Pulmonary arterial hypertension (PAH), a major subtype of pulmonary hypertension (PH), is a significant human pulmonary disease whose pathogenic mechanisms remain incompletely understood. Conventional animal models for PAH induction often fail to fully replicate the entire disease progression, making it difficult to trace the initial causes, key pathogenic events, and early disease mechanisms. We propose an evidence-based hypothesis that Broiler Ascites Syndrome (BAS) exhibits high similarity to human pulmonary arterial hypertension in terms of pathogenic triggers and molecular pathology, suggesting its potential as a spontaneous animal model for PAH research. This review systematically summarizes the pathogenic mechanisms and disease-inducing factors of BAS, analyzing its pathobiological commonalities with PAH. We demonstrate shared features in pulmonary vascular remodeling mechanisms, including cellular dysfunction, tissue fibrosis, and immune dysregulation. Furthermore, consistent reactive mechanisms are observed across different types of PAH-related studies and corresponding poultry research. This collective evidence supports the feasibility of utilizing BAS as a spontaneous animal model for PAH investigation. By comparing the pathogenic mechanisms of BAS and PAH, this work provides novel insights for developing animal models in PAH research. If validated, this model could address limitations of existing models regarding hypoxia tolerance, and right heart remodeling.

Chyloperitoneum is a rare cause of ascites that results from the leakage of lipid-rich lymph into the abdominal cavity. Numerous etiologies can cause chylous ascites, with the most common causes being malignancy, cirrhosis, infection, and post-procedural lymphatic duct injury in adults. We describe a case of delayed chylous ascites formation after a pancreaticoduodenectomy (Whipple) procedure with lymphocele formation and slow leakage into the peritoneal cavity. Prompt recognition and diagnosis are paramount given the high mortality rate, and the management of this condition includes treating the underlying cause, symptom management, nutritional modification, and, in select cases, surgical interventions such as embolization.

Extracellular vesicles (EVs), including exosomes, circulate in body fluids and carry pathological genomic information. High-grade serous ovarian carcinoma (HGSOC) is the most common subtype of ovarian cancer, characterized predominantly by copy number variations (CNVs). This study evaluated the clinical significance of EV-DNA focusing on CNV profiles and exploring its potential as a companion biomarker for predicting therapeutic response and supporting diagnosis in HGSOC. Droplet digital polymerase chain reaction detected concordant CNVs between tumor DNA and EV-DNA in ascites but not in serum. EV-DNA showed higher concordance with the CNV status of tumor DNA than cell-free DNA in ascites. The EV-DNA amount in malignant ascites was significantly higher than that in ascites from benign ovarian tumors (p < 0.05), and elevated EV-DNA was observed even in cytology-negative ovarian cancer, suggesting an increase early in disease development. Moreover, CNV profiles showed marked differences between responders and nonresponders to poly(ADP-ribose) polymerase (PARP) inhibitors. An equation based on five genes (ARID1A, NOTCH3, CSMD3, ELP4, and BARD1) showed strong predictive performance for olaparib response (area under the curve = 0.91). Collectively, these findings indicate that the CNV status of EV-DNA may serve as a non-invasive companion biomarker for patient stratification and therapeutic monitoring in HGSOC.

Adult T-cell leukemia/lymphoma (ATLL) is a rare, human T-lymphotropic virus type 1 (HTLV-1)-driven neoplasm that is often underrecognized in low-endemic regions. We describe a 23-year-old man with an eight-year history of chronic dry cough who later developed weight loss, night sweats, odynophagia, and dyspnea. CT revealed cervical/supraclavicular lymphadenopathy with innumerable pulmonary micronodules, interlobular septal thickening, and ground-glass opacities; abdominal imaging showed hepatosplenomegaly, ascites, and extensive retroperitoneal/mesenteric adenopathy. HTLV-1 ELISA and confirmatory Western blot were positive. Excisional lymph node biopsy demonstrated diffuse architectural effacement by atypical T cells with a CD3+, CD4+, CD5+, CD25+, CD7-, granzyme B+ immunophenotype and a ~90% Ki-67 index, establishing lymphomatous-type ATLL with a cytotoxic profile. Despite rapid recognition, the patient deteriorated and died from respiratory failure 15 days after diagnosis, before chemotherapy could begin. This lung-predominant presentation in a young adult illustrates how ATLL can mimic chronic pulmonary disease and evade early detection outside endemic areas. Clinicians should prioritize early tissue acquisition and a minimal T-cell panel (CD3, CD4, CD25, CD7, Ki-67); a CD4+CD25+ phenotype with CD7 loss should prompt HTLV-1 testing irrespective of geography. Streamlined access to immunophenotyping and confirmatory HTLV-1 assays is essential to reduce diagnostic delays and improve outcomes.

