Romanian Journal of Morphology and Embryology最新文献

{"title":"Abrasion and dental pulp morphological changes in occlusal dysfunction.","authors":"Adi Rusu Olaru, Mihai Raul Popescu, Iancu Emil Pleşea, Mircea Sebastian Şerbănescu, Răzvan Mihail Pleşea, Melania Olimpia Cojocaru, Elena Claudia Coculescu","doi":"10.47162/RJME.65.2.15","DOIUrl":"10.47162/RJME.65.2.15","url":null,"abstract":"<p><strong>Aim: </strong>The authors set out to assess if the presence and the degree of severity of the abrasion, as a consequence of the occlusal dysfunction, determine further morphological changes in the dental pulp.</p><p><strong>Materials and methods: </strong>Study group included teeth dental pulp from 45 cases with occlusal dysfunction, subsequently divided into two subgroups: 24 cases with abrasion (AB) and 21 cases without abrasion (NONAB). The set of morphological parameters of dental pulp were thicknesses of the outer layer, inner layer and entire peripheral pulp zone, the presence of pulpal calcifications and their extent within the dental pulp, the presence of interstitial fibrosis and its extent within the dental pulp and the vascular density (VD) of pulpal capillary network. Tissue samples were fixed in 10% buffered formalin, embedded in paraffin, and sectioned off at 4 μm. Serial slides were stained with Hematoxylin-Eosin (HE), Masson's trichrome (MT) and anti-cluster of differentiation 34 (CD34) antibodies labeled with 3,3'-Diaminobenzidine (DAB) and transformed into virtual slides on which the above-mentioned parameters were studied comparatively with the help of a dedicated in-house software, realized in MATLAB (MathWorks, USA). The numerical values of the assessed parameters were also stratified in classes, thus obtaining score scales for each parameter. Statistical tools used were Lilliefors test, t-test (two-sample assuming equal variances), Mann-Whitney test, Pearson's correlation test, one-way analysis of variance (ANOVA) test and χ² (chi-squared) test.</p><p><strong>Results and discussions: </strong>Both peripheral zone (PZ) and its layers individually tended to be thicker in the teeth with abrasion than in those without abrasion. Also, teeth with abrasion tended to develop larger amounts of calcium deposits in their dental pulp than teeth without abrasion. On the other hand, fibrotic tissue in dental pulp had no relationship with the presence or absence of abrasion. PZ as a whole and its layers evolved together in the same way, with a stronger correlation in the group of teeth without abrasion. Deposits of calcium evolved in the opposite direction to both the amount of fibrous tissue and the capillaries density of the dental pulp. Consequently, the amount of fibrous tissue and VD evolved together in the same way, more pronounced in the teeth without abrasion.</p><p><strong>Conclusions: </strong>Our preliminary study pointed out that different components of the dental pulp showed slight to moderate changes depending on the degree of abrasion in teeth with occlusal dysfunction.</p>","PeriodicalId":54447,"journal":{"name":"Romanian Journal of Morphology and Embryology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successfully physical therapy program for functional respiratory rehabilitation after lung transplant surgery - case report.","authors":"Diana Lidia Tache-Codreanu, Iuliana David, Cristiana Gabriela Popp, Lucian Bobocea, Magdalena Rodica Trăistaru","doi":"10.47162/RJME.65.2.21","DOIUrl":"10.47162/RJME.65.2.21","url":null,"abstract":"<p><p>The first lung transplant (LT) was made in Romania in 2018 at a 36-year-old male patient with chronic obstructive pulmonary disease (COPD). The study follows the first LT rehabilitation by describing the physical therapy program (PTP), the measurements of body mass and appendicular skeletal muscle mass (ASM) by bio-impedancemetry analysis (BIA) and the functional capacity assessment realized by the six-minute walk test (6MWT) and by the functional respiratory tests (FRTs) in order to evaluate the effectiveness of functional respiratory rehabilitation in this case during a period of one year. In parallel, repeated transbronchial biopsies were performed after six weeks, three months, six months and one year since the transplant. Only the first biopsies showed injuries suggesting an acute rejection, all the rest revealing mild, unspecific lesions. The patient followed 15 sessions of respiratory exercises, joints mobilizations and