Application of the Kvaal Method in Age Estimation of the Serbian Population Based on Dental Radiographs

This study aimed to evaluate the applicability of the Kvaal method in determining the age of a Serbian population. In this retrospective descriptive study, 170 dental patients (age range 16–77 years) were included. The measurements of six types of teeth were performed on digital orthopantomography radiographs according to the Kvaal method. Statistical inter-observer and intra-observer reliabilities were calculated to evaluate the reproducibility of the measurements, as well as to examine the correlation between chronological age and measured values. The evaluation revealed a substantial difference (over 12 years) between chronological and estimated age. The P ratio had the strongest correlation with chronological age for the maxillary central (r = ±0.293) and lateral incisors (r = ±0.240), whereas the pulp/root width ratio at level A had the strongest correlation for the mandibular first premolars (r = ±0.270). The lowest SD values, for measurements on teeth 15/25 (SD = 125,787), had the most accurate correlation with age. Thus, we can conclude that the original Kvaal method is not applicable in the age estimation of the Serbian population. For future research, we suggest using cone beam computer tomography as a precise technology to evaluate the applicability of Kvaal and other methods for age estimation

Ascites as First Atypical and Only Clinical Manifestation of De Novo Follicular Lymphoma

Follicular lymphoma is the most common indolent non-Hodgkin’s lymphoma and is usually initially detected in lymph nodes. Primary extranodal NHL is most commonly primarily localized in the gastrointestinal tract. We present one unusual case of ileum FL with ascites as the first clinical sign. The 73-year-old female patient was presented to the emergency department for evaluation of mild abdominal pain and abdominal swelling that had been going on for three days followed by bloating and occasional pain in the spine. The abdominal contrast-enhanced CT revealed the contrast stagnation in the distal part of the ileum. The ileum wall about 11 cm in length was thickened up to 2.9 cm and the tumor mass infiltrated all layers of ileum mesenteric lymphadenopathy up to 2 cm in diameter and significant ascites. On the upper ileum wall, the vegetative mass was described 3 cm in diameter. The patient had an emergent laparotomy with the ileocolic resection and latero-lateral ileocolic anastomosis. The microscopy finding of terminal ileum and the regional lymph nodes showed domination of cleaved cells with irregular nuclei which correspond to centrocytes. There were 0–15 large non-cleaved cells corresponding to centroblast in the microscopy high-power field. The final diagnosis was follicular lymphoma, the clinical stage 2E and histological grade by Berard and Mann criteria 1–2

Exploring Perforated Jejunal GIST: A Rare Case Report and Review of Molecular and Clinical Literature

This case report details a rare instance of a perforated jejunal gastrointestinal stromal tumor (GIST) in a 76-year-old female patient. The patient presented with acute abdominal pain and distension without any changes in bowel habits or episodes of nausea and vomiting. Initial diagnostics, including abdominal plain radiography and ultrasonography, were inconclusive; however, a computed tomography (CT) scan revealed pneumoperitoneum and an irregular fluid collection suggestive of small intestine perforations. Surgical intervention uncovered a 35 mm jejunal GIST with a 10 mm perforation. Histopathological examination confirmed a mixed cell type GIST with high malignancy potential, further substantiated by immunohistochemistry markers CD117, DOG1, and vimentin. Molecular analysis illuminated the role of key oncogenes, primarily KIT and PDGFRA mutations, emphasizing the importance of molecular diagnostics in GIST management. Despite the severity of the presentation, the patient’s postoperative recovery was favorable, highlighting the effectiveness of prompt surgical and multidisciplinary approaches in managing complex GIST cases