Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy) is a newer pathological entity described in 1969. It is a self-limiting disorder of unknown aetiology. It is likely to be mistaken for lymphoma. It predominantly affects children and adolescents. However there are no publications on this disorder in the paediatric surgical literature. In this report we describe a 3-year-old girl who presented with this disease and we critically review the therapeutic options available for children. Prednisolone therapy with long-term follow-up appears to be sufficient. Surgery should be limited to biopsy and relief of compression symptoms.
Introduction:
The association between inflammation and malignancies is being recognized. In this study, we assessed the use of preoperative neutrophil–lymphocyte ratio (NLR) and lymphocyte–monocyte ratio (LMR) in predicting cancer-specific survival (CSS) and inguinal node involvement in patients with carcinoma penis.
Methods:
Sixty-nine patients operated for squamous cell carcinoma penis with inguinal node dissection between 2012 and 2020 were identified. We recorded the type of surgery (partial/total penectomy), T stage, grade, lymphovascular invasion (LVI), perineural invasion (PNI), pathological status of inguinal nodes and nodal stage (pN1–3), extranodal extension (ENE), and CSS. The hemogram performed within 2 weeks of surgery was used for calculating NLR and LMR.
Results:
Partial penectomy was the most common surgery (65.22%) and pT2 was the most common stage (53.62%). Grade 2 was seen in 66.67%, LVI in 34.78%, PNI in 37.68%, 52.17% had inguinal node involvement with pN3 being the most common (36.23%), and 36.23% had ENE. Kaplan–Meier analysis revealed that NLR of >3 and the LMR ≤3 indicated an inferior CSS (
P
= 0.05 and 0.04, respectively). T stage, inguinal node involvement, LVI, pN stage, and ENE were also associated with inferior CSS (
P
< 0.05). On multivariate analysis, T stage was significantly associated with CSS (
P
= 0.02). The NLR >3 and LMR ≤3 were also significantly associated with the presence of pathological inguinal node involvement (
P
= 0.001 and 0.026).
Conclusion:
NLR and LMR may help in predicting CSS and inguinal node involvement in patients of carcinoma penis.
Recent advances in digital imaging technology have greatly enhanced the interpretation of critical/pathology conditions from the 2-dimensional medical images. This has become realistic due to the existence of the computer aided diagnostic tool. A computer aided diagnostic (CAD) tool generally possesses components like preprocessing, identification/selection of region of interest, extraction of typical features and finally an efficient classification system. This paper enumerates on development of CAD tool for classification of chronic liver disease through the 2-D image acquired from ultrasonic device. Characterization of tissue through qualitative treatment leads to the detection of abnormality which is not viable through qualitative visual inspection by the radiologist. Common liver diseases are the indicators of changes in tissue elasticity. One can show the detection of normal, fatty or malignant condition based on the application of CAD tool thereby, further investigation required by radiologist can be avoided. The proposed work involves an optimal block analysis (64 x 64) of the liver image of actual size 256 x 256 by incorporating Gabor wavelet transform which does the texture classification through automated mode. Statistical features such as gray level mean as well as variance values are estimated after this preprocessing mode. A non-linear back propagation neural network (BPNN) is applied for classifying the normal (vs) fatty and normal (vs) malignant liver which yields a classification accuracy of 96.8%. Further multi classification is also performed and a classification accuracy of 94% is obtained. It can be concluded that the proposed CAD can be used as an expert system to aid the automated diagnosis of liver diseases.
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