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Shaker N, Amadi CC, Ganapathi AM, Satturwar S, Shilo K. Pulmonary Histoplasmosis Complicated by Nonvalvular Right Ventricular Wall Histoplasma capsulatum Endocarditis. Int J Surg Pathol 2024; 32:565-569. [PMID: 37424325 PMCID: PMC11025303 DOI: 10.1177/10668969231185079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/02/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023]
Abstract
Histoplasmosis is commonly a self-limited fungal disease that primarily affects the lung and reticuloendothelial system. Cardiac involvement by histoplasmosis is uncommon. In this report, we provide a detailed description of severe pulmonary histoplasmosis complicated by the disease involvement of the free wall of the right ventricle. A 55-year-old female presented with cough, fevers, dyspnea, and 30-pound unintentional weight loss in 6 months. Her past medical history was significant for supraventricular tachycardia with permanent pacemaker implantation. Imaging studies revealed an intracardiac mass accompanied by mediastinal lymphadenopathy and bilateral lung nodules. Endobronchial ultrasound-guided transbronchial needle aspiration of station 4R lymph nodes revealed numerous yeast forms, morphologically consistent with Histoplasma capsulatum. The diagnosis was further corroborated by the elevated titers of serum antibodies against Histoplasma capsulatum. The right ventricular mass debulking with biopsy showed necrotizing granulomatous inflammation involving nonvalvular endocardium and myocardium of the free wall of the right ventricle. The report documents an unusual presentation of pulmonary histoplasmosis accompanied by nonvalvular endocarditis and suggests a possible association between the site of the cardiac infection and the presence of a permanent intravascular pacer device.
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Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Chiemezie C. Amadi
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Asvin M. Ganapathi
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Swati Satturwar
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Konstantin Shilo
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Shaker N, Amadi CC, Welliver M, Otterson GA, Liebner DA, Shilo K. A Case of Mediastinal Carcinosarcoma With Beta-HCG Production and KRAS Mutation. Int J Surg Pathol 2023; 31:1598-1604. [PMID: 37013353 PMCID: PMC10616989 DOI: 10.1177/10668969231166297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Carcinosarcomas of mediastinum are rare and only few well-documented cases are available in the literature. We report a detailed description of mediastinal carcinosarcoma with unique clinical manifestations and immunohistochemical and molecular profiles. A 44-year-old female with an enlarging anterior mediastinal mass was found to have a positive pregnancy test. Thoracoscopic biopsy revealed that the mass represented a carcinosarcoma with adenocarcinoma and chondrosarcoma components. The tumor focally expressed beta-HCG by immunohistochemistry and had KRAS G12A missense mutation by next generation sequencing. The case documents a rare presentation of carcinosarcoma within the mediastinum with uncommon paraneoplastic syndrome and genetic profile. Awareness of these unusual clinical and pathological manifestations of the tumor will help in reaching correct diagnosis and proper management of such patients.
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Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Chiemezie C Amadi
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Meng Welliver
- Division of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Gregory A Otterson
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - David A Liebner
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Konstantin Shilo
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Kneuertz PJ, Yudovich MS, Amadi CC, Bashian E, D'Souza DM, Abdel-Rasoul M, Merritt RE. Pulmonary artery size on computed tomography is associated with major morbidity after pulmonary lobectomy. J Thorac Cardiovasc Surg 2021; 163:1521-1529.e2. [PMID: 33685731 DOI: 10.1016/j.jtcvs.2021.01.124] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To investigate the relationship of pulmonary artery diameter (PAD) measured by computed tomography (CT) with outcomes following lobectomy. METHODS Records of patients undergoing pulmonary lobectomy for lung cancer between 2011 and 2018 were reviewed. Baseline characteristics and postoperative outcome data were derived from the institutional Society of Thoracic Surgeons database. Luminal diameter of the central pulmonary arteries and ascending aorta were measured on preoperative CTs. Logistic regression analyses were performed to test the association of PAD with complications. RESULTS A total of 736 lobectomy patients were included, who had a preoperative CT scan (25% with contrast, 75% noncontrast) available for review. A total of 141 (19.2%) patients had an enlarged main PAD ≥30 mm, and 58 (7.9%) patients had a main PAD that was larger than the ascending aorta (PA/ascending aorta ratio > 1). The right or left PAD on the surgical side was associated with major complication (odds ratio per mm, 1.12; 95% confidence interval, 1.05-1.18; P < .001), unexpected intensive care unit admission (odds ratio per millimeter, 1.11; 95% confidence interval, 1.04-1.19; P = .002), and 30-day mortality (odds ratio per millimeter, 1.25; 95% confidence interval, 1.06-1.46; P = .007). On multivariable analysis, adjusted for cardiovascular comorbidities, pulmonary function, and the operative approach, surgical side PAD remained an independent factor associated with major complication. CONCLUSIONS CT-based measurements of the PAD on the operative side may inform of the about the risk of major complications after lobectomy. Review of PA size on preoperative CT scans may help identify patients who would benefit from formal evaluation of PA pressures to improve the operative risk assessment.
