National Center for Cancer Care and Research

Background: Papillary thyroid carcinoma (PTC) is the most common form of thyroid malignancy, often presenting with regional lymph node involvement. Castleman’s disease is a rare, non-clonal lymphoproliferative disorder, typically presenting as unicentric or multicentric disease. The incidental coexistence of PTC and Castleman’s disease is exceptionally rare and can complicate the diagnostic and therapeutic approach, especially when lymphadenopathy is involved. Case Presentation: We report the case of a 36-year-old male who presented with a left-sided neck mass and was diagnosed with multifocal classic and diffuse sclerosing variants of PTC, with cervical lymph node metastases. Surgical pathology following total thyroidectomy and lymph node dissection unexpectedly revealed features of unicentric hyaline-vascular variant Castleman’s disease in a non-metastatic lymph node. Immunohistochemical staining confirmed the diagnosis. The patient was asymptomatic with regard to Castleman’s disease and was managed conservatively. PTC was managed with surgery and suppressive levothyroxine therapy, with plans for adjuvant radioactive iodine therapy. Conclusion: This case illustrates a rare dual pathology of PTC with incidental unicentric Castleman’s disease. It highlights the importance of thorough histopathological evaluation in lymphadenopathy associated with thyroid carcinoma and suggests a potential need for increased awareness of concurrent benign lymphoproliferative disorders in oncologic surgery. Further studies are needed to understand the clinical significance and possible pathophysiological link between these two conditions.

Lung perfusion scintigraphy is a cornerstone for evaluating pulmonary embolism but may reveal unexpected vascular anomalies. Persistent left superior vena cava, a congenital anomaly, can cause a right-to-left shunt when draining into the left atrium, bypassing pulmonary circulation. We report the incidental detection of persistent left superior vena cava during lung perfusion scintigraphy in a patient with post-COVID-19 hypoxia. Dual-site radiotracer injections and SPECT/CT confirmed the diagnosis, highlighting the need for adaptive imaging techniques to accurately interpret atypical findings in nuclear medicine.

ABSTRACT Accurately predicting scientific impact and ranking researchers remains a central yet complex challenge in research evaluation. Traditional metrics such as citation counts, publication totals, hybrid measures, and h‐type indices each capture limited aspects of scholarly influence, making it difficult to establish a universally accepted standard. This study proposes a novel composite index designed to enhance the robustness and fairness of researcher ranking. A dataset of 1060 neuroscience researchers comprising both awardees and non‐awardees was analysed to evaluate the ability of existing indices to identify top‐performing scientists. The five indices most strongly associated with awardees were selected and further refined using deep learning models to determine their distinctiveness and combined effectiveness. Eleven statistical models were then tested to integrate the most independent pair of indices. The H2 upper and K indices exhibited the highest disjointness value (0.97), and their harmonic mean produced the most balanced and consistent performance with an average impact score of 0.76. The resulting composite index outperformed traditional metrics, offering a more comprehensive and unbiased measure of researcher impact. This approach demonstrates a scalable and data‐driven framework for improving the accuracy of scientific evaluation and ranking systems.

Assessing a patient with a suspected bleeding disorder is a complex aspect of hematology. Prolonged activated partial thromboplastin time often indicates a coagulation factor deficiency or inhibitor and warrants detailed evaluation. Factor XI deficiency, a rare autosomal recessive disorder, shows variable bleeding tendencies with poor correlation between factor levels and bleeding risk. We report a 24-year-old asymptomatic male with an incidentally prolonged activated partial thromboplastin time during preoperative assessment for septoplasty. He had no bleeding or family history suggestive of a bleeding disorder. Mixing studies showed full correction, and factor assays confirmed severe Factor XI deficiency. Given the uncertain bleeding phenotype, a tailored perioperative plan was implemented, including fresh frozen plasma and prophylactic tranexamic acid. Recombinant activated Factor VII was available as rescue therapy, but not required. The surgery and postoperative course were uneventful, highlighting the importance of individualized perioperative management in Factor XI deficiency.