Age-related brain atrophy is a common finding, but neurodegenerative diseases such as Alzheimer's disease are associated with accelerated atrophy of the medial temporal lobe. In current practice for brain atrophy evaluation, several rating scales are being used such as the medial temporal atrophy (MTA), global cortical atrophy-frontal subscale (GCA-F) and posterior atrophy (PA) scales. Practical cut-offs to differentiate between normal and advanced brain atrophy are needed, because of their possible usefulness as a biomarker. A retrospective study was performed over a 1-year period resulting in a total of 79 subjects [27 patients with Alzheimer's disease (AD), 27 patients with minimal cognitive impairment (MCI) and 25 control subjects]. The MTA, GCA-F and PA scales were applied blinded and independent by two raters. Possible age- and disease-related cut-offs were computed. The MTA scale showed significantly better diagnostic performances and inter-rater agreement than the PA and GCA-F scales. We could not confirm the suggested MTA cut-off for each decade. However, an MTA score of >1 and >1.75 was considered pathological, respectively, in the population under and over 70 years. MTA can be of use in making distinction between age-related atrophy and abnormal increase of atrophy. Systematic assessment of regional brain atrophy through the use of MTA in MRI images could be a useful biomarker in aiding the early diagnosis of Alzheimer's disease.
Introduction: Fibroepithelial breast lesions are biphasic neoplasms characterized by proliferation of both stromal and epithelial cells. They encompass a spectrum of tumors ranging from benign fibroadenoma to potentially fatal malignant phyllodes tumor, with tumors of borderline clinical significance in-between. It is important to correctly characterize each lesion, as this defines management and thus risk of local recurrence and potential distant metastasis in case of malignancy.Case Report: A 48-year-old woman presented with a palpable retro-areolar lump in the left breast. After core biopsy, the initial pathology report initiated tumorectomy. When the final report stated a borderline phyllodes tumor with incomplete resection, reintervention was needed with wide surgical margins to avoid local recurrence. The local re-excision showed scarring and steatonecrosis as a result of the previous procedure, but no residual lesion. Consequently, there was no need for further surgical intervention.
Conclusion:Fibroepithelial lesions (FEL) of the breast are a wide variety of lesions with distinct management based on the exact pathologic character. Core needle
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