progressive global muscle strength started one month after LT surgery and was also instructed to perform the exercises at home, using a tablet given at discharge and under monthly guidance through telemedicine. All the measurements were performed before and after the rehabilitation cure, and it was repeated at three different evaluations for one year. The results showed that at the end of follow-up, the 6MWT was significantly increased from 59% of predicted distance at the intake in post-acute hospitalization to 166% at one year after LT, without desaturation that represent a very good evolution; the FRTs increased to normal, and the body weight increased with 18 kg (from severe underweight to normal weight) with constant increasement of skeletal muscle mass. The use of PTP after LT surgery significantly improves functional capacity and increases body mass and skeletal muscle mass.</p>","PeriodicalId":54447,"journal":{"name":"Romanian Journal of Morphology and Embryology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The expression of c-MYC, Cyclin D1 and Ki-67/MIB-1 in benign and malignant thyroid tissues: is there any diagnostic value?","authors":"Evropi Forozidou, Antonia Syrnioti, Styliani Laskou, Alexandros Poutoglidis, Konstantinos Sapalidis, Triantafyllia Koletsa","doi":"10.47162/RJME.65.2.13","DOIUrl":"10.47162/RJME.65.2.13","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the immunohistochemical (IHC) expression and the diagnostic value of c-MYC, Cyclin D1, and Ki-67∕MIB-1 in follicular adenomas (FAs), follicular carcinomas (FCs), and anaplastic carcinomas (ACs) of the thyroid gland, as well as in their corresponding adjacent, non-neoplastic thyroid tissue (NNTT).</p><p><strong>Materials and methods: </strong>We conducted a retrospective study of patients who were pathologically diagnosed with FA, FC, or AC after total thyroidectomy. Tissue microarrays with cores taken from neoplastic and adjacent NNTT were constructed. Immunohistochemistry for anti-c-MYC, anti-Cyclin D1, and anti-Ki-67∕MIB-1 antibodies was performed, and the positivity was evaluated.</p><p><strong>Results: </strong>Twenty-eight specimens were included. Nuclear c-MYC positivity was observed in 4∕11 FCs, and 3∕4 ACs, whereas cytoplasmic c-MYC positivity was found in 16∕24 NNTTs. Globally, there were statistically significant differences between neoplasms and NNTTs, with higher nuclear c-MYC and Cyclin D1 expression observed in neoplasms (p=0.017 and p=0.001, respectively). In contrast, cytoplasmic positivity was seen solely in NNTTs (p=0.001). Cyclin D1 positivity was noted in 11∕13 FAs, 7∕11 FCs, 2∕4 ATCs, and only in one NNTT. A statistically significant correlation was found between MIB1 and c-MYC nuclear positivity (p=0.040).</p><p><strong>Conclusions: </strong>Our findings exhibit a clear difference in the IHC expression of c-MYC and Cyclin D1 between different types of thyroid tumors, as well as between the neoplastic and NNTT. Nuclear c-MYC positivity excludes the benign nature of a thyroid lesion, in contrast to cytoplasmic positivity, which demonstrates normal or hyperplastic nature.</p>","PeriodicalId":54447,"journal":{"name":"Romanian Journal of Morphology and Embryology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classic and molecular cytogenetic findings in leukemia patients from the Western part of Romania.","authors":"Cristina Annemari Popa, Nicoleta Ioana Andreescu, Teodora Smaranda Arghirescu, Carmen Angela Maria Petrescu, Cristian Marius Jincă, Emil Florin Huţ, Răzvan Gabriel Drăgoi, George Puenea, Daniel Popa","doi":"10.47162/RJME.65.2.06","DOIUrl":"10.47162/RJME.65.2.06","url":null,"abstract":"<p><p>Acute lymphoblastic leukemia (ALL) is the most common type of leukemia in childhood and rare in adults, while acute myeloid leukemia (AML) is less common in children and more common in older adults. The aim of the study was to present our experience for the diagnostic of leukemia by using the classic and molecular cytogenetic methods. The study was conducted between 2009 and 2019 within the Classic and Molecular Genetic Laboratory of the Oncohematology Department from the Louis Ţurcanu Emergency Hospital for Children, Timişoara, Romania. The study group included 337 children and adults, evaluated between 2009 and 2019. By using the conventional and molecular cytogenetic technique, the cytogenetic anomalies found were 35 numerical chromosomal abnormalities, 10 (9;22)(q34;q11) [four