Turkish Journal of Pathology最新文献

{"title":"When Cysts Strike: A Unique Case of Isolated Renal Hydatid Disease in a Child.","authors":"Nikhil Kumar, Sandip Kumar Rahul, Harish Kumar Bohra, Vimal Singh Munda, Varsha Vijayan, Nidhi Priya Allie-Barla","doi":"10.5146/tjpath.2025.13871","DOIUrl":"https://doi.org/10.5146/tjpath.2025.13871","url":null,"abstract":"<p><p>Echinococcus granulosus, also known as the 10.5146/tjpath.2024.13488dog tapeworm, causes echinococcosis or hydatid disease in humans. It is an anthropozoonotic and non-endemic disease. Hydatid cysts are most commonly found in the liver and lungs, but can occur in any other organ, including the brain, kidneys, bones, and peritoneal cavity. Isolated renal hydatidosis is an extremely rare condition, accounting for only 2-4% of all cases of hydatidosis, with its occurrence in children being even rarer. We are reporting a rare case of isolated renal hydatidosis in a 12-year-old boy.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor Budding as an Independent Prognostic Histopathological Marker in Oral Squamous Cell Carcinoma - An Indian Tertiary Care Center Experience.","authors":"Anand Vijaya Narayanan, Krishnapriya Umashankar, Sithara Aravind, Sangeetha K Nayanar, Sandeep Vijay","doi":"10.5146/tjpath.2025.13761","DOIUrl":"https://doi.org/10.5146/tjpath.2025.13761","url":null,"abstract":"<p><strong>Objective: </strong>Oral squamous cell carcinoma is the most common head and neck malignancy reported worldwide. Tumor budding represents a histopathological feature characterized by the presence of isolated single/small clusters of cancer cells dispersed within the stroma at the invasive tumor front. Its prognostic significance has not been studied much in lip and oral squamous cell carcinomas in India. The aim of this study was to investigate the prognostic role of tumor budding in a large single-center retrospective cohort of 333 patients with oral squamous cell carcinoma at a tertiary cancer center in North Kerala, India.</p><p><strong>Material and methods: </strong>The primary resection slides of 333 patients with oral squamous cell carcinoma from 2018 to 2020 were retrieved from the pathology archives and were evaluated by two independent pathologists for tumor budding and other histopathological parameters. The survival data were collected from the patient files.</p><p><strong>Results: </strong>We found a significant association between tumor budding and other known histopathological prognosticators using Chi-square analysis. Univariate logistic analysis showed tumor budding, depth of invasion ( > 10 mm), worst pattern of invasion 5, and perineural invasion were significantly associated with locoregional recurrence/distant metastasis. Multivariate logistic regression analysis identified tumor budding as an independent prognostic marker for locoregional recurrence/distant metastasis. Univariate cox proportionality analysis showed that tumor budding, depth of invasion ( > 10 mm), worst pattern of invasion 5, pathological T4 stage, and perineural invasion were associated with decreased overall survival and poor disease-free survival in patients with oral squamous cell carcinoma. Multivariate cox proportionality analysis showed tumor budding as the only independent predictor for decreased overall survival and poor disease-free survival.</p><p><strong>Conclusion: </strong>Based on this study, we can conclude that tumor budding is a simple and a reliable independent prognosticator that facilitates personalized management in patients with oral squamous cell carcinoma.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of HEG1 and Claudin-4 Immunohistochemistry in the Differential Diagnosis of Lung Adenocarcinoma from Malignant Mesothelioma in Pleural Effusion Cytology.","authors":"Aziza E Abdelrahman, Fatma A Elbadry, Taiseer R Ibrahim, Mohamed Ali Alabiad, Mohamed Awad","doi":"10.5146/tjpath.2025.13801","DOIUrl":"https://doi.org/10.5146/tjpath.2025.13801","url":null,"abstract":"<p><strong>Objective: </strong>Cytological examination of pleural effusion is minimally invasive and low risk but faces challenges due to the lack of architectural features, low cell counts, and overlapping characteristics among reactive mesothelial cells (RMCs), carcinoma cells, and malignant epithelioid mesothelioma (MPM) cells. The aim of this was study to detect the diagnostic accuracy of the expression of HEG1 and Claudin-4 in distinguishing malignant mesothelioma from lung adenocarcinoma in pleural effusion.</p><p><strong>Material and methods: </strong>The present study was carried out on 84 cases of pleural effusion. Sixty-four representative cell blocks of the studied malignant cases and twenty control cases were stained with HEG1 and Claudin-4 immunostaining, and the results were recorded.