ interrupted granular staining in superficial dermal vessel walls. IgM, IgA and Fibrinogen: negative) favoring a drug associated ANCA-negative LCV. The macular rash improved after discontinuing me-thimazole. In conclusion, the association between DIF positive LCV and Methimazole with a negative ANCA is rare and should be considered in the clinical differential of drug induced palpable purpura indicating skin biopsy and DIF confirmation

Metastatic small round blue cell tumor. A genetic puzzle.

Small round blue cell tumor represents a group of the aggressive solid tumors which are mostly found in pediatric and young adolescent population. Case presentation: A 26 year old male with history of enlarging right groin mass for several months with no recent work up who presented with progressively worsening shortness of breath over the past two weeks. CT chest revealed mediastinal lymphadenopathy with diffuse pulmonary nodules and septal thickening throughout both lungs. Patient developed spontaneous pneumothorax of left lung which was managed by 28 Fr chest tube placement. Bronchoscopy was performed which revealed diffuse whitish nodules throughout endobronchial mucosa (Figure1). Endobronchial biopsy showed small round blue cell tumor (SRBCT). The biopsy of right groin mass also confirmed the diagnosis of SRBCT. Immunohistochemical staining was positive for CAM 5.2 and Desmin, but negative for CD56 and leukocyte common antigen. RT-PCR for EWS-Fli1 and EWS-ERG were negative. Break apart FISH for EWSR1 was positive. Follow-up PCR was positive for Ewing sarcoma gene (EWS) and Wilms\u27 tumor gene (WT1) rearrangement, indicating presence of t(11;22)(p13;q12). These findings are consistent with desmoplastic small round cell tumor (DSRCT). Patient received the first round chemotherapy regimen with vincristine, cyclophosphamide, and doxorubicin. Discussion: Malignant small round blue cell tumors (SRBCT) is a group of morphologically similar rare tumors that include: Ewing sarcoma family of tumors (EFT), peripheral primitive neuroectodermal tumor (PNET), small cell osteosarcoma, mesenchymal chondrosarcoma and DRSCT among others. Therefore, accurate sub-typing is essential because therapeutic options and prognoses very widely depending on the diagnosis. These cancers are difficult to distinguish by light microscopy, and currently no single test can precisely distinguish these cancers. To confirm the diagnosis, pathologists rely on several techniques, including immunohistochemistry, cytogenetics, interphase fluorescence in situ hybridization, and reverse transcription-polymerase chain reaction (RT-PCR). The presence of the specific cytogenetic abnormality t(11;22)(p13;q12) involving EWS- WT1 fusion confirms the diagnosis. The prognosis of DSRCT remains very poor with 5-year survival rate of 15%. The treatment with intense alkylator therapy (P6 protocol), and gross total resection and external beam radiotherapy seemed to improve overall survival. (Figure Presented)