Woody breast (WB) is a prominent growth-related defect affecting chicken meat quality and animal welfare and may contribute to economic loss through carcass condemnation. This study aimed to characterize truckload-level patterns involving WB-type condemnation during whole-bird inspection at a federally inspected abattoir in Alberta, Canada, and to further examine its associations with other rejection causes and potential contributing factors. Data from 13,849 truckloads representing 112 growers (April 2021-March 2024) were analyzed. Rejections due to dead-on-arrival (DOA) and condemnations recorded during postmortem inspection totaled 1.56% of broilers, with subcutaneous issues (0.77%), DOA (0.36%), WB-type condemnation (0.18%), ascites (0.11%), and dark-colored carcasses (0.08%) being the primary causes. Liver conditions (0.05%) and respiratory issues (0.03%) frequently co-occurred with WB-type condemnation, DOA, and ascites, with their within-load proportions often exceeded the respective medians when occurring together. These conditions were more common during cold seasons and in raised without antibiotics (RWA) systems, whereas subcutaneous issues were more prevalent during warm seasons and in systems not strictly limited to RWA. Higher average body weight and relatively younger age were associated with increased DOA, ascites, and WB-type condemnation even within the commercially targeted range. Greater within-load weight heterogeneity was also associated with condemnation causes, particularly respiratory and liver conditions. Clear-off loads showed higher proportions of WB-type condemnations and dark-colored carcasses, but lower rates of subcutaneous issues. These findings describe truckload-level patterns of association and may help inform management strategies to reduce condemnation burden, including WB-related defects.

Blunt abdominal trauma can be difficult to evaluate, especially when an unusual injury mimics a far more common one. We present a case of a 17-year-old boy who was struck in the abdomen by bicycle handlebars. His initial imaging suggested a possible bladder rupture because of the presence of both intraperitoneal and extraperitoneal fluid. A retrograde CT cystogram, however, ruled out any bladder injury. Because of his worsening condition, he underwent an urgent laparoscopy followed by exploratory laparotomy, which revealed a large volume of milky-white free fluid, suggestive of chyle, within the abdomen. Laboratory analysis of the aspirated fluid showed a high triglyceride level of 1,079 mg/dL, confirming the chylous nature of the fluid. There was an enlarged and engorged cisterna chyli in the retroperitoneum suggesting lymphatic injury. Treatment involved applying fibrin sealant in the region of the cisterna chyli, placing a peritoneal drain, and keeping a diet based on medium-chain triglycerides. The patient recovered well without any recurrence of chylous ascites. This case highlights the need to consider rare lymphatic injuries causing posttraumatic chylous ascites when evaluating blunt abdominal trauma with diffuse abdominal fluid collection, particularly when common injuries have been ruled out but the patient's clinical status continues to worsen.

Objective: To analyze the clinical characteristics and key points of diagnosis and treatment in patients with pseudomyxoma peritonei (PMP) presenting with external abdominal hernia as the initial manifestation. Methods: A descriptive case-series study was conducted. From May 2015 to September 2024, a total of 569 patients diagnosed with PMP and treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) were admitted to Beijing Shijitan Hospital. Among them, 13 patients (2.3%) presented with external abdominal hernia as the initial clinical manifestation. Clinical data of these 13 patients were retrospectively analyzed, including the type of inguinal hernia, pathological diagnosis, peritoneal cancer index (PCI), interval from pathological diagnosis to first CRS+HIPEC, completeness of cytoreduction (CC) score, operation duration, and serious adverse events within 30 postoperative days and prognosis. Results: The median age of the 13 patients was 51 years (range 33-71 years), including 10 males. Twelve patients presented with inguinal hernia as the initial symptom: 6 with right inguinal hernia, 5 with left inguinal hernia, and 1 with bilateral inguinal hernia. The remaining 1 patient had an umbilical hernia. The hernia contents were tumor tissue and mucus in 11 patients, while 2 patients had complete spontaneous reduction of hernia contents. Pathological diagnosis showed low-grade in 10 cases, acellular mucus, high-grade, and high-grade with signet-ring cells in 1 case each. The median interval from pathological diagnosis to first standard CRS+HIPEC was 2.5 (range 0.6-11.6) months . Perioperative assessment showed that 7 patients had PCI < 20, 9 patients had CC score 0-1, median ascites volume was 800 (range 0-20 000) ml, median Karnofsky performance status score was 90 (range 80-100), and median operation duration was 655 (range 403-1018) minutes . Seven patients developed postoperative serious adverse events: 4 involving the respiratory system, 1 the circulatory system, 1 the digestive system, and 1 with infection. No deaths occurred within 30 postoperative days. The median follow-up was 61.2 months (95%CI: 36.3-86.1), the mean overall survival was 124.3 months (95%CI: 92.1-156.6), and 2 patients died. Conclusions: In PMP patients presenting with external abdominal hernia as the initial symptom, inguinal hernia is the most common type, and most hernia contents cannot be reduced spontaneously. If PMP is suspected during surgery for external abdominal hernia, prompt referral to a specialized peritoneal metastasis center for CRS+HIPEC is recommended.