Multifocal Fibrosing Thyroiditis: an Under-recognized Mimicker of Papillary Thyroid Carcinoma

Multifocal fibrosing thyroiditis (MFT) is an enigmatic entity, characterized by multiple fibrotic scar-like lesions with a paucicellular fibrotic center surrounded by a cellular peripheral area with reactive-appearing follicular cell atypia and variable chronic inflammation. Although poorly recognized and likely underreported in surgical pathology, the entity is considered rare with only 65 cases to date–including the current one reported to expand on the preoperative findings of this under-recognized entity. The average age of the patients is 46.8 years (range 15–71 years), 94% are female, with female to male ratio of 15:1. Individual MFT lesions typically have a superficial location. The average number of fibrotic lesions is 15.4 (range 2–51 per MFT case). Their average size is 3.1 mm (range 0.4–15.1). MFT is a disorder of diseased thyroids, typically found postoperatively in glands removed for other reasons, such as chronic lymphocytic/Hashimoto thyroiditis (32.3%), follicular nodular disease (nodular hyperplasia) (30.1%), hyperthyroidism/diffuse hyperplasia (Graves disease) (9.2%). Intriguing is the association with papillary thyroid carcinoma–present in 38.5% of MFT cases, and particularly with sub-centimetric and multifocal papillary thyroid carcinoma, with which MFT can be confused. Cases where MFT is the only thyroid pathology (7.7%) can be preoperatively mistaken for papillary thyroid carcinoma, due to worrisome ultrasound (US) and cytologic features, both of which are here documented for the first time as a component of this article. Wider recognition of MFT and of its cytologic and ultrasound features at preoperative evaluation may reduce unnecessary thyroidectomies

Do Micronutrient and Omega-3 Fatty Acid Supplements Affect Human Maternal Immunity during Pregnancy? A Scoping Review

Maternal dietary micronutrients and omega-3 fatty acids support development of the fetal and neonatal immune system. Whether supplementation is similarly beneficial for the mother during gestation has received limited attention. A scoping review of human trials was conducted looking for evidence of biochemical, genomic, and clinical effects of supplementation on the maternal immune system. The authors explored the literature on PubMed, Cochrane Library, and Web of Science databases from 2010 to the present day using PRISMA-ScR methodology. Full-length human trials in English were searched for using general terms and vitamin A, B12, C, D, and E; choline; iodine; iron; selenium; zinc; and docosahexaenoic/eicosapentaenoic acid. Of 1391 unique articles, 36 were eligible for inclusion. Diverse biochemical and epigenomic effects of supplementation were identified that may influence innate and adaptive immunity. Possible clinical benefits were encountered in malaria, HIV infections, anemia, Type 1 diabetes mellitus, and preventing preterm delivery. Only limited publications were identified that directly explored maternal immunity in pregnancy and the effects of micronutrients. None provided a holistic perspective. It is concluded that supplementation may influence biochemical aspects of the maternal immune response and some clinical outcomes, but the evidence from this review is not sufficient to justify changes to current guidelines.</jats:p

ETV6::ABL1-Positive Myeloid Neoplasm: A Case of a Durable Response to Imatinib Mesylate without Additional or Previous Treatment

ETV6::ABL1 rearranged neoplasms are rare hematological diseases. To date, about 80 cases have been reported, including myeloid and lymphoid leukemias. The ETV6 gene codes for an ETS family transcription factor and several fusion partners have been described. When translocated, ETV6 causes the constitutive activation of the partner genes. Here, we report the case of a 54-year-old woman with a cryptic insertion of the 3′ region of ABL1 in the ETV6 gene. The patient was first diagnosed with idiopathic hypereosinophilic syndrome, according to the clinical history, conventional cytogenetics, standard molecular analyses and pathologist description. Next generation sequencing of diagnosis samples unexpectedly detected both ETV6::ABL1 type A and B fusion transcripts, which were then confirmed by FISH. The diagnosis was Myeloid/Lymphoid neoplasm with ETV6::ABL1 fusion, and the patient received imatinib mesylate treatment. In a follow-up after more than one year, the patient still maintained the molecular and complete hematological responses. This case highlights the importance of timely and proper diagnostics and prompt tyrosine kinase inhibitor treatment

Polarization in young open cluster NGC 6823

We present multiwavelength linear polarimetric observations of 104 stars towards the region of young open cluster NGC 6823. The polarization towards NGC 6823 is dominated by foreground dust grains and we found the evidence for the presence of several layers of dust towards the line of sight. The first layer of dust is located approximately within 200 pc towards the cluster, which is much closer to the Sun than the cluster (~ 2.1 kpc). The radial distribution of the position angles for the member stars are found to show a systematic change while the polarization found to reduce towards the outer parts of the cluster and the average position angle of coronal region of the cluster is very close to the inclination of the Galactic parallel (~ 32 degree). The size distribution of the grains within NGC 6823 is similar to those in general interstellar medium. The patchy distribution of foreground dust grains are suggested to be mainly responsible for the both differential reddening and polarization towards NGC 6823. The majority of the observed stars do not show the evidence of intrinsic polarization in their light.Comment: 16 pages, 6 tables, 11 figures, Accepted for publication in MNRA

IDENTIFICAZIONE DELLE LESIONI POLMONARI IN RM CON UNA SEQUENZA VIBE MODIFICATA E CON UNA SEQUENZA VIBE STANDARD: UN CONFRONTO CON LA TC.