</p><p><strong>Results: </strong>Positive membranous HEG1 immunoexpression was found in 95% of RMCs in benign effusions. Also, positive membranous HEG1 immunoexpression was found in 96% of cases of MPM, and only 2.6% of lung adenocarcinoma cases. There was a statistically significant difference between benign effusion with RMCs and lung adenocarcinoma immunoreactivity. There was a highly statistically significant difference between HEG1 immunoexpression in MPM and lung adenocarcinoma. On the other hand, all cases of benign effusions and all MPM cases had negative Claudin-4 immunoexpression while positive membranous Claudin-4 immunoexpression was found in 94.9% of lung adenocarcinoma cases. There was a statistically significant difference in immunoexpression of Claudin-4 between benign effusion and lung adenocarcinoma. There was a statistically significant difference in the immunoexpression of Claudin-4 between MPM and lung adenocarcinoma.</p><p><strong>Conclusion: </strong>HEG1 and Claudin-4 IHC staining is extremely valuable in the differential diagnosis between reactive or malignant mesothelial cells and adenocarcinoma in pleural effusion.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Marrow Necrosis After Curative Allogeneic Hematopoietic Stem Cell Transplant Associated with Deep Diving.","authors":"Hajdhica Thanasi, Daniele Avenoso, Liron Barnea Slonim","doi":"10.5146/tjpath.2024.13488","DOIUrl":"https://doi.org/10.5146/tjpath.2024.13488","url":null,"abstract":"<p><p>Bone marrow necrosis, albeit an infrequent finding, is usually associated with highly proliferative malignant disorders, such as leukemia, lymphoma, or sickle cell anemia, solid tumor metastasis, and infections. It is also a typical finding in Caisson disease and in divers that developed decompression illness. Herein we report a case of bone marrow necrosis post deep diving in a bone marrow transplant recipient.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the Effectiveness of an Algorithm as an Auxiliary Method in Intraoperative Consultations of Central Nervous System Tumors.","authors":"Emel Cakir, Ismail Saygin, Ayten Livaoglu, Gizem Teoman, Zeynep Sagnak Yilmaz, Arife Cicek Malat, Muserref Muge Ustaoglu","doi":"10.5146/tjpath.2024.13494","DOIUrl":"10.5146/tjpath.2024.13494","url":null,"abstract":"<p><strong>Objective: </strong>One of the most difficult areas in a surgical pathology practice is intraoperative consultation. In a previous study, we proposed an algorithm that provides a systematic approach to intraoperative consultation for central nervous system tumors. Our aim was to demonstrate the effectiveness of this algorithm.</p><p><strong>Material and methods: </strong>102 cases were selected from intraoperative consultation procedures performed at our institution between 2012 and 2020. The algorithm was tested by five observers. The observers examined the smears and frozen sections without the algorithm, and then with the algorithm.</p><p><strong>Results: </strong>The percentage change in the rate of correct diagnoses made by the four observers (O) increased after using the algorithm (O2: 8%, O3: 5%, O4: 8% and O5: 13%), but decreased for only one observer (O1) (5%). The most common error made by the four observers was `grading of glial tumors` (O1: 40%; O2: 23%; O4: 40% and O5: 27.5%), and this group of errors was mostly corrected by using the algorithm (O1: 33%; O2: 3.8%; O4: 23% and O5: 10%). For two observers (O2 and O5), a statistically significant change in diagnostic levels was observed after using the algorithm (p=0.024 and p=0.040; respectively). In addition, thanks to the use of the algorithm, a high degree of agreement was found between the observers` diagnoses (77.7%, p < 0.001).</p><p><strong>Conclusion: </strong>In the intraoperative consultation of central nervous system lesions, algorithms can help to increase the accuracy of the diagnosis and reduce interobserver variability. This study demonstrates that an algorithmic approach is an effective method for pathologists in intraoperative consultation procedures.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"9-15"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solitary Rectal Ulcer Syndrome - A Rare Entity in the Pediatric Population.","authors":"Megha Sawhney, Jyotsna Madan, Devajit Nath, Akanksha Bhatia, Neema Tiwari, Umesh Shukla","doi":"10.5146/tjpath.2025.13667","DOIUrl":"10.5146/tjpath.2025.13667","url":null,"abstract":"<p><strong>Objective: </strong>To study and correlate the clinicopathological findings of Solitary Rectal Ulcer Syndrome (SRUS) in 10 pediatric patients.