ALL, one AML, five chronic myeloid leukemia (CML)] translocations, nine (15;17)(q24;q21) translocations, three (14;14)(q11;q32) translocations, two (4;11)(q21;q23) translocations, one (1;14)(p32;q11) translocation, one (7;14)(qter;q11) translocation, one (8;21)(q22;q22) translocation, one (9;14)(p12;q32) translocation, seven rearrangements of the MLL gene and two rearrangements of the core-binding factor subunit beta∕myosin heavy chain 11 (CBFB∕MYH11) gene. The use of conventional and molecular cytogenetic analysis is one of the most important prognostic indicators in acute leukemia patients, allowing the identification of biologically distinct subtypes of disease and selection of appropriate treatment approaches.</p>","PeriodicalId":54447,"journal":{"name":"Romanian Journal of Morphology and Embryology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The particularities of connective fibers from the wall of varicose veins extirpated by cryostripping.","authors":"Andrei Florin Părău, Amalia Raluca Ceauşu, Nela Puşa Gaje, Sorin Olariu, Marius Raica","doi":"10.47162/RJME.65.2.14","DOIUrl":"10.47162/RJME.65.2.14","url":null,"abstract":"<p><strong>Introduction: </strong>The varicose vein affects more than 30% of the general population. Significantly increased rates were noticed in women and older population. From the histopathological point of view, venous arterialization, smooth muscle cell hypertrophy, and hyperplasia are the main changes noticed in varicose vein disease. Some of the main therapeutic methods used in the management of varicose disease are injection sclerotherapy, conservative, surgical, saphenous vein inversion and removal, high saphenous ligation, ambulatory phlebectomy, transilluminated powered phlebectomy, endovascular management, cryostripping.</p><p><strong>Aim: </strong>The aim of this study was to evaluate the morphology of connective fibers from the wall of the varicose veins extirpated by cryostripping.</p><p><strong>Patients, materials and methods: </strong>The study included 109 samples taken by cryostripping method. Hematoxylin-Eosin, Masson's trichrome, Silver and Orcein staining were applied. The assessment of fibers was made according to score values between 0 and 3.</p><p><strong>Results: </strong>It was found no major structural differences in terms of alterations of collagen fibers induced by the applied surgical procedure. It was noticed duplications and multiplications of the internal elastic lamina, as diffuse and nodular forms. Depletion of elastic fibers at the media was a lesion identified in most of the specimens. The depletion of reticulin fibers correlates with the accumulation of collagen fibers, which partially or completely replace the network in the media and intima. No correlation was found between changes in the reticulin network and the time between prelevation and buffered formalin fixation, the maximum time investigated being five days.</p><p><strong>Conclusions: </strong>The Orcein staining in the venous vessel evaluation panel may be a useful investigation.</p>","PeriodicalId":54447,"journal":{"name":"Romanian Journal of Morphology and Embryology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of FGF21 in the interplay between obesity and non-alcoholic fatty liver disease: a narrative review.","authors":"Cristina Elena Negroiu, Robertina Iulia Tudoraşcu, Maria Cristina Beznă, Adrian Ionuţ Ungureanu, Sorina Octavia Honţaru, Suzana Dănoiu","doi":"10.47162/RJME.65.2.02","DOIUrl":"10.47162/RJME.65.2.02","url":null,"abstract":"<p><p>Obesity poses a significant and escalating challenge in contemporary society, increasing the risk of developing various metabolic disorders such as dyslipidemia, cardiovascular diseases, non-alcoholic fatty liver disease (NAFLD), type 2 diabetes, and certain types of cancer. The current array of therapeutic interventions for obesity remains insufficient, prompting a pressing demand for novel and more effective treatments. In response, scientific attention has turned to the fibroblast growth factor 21 (FGF21) due to its remarkable and diverse impacts on lipid, carbohydrate, and energy metabolism. This comprehensive review aims to delve into the multifaceted aspects of FGF21, encompassing its discovery, synthesis, functional roles, and potential as a biomarker and therapeutic agent, with a specific focus on its implications for NAFLD.