Scopo valutare l\u2019accuratezza della RM a 3 Tesla nell\u2019individuazione di lesioni polmonari con una sequenza VIBE modificata e con una sequenza VIBE standard, usando la TC come riferimento. Materiale e metodi abbiamo rivalutato retrospettivamente 37 pazienti oncologici (11 pediatrici e 26 adulti; 19 F) sottoposti a TC e PET/RM da 3T il cui protocollo prevedeva una sequenza VIBE acquisita a respiro trattenuto con echo time (TE) di 0.89 ms e flip angle (FA) di 3\ub0. Le VIBE sono state valutate da tre osservatori per l'identificazione di noduli >5mm o =5mm. Un quarto osservatore ha valutato delle sequenze VIBE standard (TE di 1.2 ms e FA di 10\ub0), anch\u2019esse incluse nel protocollo, ed infine un quinto lettore ha analizzato le immagini TC (considerate come standard di riferimento).Sia per paziente che per singola lesione sono state calcolate sensibilit\ue0 e specificit\ue0 per le due categorie di noduli ed il coefficiente di correlazione intraclasse (ICC) per i lettori delle VIBE modificate. Risultati analisi per paziente (positivit\ue0=1 lesione): sensibilit\ue0 84.6% e specificit\ue0 di 100% per noduli>5mm (VIBE standard 69.2% e 100%) e 44.4% e 100% per noduli=5mm (VIBE standard 33.3% e 100%). Analisi per lesione (presenza/assenza): sensibilit\ue0 di 83.9% per noduli>5mm (VIBE standard 67.74%) e 37.5% per noduli=5mm (VIBE standard 18.7%). L\u2019ICC nell\u2019analisi per paziente era 0.911 per noduli>5mm e 0.902 per noduli=5mm; nell\u2019analisi per lesione 0.866 per noduli>5mm e 0.699 per noduli=5mm. Conclusioni la sequenza VIBE modificata \ue8 riproducibile ed accurata per l\u2019individuazione di noduli >5mm, mentre l\u2019accuratezza risulta meno soddisfacente per i noduli=5mm. L\u2019utilizzo della sequenza modificata nei protocolli RM sembra ragionevole per migliorare la visualizzazione del polmone

Broad-band Optical Polarimetric Studies toward the Galactic young star cluster Be 59

We present multiwavelength optical linear polarimetric observations of 69 stars toward the young open cluster Be 59. The observations reveal the presence of three dust layers located at the distances of \sim300, \sim500 and \sim700 pc. The dust layers produce a total polarization Pv \sim 5.5 per cent. The mean values of polarization and polarization angles due to the dust layers are found to increase systematically with distance. We show that polarimetry in combination with the (U - B) - (B - V) colour-colour diagram yields a better identification of cluster members. The polarization measurements suggest that the polarization due the intra-cluster medium is \sim 2.2 per cent. An anomalous reddening law exists for the cluster region, indicating a relatively larger grain size than that in the diffuse ISM. The spatial variation of the polarization and E(B - V) is found to increase with radial distance from the cluster center, whereas the {\theta}v and {\lambda}max are found to decrease with increasing radial distance from the cluster center. About 40 per cent of cluster members show the signatures of either intrinsic polarization or rotation in their polarization angles. There is an indication that the star light of the cluster members might have been depolarized because of non-uniform alignment of dust grains in the foreground dust layers and in the intra-cluster medium.Comment: 22 pages, 14 figures and 7 tables, Accepted in MNRA

Multi-wavelength polarimetric study towards the open cluster NGC 1893

We present multi-wavelength linear polarimetric observations for 44 stars of the NGC 1893 young open cluster region along with V-band polarimetric observations of stars of other four open clusters located between l ~160 to ~175 degree. We found evidence for the presence of two dust layers located at a distance of ~170 pc and ~360 pc. The dust layers produce a polarization Pv ~2.2%. It is evident from the clusters studied in the present work that, in the Galactic longitude range l ~160 to 175 degree and within the Galactic plane (|b| < 2 degree), the polarization angles remain almost constant, with a mean ~163 degree and a dispersion of 6 degree. The small dispersion in polarization angle could be due to the presence of uniform dust layer beyond 1 kpc. Present observations reveal that in case of NGC 1893, the foreground two dust layers, in addition to the intracluster medium, seems to be responsible for the polarization effects. It is also found that towards the direction of NGC 1893, the dust layer that exists between 2-3 kpc has a negligible contribution towards the total observed polarization. The weighted mean for percentage of polarization (Pmax) and the wavelength at maximum polarization ({\lambda}max) are found to be 2.59 \pm 0.02% and 0.55 \pm 0.01 \mum respectively. The estimated mean value of {\lambda}max indicates that the average size of the dust grains within the cluster is similar to that in the general interstellar medium. The spatial variation of the polarization is found to decrease towards the outer region of the cluster. In the present work, we support the notion, as already has been shown in previous studies, that polarimetry, in combination with (U-B)/(B-V) colour-colour diagram, is a useful tool for identifying non-members in a cluster.Comment: 36 pages, 12 figures, 10 tables, accepted for the publication in MNRA