A minute focus of extranodal marginal zone B-cell lymphoma arising in Hashimoto thyroiditis diagnosed with PCR after laser capture microdissection: a case report

<p>Abstract</p> <p>Background</p> <p>Primary thyroid gland lymphomas are uncommon tumours that occur in the setting of lymphocytic thyroiditis or Hashimoto's disease in almost all cases. In this condition a distinction between an inflammatory lymphoid infiltrate and a low grade lymphoma may be extremely difficult and precise criteria are necessary for a correct diagnosis.</p> <p>Patient and methods</p> <p>We report a case of a minute focus of primary extranodal marginal zone B-cell lymphoma (EMZBCL), incidentally discovered in a 63-year-old man with Hashimoto thyroiditis (HT) and diagnosed by means of polymerase chain reaction (PCR) after laser capture microdissection.</p> <p>The histological examination of surgical specimen confirmed the diagnosis of HT and showed a minute focus of dense lymphoid infiltrate (less than 4 mm in diameter), composed by centrocyte-like cells forming MALT balls. Immunoistochemistry was not useful. A microscopic focus of EMZBCL was suspected on the basis of morphological features. PCR assays revealed the rearrangement of the heavy chain of immunoglobulins only in the microdissected suspicious area, confirming the diagnosis of EMZBCL.</p> <p>Conclusion</p> <p>Our finding suggests that in cases of autoimmune thyroiditis a careful examination of the thyroid specimen is warranted, in order to disclose areas or small foci of lymphomatous transformation. Furthermore, in difficult cases with doubtful immunohistological findings, ancillary techniques, such as molecular studies, are necessary for a conclusive diagnosis.</p

Soil bulk electrical resistivity and forage ground cover: nonlinear models in an alfalfa (Medicago sativa L.) case study

Alfalfa is a highly productive and fertility-building forage crop; its performance, can be highly variable as influenced by within-field soil spatial variability. Characterising the relations between soil and forage- variation is important for optimal management. The aim of this work was to model the relationship between soil electrical resistivity (ER) and plant productivity in an alfalfa (Medicago sativa L.) field in Southern Italy. ER mapping was accomplished by a multi-depth automatic resistivity profiler. Plant productivity was assessed through normalised difference vegetation index (NDVI) at 2 dates. A non-linear relationship between NDVI and deep soil ER was modelled within the framework of generalised additive models. The best model explained 70% of the total variability. Soil profiles at six locations selected along a gradient of ER showed differences related to texture (ranging from clay to sandy-clay loam), gravel content (0 to 55%) and to the presence of a petrocalcic horizon. Our results prove that multi-depth ER can be used to localise permanent soil features that drive plant productivity

Soil Sealing: Quantifying Impacts on Soil Functions by a Geospatial Decision Support System

Soil sealing is considered among the most dangerous of land degradation processes on global, European and national scales. Despite important policy documents aiming to mitigate this soil threat, it currently shows no signs of abating, and current efforts often do not result in appropriate implementation of soil sealing mitigation in spatial planning, which represents the subject area governing soil sealing. In this paper, we show a spatial decision support system â\u80\u93 based on a Geospatial Cyberinfrastructure â\u80\u93 with the aim of applying it as an operational instrument aiming towards soil sealing mitigation. The system has the ambition to impact on those who take decision over soil sealing; typically, these are not agriculture experts but rather spatial planners. This tool, focusing on mitigating such crucial land degradation, allows the users â\u80\u93 via the Web â\u80\u93 to produce â\u80\u98what-ifâ\u80\u99 land planning scenarios thanks to the â\u80\u98on-the-flyâ\u80\u99 modelling engines. Therefore, integrated geospatial quantitative data and procedures may be directly and freely used by planners. The tool has been applied to and tested in an area in the South of Italy. Results from two applications are reported: one addressing municipal planning and the other on a more detailed spatial scale. Furthermore, results include quantification of rural fragmentation, loss of soil ecosystem services and an estimate of soil sealing evolution over time. The tool was developed with the help of end users and indirectly explores a change of paradigm where soil science and landscape/urban planning work together to provide operational instruments that may be adopted by local communities in addressing soil sealing issues with a proactive approach. Copyright © 2017 John Wiley & Sons, Ltd

Appendectomy during the COVID-19 pandemic in Italy: a multicenter ambispective cohort study by the Italian Society of Endoscopic Surgery and new technologies (the CRAC study)

Major surgical societies advised using non-operative management of appendicitis and suggested against laparoscopy during the COVID-19 pandemic. The hypothesis is that a significant reduction in the number of emergent appendectomies was observed during the pandemic, restricted to complex cases. The study aimed to analyse emergent surgical appendectomies during pandemic on a national basis and compare it to the same period of the previous year. This is a multicentre, retrospective, observational study investigating the outcomes of patients undergoing emergent appendectomy in March–April 2019 vs March–April 2020. The primary outcome was the number of appendectomies performed, classified according to the American Association for the Surgery of Trauma (AAST) score. Secondary outcomes were the type of surgical technique employed (laparoscopic vs open) and the complication rates. One thousand five hundred forty one patients with acute appendicitis underwent surgery during the two study periods. 1337 (86.8%) patients met the inclusion criteria: 546 (40.8%) patients underwent surgery for acute appendicitis in 2020 and 791 (59.2%) in 2019. According to AAST, patients with complicated appendicitis operated in 2019 were 30.3% vs 39.9% in 2020 (p = 0.001). We observed an increase in the number of post-operative complications in 2020 (15.9%) compared to 2019 (9.6%) (p &lt; 0.001). The following determinants increased the likelihood of complication occurrence: undergoing surgery during 2020 (+ 67%), the increase of a unit in the AAST score (+ 26%), surgery performed &gt; 24&nbsp;h after admission (+ 58%), open surgery (+ 112%) and conversion to open surgery (+ 166%). In Italian hospitals, in March and April 2020, the number of appendectomies has drastically dropped. During the first pandemic wave, patients undergoing surgery were more frequently affected by more severe appendicitis than the previous year's timeframe and experienced a higher number of complications. Trial registration number and date: Research Registry ID 5789, May 7th, 2020