</p><p><strong>Material and methods: </strong>This study is a retrospective study of patients from January 2017 to June 2024. The clinical records were reviewed for details of the clinical presentation, colonoscopic findings, associated local and systemic diseases, and other investigations.</p><p><strong>Results: </strong>The mean age of presentation was 10±1 years, and the youngest child was 6 years old. The most common clinical presentation was rectal bleeding and a single ulcer on endoscopy. Histological findings included crypt distortion, crypt branching, and fibromuscular obliteration of the lamina propria. Immunohistochemistry (IHC) for Smooth Muscle Actin (SMA) and special staining with Masson Trichrome (MT) were used to highlight fibromuscular areas whenever in doubt.</p><p><strong>Conclusion: </strong>The pathogenesis of SRUS is not well understood. It may be associated with chronic mucosal and hypoperfusion-induced ischemic injury to the rectal mucosa due to trauma or increased rectal pressure during straining. Solitary rectal ulcer is a misnomer, as the patient may present with multiple or no ulcers. Endoscopy and histopathology help to diagnose SRUS. Timely and correct diagnosis reduces the morbidity associated with this entity.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"16-20"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed Neuroendocrine Non-Neuroendocrine Tumor (MINEN) of the Liver: Report of Two Cases and Review of the Literature.","authors":"Basharat Mubeen, Malini Eapen, S Sudhindran, Nikhil Krishna Haridas","doi":"10.5146/tjpath.2024.13492","DOIUrl":"10.5146/tjpath.2024.13492","url":null,"abstract":"<p><strong>Objective: </strong>To highlight two cases mixed neuroendocrine non-neuroendocrine tumors (MINEN) of the liver and to review the literature till date. To present two cases of MINEN of the liver diagnosed in our centre with clinical & diagnostic workup, the treatment modalities, and follow up. Extensive review of the literature and compilation of the presentation and treatment modalities used in those cases.</p><p><strong>Case reports: </strong>Thirty-three cases of MINEN of the liver have been reported till date including ours. Our cases presented as incidental masses in liver during workup for other symptoms. AFP levels were normal in both cases but PIVKA (Protein induced by vitamin K absence) levels were increased. Resection was done in one of the cases while the other patient had to undergo transplantation. A diagnosis of MINEN was made on H&E, and confirmed on IHC. One patient was unfit for systemic chemotherapy whereas the other patient received cisplastin and etoposide based chemotherapy. Both patients developed metastasis on follow up but are still alive after 12-15 months.</p><p><strong>Conclusion: </strong>MINEN is an uncommon tumor of the liver with a poor prognosis as shown by the few studies available. Recurrence and distant metastases are often described even after complete resection and the course is fatal. The role of adjuvant chemotherapy following surgical resection is not fully elucidated. Mean survival in the cases reported ranged from 1 month to 33 months. However, no significant differences were seen in the clinicopathologic profile of the cases described so far. Further multiinstitutional studies and follow up will help to further characterize this subtype for appropriate treatment.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"21-29"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Utility of NKX3.1 in Mesenchymal Chondrosarcoma on Needle Biopsy: A Case Report of a Supraclavicular Soft Tissue Mass with Literature Review.","authors":"Sunil Pasricha, Divya Bansal, Himanshu Rohela, Anila Sharma, Rakesh Oberoi, Vikas Reddy, Ullas Batra, Anurag Mehta","doi":"10.5146/tjpath.2025.13752","DOIUrl":"10.5146/tjpath.2025.13752","url":null,"abstract":"<p><p>We report a case of young female in her 20s who presented with a supraclavicular soft tissue mass. Diagnostic biopsy showed a malignant round cell tumor with areas of spindling and hyalinized stroma. The utilization of an immunohistochemistry panel revealed positive results for NKX2.2 and CD99 expression. This positivity led to the consideration of a differential diagnosis of Ewing sarcoma, EWSR1::NFATC2- rearranged sarcoma, and mesenchymal chondrosarcoma for further assessment. On further immunohistochemistry with NKX3.1 and EWSR1 break-apart fluorescent in situ hybridization analysis, a diagnosis of mesenchymal chondrosarcoma was rendered which was later on confirmed with biphasic histology on excision specimen. NKX3.1 is a useful immunohistochemistry marker to resolve the differentials when dealing with undifferentiated small round cell sarcoma of bone and soft tissue, especially on a needle biopsy.