</p>","PeriodicalId":54447,"journal":{"name":"Romanian Journal of Morphology and Embryology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated cutaneous squamous cell carcinoma grading using deep learning with transfer learning.","authors":"Alexandra Buruiană, Mircea Sebastian Şerbănescu, Bogdan Pop, Bogdan Alexandru Gheban, Carmen Georgiu, Doiniţa Crişan, Maria Crişan","doi":"10.47162/RJME.65.2.10","DOIUrl":"10.47162/RJME.65.2.10","url":null,"abstract":"<p><strong>Introduction: </strong>Histological grading of cutaneous squamous cell carcinoma (cSCC) is crucial for prognosis and treatment decisions, but manual grading is subjective and time-consuming.</p><p><strong>Aim: </strong>This study aimed to develop and validate a deep learning (DL)-based model for automated cSCC grading, potentially improving diagnostic accuracy (ACC) and efficiency.</p><p><strong>Materials and methods: </strong>Three deep neural networks (DNNs) with different architectures (AlexNet, GoogLeNet, ResNet-18) were trained using transfer learning on a dataset of 300 histopathological images of cSCC. The models were evaluated on their ACC, sensitivity (SN), specificity (SP), and area under the curve (AUC). Clinical validation was performed on 60 images, comparing the DNNs' predictions with those of a panel of pathologists.</p><p><strong>Results: </strong>The models achieved high performance metrics (ACC>85%, SN>85%, SP>92%, AUC>97%) demonstrating their potential for objective and efficient cSCC grading. The high agreement between the DNNs and pathologists, as well as among different network architectures, further supports the reliability and ACC of the DL models. The top-performing models are publicly available, facilitating further research and potential clinical implementation.</p><p><strong>Conclusions: </strong>This study highlights the promising role of DL in enhancing cSCC diagnosis, ultimately improving patient care.</p>","PeriodicalId":54447,"journal":{"name":"Romanian Journal of Morphology and Embryology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-traumatic avascular necrosis of the talus.","authors":"Paul Alexandru Deme, Dan Ioan Fruja, Nicolae Cătălin Hreniuc, Graţian Cosmin Damian, Florin Mihai Marcu, Roland Fazakas, Casiana Boru, Nicoleta Zurbău-Anghel, Alexandru Mircea Pop","doi":"10.47162/RJME.65.2.23","DOIUrl":"10.47162/RJME.65.2.23","url":null,"abstract":"<p><p>In this comprehensive case report, we examine a 29-year-old male who suffered a high-energy vehicular accident, resulting in a type III Hawkins fracture of the talus. This specific fracture type is critically associated with a greater than 90% risk of progressing to avascular necrosis (AVN) of the talus, a severe and debilitating condition. Alongside this, the patient sustained fractures of the medial and lateral malleolus. Due to extensive swelling and severe circulatory disorders, an immediate emergency surgical procedure was necessitated, employing nail fixation as a stabilizing intervention. Over the course of 12 months following the surgery, despite routine post-operative imaging including X-rays and computed tomography (CT) scans, the patient continued to experience significant pain and impairment. This condition led to further investigations, culminating in a magnetic resonance imaging (MRI) that revealed an area of 19.8∕20.9 mm of AVN on the talus dome's upper-lateral facet. Interestingly, earlier CT scans had indicated multiple osteitic lesions, but these findings lacked a clear clinical correspondence, presenting a diagnostic challenge. To resolve this ambiguity and to definitively distinguish between necrosis and infection, a targeted histopathological analysis was deemed necessary. This analysis was conducted on a bone fragment extracted during a follow-up surgical procedure for nail removal. The results from this analysis present an area of bone and myeloid tissue necrosis unequivocally confirming the presence of AVN, effectively ruling out osteitis as a potential diagnosis. This critical diagnostic clarification allowed for a shift in therapeutic strategy, enabling the initiation of a more focused and potentially curative treatment regimen.