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Affiliation(s)
- Peter J Kneuertz
- Division of Thoracic Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
| | - Max S Yudovich
- Division of Thoracic Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Chiemezie C Amadi
- Division of Thoracic Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Elizabeth Bashian
- Division of Thoracic Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Desmond M D'Souza
- Division of Thoracic Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Mahmoud Abdel-Rasoul
- Center for Biostatistics, The Ohio State University College of Medicine, Columbus, Ohio
| | - Robert E Merritt
- Division of Thoracic Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Erdal BS, Demirer M, Little KJ, Amadi CC, Ibrahim GFM, O’Donnell TP, Grimmer R, Gupta V, Prevedello LM, White RD. Are quantitative features of lung nodules reproducible at different CT acquisition and reconstruction parameters? PLoS One 2020; 15:e0240184. [PMID: 33057454 PMCID: PMC7561205 DOI: 10.1371/journal.pone.0240184] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/22/2020] [Indexed: 12/30/2022] Open
Abstract
Consistency and duplicability in Computed Tomography (CT) output is essential to quantitative imaging for lung cancer detection and monitoring. This study of CT-detected lung nodules investigated the reproducibility of volume-, density-, and texture-based features (outcome variables) over routine ranges of radiation dose, reconstruction kernel, and slice thickness. CT raw data of 23 nodules were reconstructed using 320 acquisition/reconstruction conditions (combinations of 4 doses, 10 kernels, and 8 thicknesses). Scans at 12.5%, 25%, and 50% of protocol dose were simulated; reduced-dose and full-dose data were reconstructed using conventional filtered back-projection and iterative-reconstruction kernels at a range of thicknesses (0.6-5.0 mm). Full-dose/B50f kernel reconstructions underwent expert segmentation for reference Region-Of-Interest (ROI) and nodule volume per thickness; each ROI was applied to 40 corresponding images (combinations of 4 doses and 10 kernels). Typical texture analysis metrics (including 5 histogram features, 13 Gray Level Co-occurrence Matrix, 5 Run Length Matrix, 2 Neighboring Gray-Level Dependence Matrix, and 3 Neighborhood Gray-Tone Difference Matrix) were computed per ROI. Reconstruction conditions resulting in no significant change in volume, density, or texture metrics were identified as "compatible pairs" for a given outcome variable. Our results indicate that as thickness increases, volumetric reproducibility decreases, while reproducibility of histogram- and texture-based features across different acquisition and reconstruction parameters improves. To achieve concomitant reproducibility of volumetric and radiomic results across studies, balanced standardization of the imaging acquisition parameters is required.
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Affiliation(s)
- Barbaros S. Erdal
- Department of Radiology, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
| | - Mutlu Demirer
- Department of Radiology, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
| | - Kevin J. Little
- Department of Radiology, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
| | - Chiemezie C. Amadi
- Department of Radiology, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
| | - Gehan F. M. Ibrahim
- Department of Radiology, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
| | - Thomas P. O’Donnell
- Siemens Healthineers, Malvern, Pennsylvania, United States of America and Erlangen, Germany
| | - Rainer Grimmer
- Siemens Healthineers, Malvern, Pennsylvania, United States of America and Erlangen, Germany
| | - Vikash Gupta
- Department of Radiology, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
| | - Luciano M. Prevedello
- Department of Radiology, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
| | - Richard D. White
- Department of Radiology, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
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Amadi CC, Brust RD, Skerritt MR, Campbell DL. Regulation of Kv4.3 Closed-State Inactivation and Recovery by Extracellular Potassium and Intracellular KChIP2b. Channels (Austin) 2014; 1:305-14. [DOI: 10.4161/chan.5017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Affiliation(s)
- Kelly M. Wanamaker
- Department of Thoracic and Cardiovascular Surgery; Allegheny General Hospital; Pittsburgh, Pennsylvania
| | - Chiemezie C. Amadi
- Department of Radiology; Allegheny General Hospital; Pittsburgh, Pennsylvania
| | - Jeffrey S. Mueller
- Department of Radiology; Allegheny General Hospital; Pittsburgh, Pennsylvania
| | - Robert J. Moraca
- Department of Thoracic and Cardiovascular Surgery; Allegheny General Hospital; Pittsburgh, Pennsylvania
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Wu JK, Goodrich JT, Amadi CC, Miller T, Mulliken JB, Shanske AL. Interparietal bone (Os Incae) in craniosynostosis. Am J Med Genet A 2011; 155A:287-94. [PMID: 21271643 DOI: 10.1002/ajmg.a.33800] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Accepted: 10/17/2010] [Indexed: 11/11/2022]
Abstract
The interparietal bone, Os Incae, is formed in a persistent mendosal suture. This suture is a normal variant in the human skull, well-known in anatomy and radiology textbooks. We report 11 children with craniosynostosis in the presence of an interparietal bone, five from Children's Hospital at Montefiore and six children from Children's Hospital Boston. The true incidence of an interparietal bone in patients with craniosynostosis or craniofacial anomalies is not known; nor are there recognized sequelae of an interparietal bone (bathrocephaly). Hypotheses regarding mechanisms that may contribute to the formation of an interparietal bone are discussed.
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Affiliation(s)
- June K Wu
- Department of Plastic and Reconstructive Surgery, Albert Einstein College of Medicine, Bronx, New York, USA
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