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Background This study aimed to compare the diagnostic accuracy of high-frequency ultrasound (HFUS) and fiberoptic ductoscopy (FDS) for pathologic nipple discharge (PND). Methods HFUS and FDS were conducted in 210 patients with PND (248 lesions) treated at our hospital. The diagnostic accuracy of these two methods was compared using pathological diagnosis as the standard. Results Among 248 lesions, 16 and 15 of 16 malignant lesions were accurately diagnosed by HFUS and FDS, respectively. Of 232 benign lesions, 183 and 196 cases were accurately diagnosed by HFUS and FDS, respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of HFUS in diagnosis of intraductal lesions were 84.36% (95% CI 79.26–88.39%), 60% (95% CI 23.07–92.89%), 96.03% (95% CI 96.55–99.83%), and 7.31% (95% CI 2.52–19.4%) respectively. The sensitivity, specificity, PPV, and NPV of FDS in diagnosis of intraductal lesions were 86.83% (95% CI 82.00–90.52%), 100% (95% CI 56.55–100%), 100% (95% CI 98.21–100%), and 13.51% (95% CI 5.91–27.98%) respectively. Diagnostic accuracy rates of HFUS and FDS were 83.87% (208/248) and 85.08% (211/248), respectively, exhibiting no statistically differences (χ2 = 0.80, P > 0.05). The accuracy of HFUS combined with FDS was 93.14% (231/248), showing statistically differences (χ2 = 10.91, P < 0.05). Conclusions Both HFUS and FDS demonstrated high diagnostic values for PND. HFUS has the advantage of non-invasive for nipple discharge with duct ectasia, exhibited good qualitative and localization diagnostic values. It is the preferred evaluation method for patients with nipple discharge. When HFUS cannot identify the cause of PND, FDS can be considered.

Objectives This study reports a rare case of primary extragenital choriocarcinoma in the spleen presenting as acute abdominal pain. We expect this case to provide more valuable information for clinicians in the future. Case presentation The patient was a 22-year-old woman, with a healthy child and a history of bilateral ovarian cyst resection a week before, who presented with severe and sudden pain in the left upper abdomen. The patient was admitted to the emergency department. Emergency ultrasound revealed a huge solid mass in the enlarged spleen. Emergency computed tomography examination suggested acute splenic rupture. Microscopic examination confirmed that the mass contained nested syncytiotrophoblast and cytotrophoblast cells, and the serum beta-human chorionic gonadotropin (β-hCG) level was 54,547.6 IU/L (normal β-hCG level <5 IU/L) after surgery. Primary extragenital choriocarcinoma in the spleen was considered as the cause of splenic rupture. Conclusions Primary extragenital choriocarcinoma of the spleen is extremely rare. Serum β-hCG tests and systemic abdominal ultrasonography are of great value for the diagnosis of the disease.

Sinus of Valsalva aneurysm (SVA) is considered to be an uncommon cardiac anomaly, carrying a very high rate of mortality. After treatment, the prognosis is excellent. Thus, it is important to make a timely diagnosis and clarify the anatomical details of the SVA. Here, we report a right SVA with dissection into the interventricular septum, with bulging and incomplete rupture into the left outflow tract. The SVA was evaluated using echocardiography (transoesophageal, transthoracic, and three-dimensional echocardiography) and cardiac computed tomography (CT), especially three-dimensional reconstruction, to help us plan the surgical approach. After surgery, the patient's recovery was favorable.