</p>","PeriodicalId":54447,"journal":{"name":"Romanian Journal of Morphology and Embryology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triple-negative breast cancer: from classical clinicopathological features to androgen receptor profile.","authors":"Iulian Prutianu, Simona Eliza Giuşcă, Bogdan Gafton, Mariana Bianca Chifu, Cristina Terinte, Alexandra Antonescu, Larisa Popovici, Irina Draga Căruntu","doi":"10.47162/RJME.65.2.07","DOIUrl":"10.47162/RJME.65.2.07","url":null,"abstract":"<p><p>Triple-negative breast cancer (BC) represents an extensively analyzed entity to establish the overall framework of clinicopathological characteristics, with an impact on defining prognostic and predictive factors. The relationship between triple-negative BC and androgen receptor (AR) is far from being clarified. We aimed to evaluate the classical clinicopathological spectrum that characterized a triple-negative BC, focusing on AR expression. The study group comprised 124 cases of triple-negative BC. The main clinicopathological parameters were extracted from medical records. The immunohistochemical (IHC) exam was run using the following antibodies: anti-estrogen receptor (ER), anti-progesterone receptor (PR), anti-human epidermal growth factor receptor (HER2∕neu), anti-Ki67 and anti-AR. AR immunoexpression was assessed as absent (completely negative) or present (unrelated to percentages and intensity). Data were statistically analyzed. AR expression was positive in 78 (63%) cases and negative in 46 (37%) cases. Among the study group, 28 cases exhibited an AR percentage ranging from 1% to 10%, 15 cases showed a percentage between 11% and 50%, while 12 cases had AR values between 51% and 75% and 23 cases fell within the AR range of 76% to 100%. No significant differences between AR immunoexpression (negative versus positive), clinicopathological characteristics and survival parameters were found. Statistically significant differences were registered between histological type, tumor stage, distant metastasis, tumor-infiltrating lymphocytes (TILs), treatment and residual cancer burden (RCB), and survival parameters. Thus, our results sustain that AR does not affect the biological behavior of triple-negative BC.</p>","PeriodicalId":54447,"journal":{"name":"Romanian Journal of Morphology and Embryology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eosinophilic fasciitis: unraveling the clinical tapestry of a rare case and review of literature.","authors":"Aifer Cherim, Alexandra Eugenia Bastian, Cristiana Gabriela Popp, Maia Ioana Mihon, Ion Cristian Efrem, Ananu Florentin Vreju, Răzvan Adrian Ionescu","doi":"10.47162/RJME.65.2.22","DOIUrl":"10.47162/RJME.65.2.22","url":null,"abstract":"<p><p>Eosinophilic fasciitis (EF) remains a diagnostic challenge due to its rarity and resemblance to scleroderma. This case report aims to provide a cohesive exploration of EF's clinical nuances, emphasizing the importance of accurate diagnosis and effective management. A 52-year-old male developed bilateral forearm and calf hardening, along with erythema, pruritus, and pain four months prior to the presentation in our Clinic. The symptoms initially debuted bilaterally in the forearms and progressed to involve the calves, distal arms, and thighs. Clinical examination revealed symmetrical plaques on forearms and calves, featuring erythematous, hyper, and hypopigmented elements extending proximally, a positive \"groove sign\" and a moderate difficulty in knee joint flexion. Despite these findings, the patient was generally in good condition, without any other notable clinical signs. Initial laboratory findings showed slightly increased percentual eosinophil levels, elevated C-reactive protein (CRP), normal erythrocyte sedimentation rate (ESR), and negative antinuclear and scleroderma specific antibodies. Magnetic resonance imaging (MRI) demonstrated enhanced fascial signal and thickening while the fascia-muscle biopsy revealed marked edema and inflammatory lymphoplasmacytic infiltrate, consistent with the diagnosis of EF. The patient showed a favorable response to systemic corticosteroids. EF predominantly affects males aged 30 to 60 and is characterized by a sudden onset and unclear etiological factors. Differential diagnosis requires careful exclusion of scleroderma and other mimicking conditions. Diagnostic modalities such as skin-muscle biopsy and MRI reveal characteristic findings like inflammatory infiltrate and fascial thickening. Accurate diagnosis and differentiation from scleroderma are crucial, with early intervention involving glucocorticoids and immunosuppressive agents improving long-term outcomes.</p>","PeriodicalId":54447,"journal":{"name":"Romanian Journal of Morphology and Embryology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}