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":"1 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting Virchow`s Node: Exploring the Diagnostic Spectrum of the Supraclavicular Lymph Node Through Fine-Needle Aspiration Cytology in a Tertiary Care Hospital.","authors":"Sumaira Qayoom, Nida Shabbir, Mala Sagar, Riddhi Jaiswal, Naseem Akhtar, Madhu Kumar","doi":"10.5146/tjpath.2025.13817","DOIUrl":"https://doi.org/10.5146/tjpath.2025.13817","url":null,"abstract":"<p><strong>Objective: </strong>Virchow`s node, described in 1848, represents a metastasis to the left supraclavicular lymph node, commonly arising from gastric cancer. However, in regions with lower gastric cancer incidence, the relevance of Virchow`s node and the spectrum of diagnosis associated with supraclavicular lymphadenopathy (SCLAP) needs reevaluation. This study aimed to analyze the spectrum of fine-needle aspiration cytology (FNAC) at a tertiary care institute.</p><p><strong>Material and methods: </strong>We retrospectively reviewed all supraclavicular lymph node aspirations performed between March 2019 and August 2022. Data were collected from the Department of Pathology`s electronic records and descriptive analyses were performed.</p><p><strong>Results: </strong>Out of 270 FNAC procedures for SCLAP, 50 were non-diagnostic. Of the 220 patients, cytological diagnosis was categorized as metastatic malignancy in 120 (54.5%) patients, granulomatous lymphadenitis in 57 (25.9%), reactive lymphadenitis in 11 (5.0%), acute suppurative lymphadenitis in 21 (9.5%), and lymphoproliferative disorder in 10 (4.54%) patients. Among the 120 metastatic cases, the most common type was adenocarcinoma (58.3%). The most common primary site was the lung (22.5%), oral cavity (19.2%), breast (12.5%), and gallbladder (10%). Primary gut carcinomas constitute only 9% of supraclavicular lymph node metastases.</p><p><strong>Conclusion: </strong>The findings suggest a need to reconsider the clinical significance of Virchow`s node, especially in regions with different cancer epidemiology. FNAC remains a critical diagnostic tool in evaluating SCLAP.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":"1 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the Relationship Between EGFR Mutations and PD-L1, ALK, and ROS1 Alterations in Patients with Non- Small-Cell Lung Cancer: The Most Extensive Study Conducted in Iran.","authors":"Sepideh Hadimaleki, Roham Sarmadian, Abolfazl Gilani, Parisa Mehrasa, Ali Esfahani, Mortaza Raeisi, Yousef Roosta, Amir Vahedi","doi":"10.5146/tjpath.2025.13827","DOIUrl":"https://doi.org/10.5146/tjpath.2025.13827","url":null,"abstract":"<p><strong>Objective: </strong>Lung cancer, the second most common type of cancer, is the leading cause of cancer-related mortality, with non-small-cell lung carcinoma (NSCLC) being the most prevalent subtype. The presence of EGFR mutations in NSCLC influences tumor behavior and treatment response. The prevalence of EGFR mutation in Iranian patients is limited. This study investigated the frequency of EGFR mutation and its association with PD-L1, ALK, and ROS1 expression in patients with NSCLC from Northwest Iran.</p><p><strong>Material and methods: </strong>A retrospective analysis was conducted on 647 cases of NSCLC from April 2018 to August 2024 at Imam Reza Hospital in Tabriz, Iran. Histologic diagnoses were confirmed, and patient data were collected. EGFR mutation testing targeted exons 18-21 using Sanger sequencing and Real-Time PCR. ALK and ROS1 rearrangements were assessed using fluorescence in situ hybridization (FISH), while PD-L1 expression was evaluated through immunohistochemistry (IHC). The statistical analysis was performed using SPSS version 27.0.</p><p><strong>Results: </strong>The cohort comprised 430 males and 217 females, with a median age of 62 years (IQR: 54-70). EGFR mutations were identified in 171 (26.4%) cases, more frequently in females (33.6% vs. 22.8%; p = 0.003). The most common mutation was exon 19 deletion (56.7%), followed by L858R (21.6%). No significant association was found between EGFR mutations and ALK (p = 0.126) or PD-L1 expressions ( p = 0.29). ROS1 mutations were not detected.</p><p><strong>Conclusion: </strong>This study confirmed the mutual exclusivity of EGFR and ALK mutations and found no significant association with PD-L1. Comprehensive EGFR testing remains crucial to guide targeted therapies. Broader studies are needed to include diverse populations and additional clinical factors to improve personalized treatment.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":"1 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}