We compared Doppler spectral parameters in acute inflammatory, reactive, lymphomatous, and metastatic lymph nodes, and evaluated pulsed Doppler sonography as a method for distinguishing between different causes of cervical lymphadenopathy. Spectral Doppler analysis with measurements of resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end-diastolic velocity (EDV) was performed in 197 patients with cervical lymphadenopathy. Results of Doppler analysis were compared with findings of cytology and histology or with clinical presentation and follow-up. Student's t-test was used to assess statistical significance of differences in Doppler parameters between groups of patients. Significant differences for RI and PI were shown between all groups of patients except between lymphomatous and reactive nodes. Specificity of 100% for metastatic nodal involvement was shown for cutoff values RI>0.80 and PI>1.80. A positive predictive value (PPV) of 100% for acute lymphadenitis was shown for cutoff values RI<0.50 and PI<0.60. An EDV>9 cm/s has 100% negative predictive value for nodal metastasis, and EDV<1 cm/s has 100% specificity and PPV for metastasis. Although there exist differences in RI, PI, PSV, and EDV between different nodal diseases, none of these parameters offer both good sensitivity and good specificity, and only extreme cutoff values may occasionally be helpful in differential diagnosis. Doppler spectral analysis is a valuable noninvasive adjunct which can help in differentiation between metastatic, lymphomatous, acute inflammatory, and reactive lymphadenopathy, but cannot obviate biopsy in the majority of cases.

We hypothesized that quadrant prostate biopsy (QPB) provides sufficient first-line pathological evaluation of patients with presumed advanced prostate cancer (PC). The aim of this study was to investigate whether the reduction of core number in first-line PB from 6-12 to 4 in patients with presumed advanced PC leads to loss of clinically relevant information. We retrospectively studied 113 men that underwent PB, classified in two groups: "H" (high) and "L" (low likelihood of having advanced PC), according to PSA, digital rectal and transrectal ultrasound findings. Pathological results of 6-12-core PB and QPB were retrospectively compared for the presence of malignancy, percentage of positive cores, Gleason score (GS), and the presence of high-grade prostatic intraepithelial neoplasia (HGPIN). PC detection rate was not impaired in group H but dropped significantly in group L, and the percentage of positive cores was not significantly changed in group H (p=0.39), but decreased in group L (p=0.04), due to sampling scheme reduction. No HGPIN was missed with QPB in group H, while 2 HGPINs were missed in group L. No significant change in GS in either group was observed (p=0.12, p=0.13) due to reduction to QPB. We conclude that in patients with presumed advanced PC, reduction of the number of cores in PB may be an acceptable diagnostic strategy, but further studies are needed to analyze the impact of PB scheme reduction on other relevant pathological information obtained from PB.

Umjetna inteligencija (UI), engl. Artificial intelligence – (AI) zasigurno je najrazvikanija i najrasprostranjenija riječ u područjima znanstvenog istraživanja u proteklih nekoliko godina te je postala najzanimljivije područje razvoja. Pravovremeno prepoznavanje UI kao strategijskog opredjeljenja i investicijskog ulaganja jedno je od najzanimljivijih, ali najsloženijih područja ekonomske teorije i prakse. Usko povezana s procesom društveno ekonomskog razvitka investicija svojim multiplikativnim djelovanjem na gospodarstvo kao cjelinu, bitno opredjeljuje praktično sve ekonomske tokove pa i stanja. Strategijsko planiranje bi svakako trebalo podrazumijevati investicijsko ulaganje u UI te se u značajnoj mjeri koristiti kao mehanizam alokacije raspoloživih resursa posebno u malome gospodarstvu koje ima ograničene prirodne i privredne resurse kao što je hrvatsko.

Mediastinal (thymic) large B-cell lymphoma (Med-DLBCL) is a subtype of diffuse large B-cell lymphomas (DLBCL) with a typical radiological appearance of bulky anterior mediastinal mass, often with areas of necrosis. We report a case of Med-DLBCL with unusual radiological findings and clinical development. Computed tomography (CT) obtained at presentation revealed a huge anterior mediastinal tumor with an axial diameter of 180 mm. Nineteen days after the first cycle of chemotherapy, chest radiography and CT revealed large areas of tumor necrosis and pneumomediastinum with air-fluid levels. To our knowledge, air-fluid levels inside Med-DLBCL have not been previously described. This finding, in combination with necrotic sputum, may indicate communication between the tracheobronchial tree and the tumor.