Aggressive Natural Killer Cell Leukemia: A Rare And Rapidly Progressive Hematologic Malignancy—Case Report And Literature Review, Jennifer Priessnitz, Ali Hariri, Yuliya Levkiavska, Kyle E. Bonner, Stephan I. Fisher, Joshua M. Sill

Department of Medicine Faculty Publications

Aggressive natural killer cell leukemia (ANKL) is a rare, fulminant hematologic malignancy characterized by neoplastic proliferation of mature NK cells. It is frequently associated with Epstein-Barr virus (EBV) infection, although EBV-negative cases have also been reported. While typically observed in young to middle-aged adults of East Asian descent, increasing recognition has led to identification of ANKL across diverse age groups and ethnicities. The disease is defined by a rapid clinical course and poor prognosis, underscoring the importance of early diagnosis and effective treatment. We present a case of a 71-year-old Caucasian male who developed fever, altered mental status, hepatosplenomegaly, pancytopenia, …

Insurance Disparities In Hidradenitis Suppurativa: A Comprehensive Review Of Demographics, Outcomes, And Access To Care, Alim Osman, Alexandra R. Nigro, Michael C. Povelaitis, Marc Z. Handler

Department of Medicine Faculty Publications

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that disproportionately affects women, African Americans, and individuals of biracial descent. It is associated with substantial physical and psychiatric morbidity, reducing quality of life.

Objective: This review analyzed disparities in treatment outcomes, disease progression, and healthcare access among HS patients based on insurance type.

Methods: Using PRISMA guidelines, a comprehensive literature search identified 7 studies meeting inclusion criteria. Owing to data heterogeneity, studies were qualitatively analyzed.

Results: Findings consistently demonstrated that Medicaid patients experienced worse outcomes than those with private insurance or Medicare. Medicaid patients had higher rates of comorbid …

Percutaneous Closure Of Ventricular Septal Rupture After Myocardial Infarction:, Thomas A. Cook, Simone K. Schumaecker, Anjani Patibandla, Nicholas J. Valle, Matthew R. Summers

Department of Medicine Faculty Publications

BACKGROUND: Ventricular septal rupture (VSR) following acute myocardial infarction is a rare but deadly complication with mortality rates exceeding 90% when left untreated. Coronary ischaemia leads to myocardial necrosis and friability resulting in septal rupture, most commonly 3-5 days post-infarction. The sudden development of a left-to-right shunt causes volume overload in the right ventricle, pulmonary vasculature, and left atrium, precipitating biventricular failure, and cardiogenic shock. Management requires careful consideration of timing and modality of closure along with stabilization with mechanical circulatory support in severe cases.

CASE SUMMARY: A 65-year-old female presented with anterior ST-segment elevation myocardial infarction complicated by VSR …

Selenium And Liver Steatosis And Fibrosis: Opposing Direct And Steatosis-Mediated Associations In A Large Cohort, Neda Rehan, Jubilee Benedict, Rehan Qayyum

Department of Medicine Faculty Publications

Background and Aims

Epidemiologic studies have reported conflicting associations between selenium exposure and liver disease. Whether selenium exerts opposing direct and steatosis-mediated effects on liver fibrosis is unknown. To evaluate the associations of blood selenium with elastography-defined hepatic steatosis and fibrosis and to determine whether hepatic steatosis mediates the relationship between selenium and fibrosis.

Methods

We conducted a cross-sectional analysis of adults aged >= 18 years in NHANES 2017-2023. Hepatic steatosis was assessed using the controlled attenuation parameter (CAP) and fibrosis using liver stiffness measurement (LSM). Blood selenium was categorized into quartiles. Survey-weighted multivariable linear regression and structural equation modeling …

Seasonal And Geographic Patterns Of Gastroschisis In Canada: Protective Effect Of Periconceptional Sunlight Exposure, Shiliang Liu, Shin Jie Yong, Dunjin Chen, Gavin C. Hughes, Claude L. Hughes

Department of Medicine Faculty Publications

Background: Gastroschisis is a right-sided, full-thickness defect with extra-amnionic herniation of abdominal contents directly into the amniotic cavity. The causes of gastroschisis remain obscure. We hypothesized that limited periconceptional sunlight exposure might lead to insufficient vitamin D during fetal development and play a role in gastroschisis etiology.

Methods: We conducted a population-based cohort study of infants conceived in Canada between April 2006 and March 2020. We used winter months (i.e., November and December) and northern geographic latitudes as indicators of insufficient sunlight exposure, while summer months (July and August) and southern geographic latitudes were considered as reference. We examined the …

T-Cells May Represent A Novel Biomarker For Female Pattern Hair Loss, Juan Marrero Berrios, Iain Noel Encarnacion, Noelle Desir, Aman Prasad, Matthew Hedberg, Susan Taylor, John T. Seykora

Department of Medicine Faculty Publications

[Introduction] Androgenetic alopecia (AGA) is a common non-scarring alopecia classically attributed to androgen sensitivity and genetics. Histopathologic studies have identified perifollicular and perivascular lymphocytic and histiocytic infiltrates, through the composition and clinical relevance of this infiltrate have not been fully characterized.¹ Our study aims to address this gap through detailed quantitative immunohistochemical characterization (IHC) of the inflammatory infiltrate in female patients with AGA compared to telogen effluvium (TE), a non-inflammatory control.

Drug-Induced Lichen Planus Associated With Ocrelizumab, Avery Seward, John D. Strickley, Jeffrey P. Callen

Department of Medicine Faculty Publications

This case report highlights recurrent cutaneous lichen planus as a rare adverse effect of ocrelizumab, with flares occurring after each infusion and improving with prophylactic prednisone. Recognizing this association may help clinicians diagnose and manage similar cases while allowing patients to continue an otherwise effective therapy.

Missed Opportunities For Stroke Prevention In Patients With Hypertension: A Retrospective Case-Control Study, Huanhuan Yang, Yuntian Liu, Chungsoo Kim, Chenxi Huang, Mitsuaki Sawano, Patrick Young, Jacob Mcfadden, Mark Anderson, John S. Burrows, Harlan M. Krumholz, John E. Brush Jr., Yuan Lu

Department of Medicine Faculty Publications

Background

Hypertension is the leading modifiable risk factor for ischemic stroke, yet the adequacy of preventative hypertension care in routine clinical practice remains suboptimal, potentially representing missed opportunities for stroke prevention. We evaluated the association between hypertension care delivery and incident ischemic stroke.

Methods

 We conducted a retrospective, matched, nested case-control study among adults with hypertension using data from a large regional health system (2010-2024). Patients with a first-ever ischemic stroke were matched 1:2 to controls on age, sex, race and ethnicity, and calendar time. Three care metrics were assessed: (1) outpatient visits with blood pressure measurement per year; (2) …

Element-Based Predictive Modeling Of Hydrothermal Liquefaction Bioproducts Derived From Corn Stover, Isamu Umeda, Meicen Liu, Yi Zheng, Jiefu Wang, Zhiwu Wang, Sandeep Kumar

Civil & Environmental Engineering Faculty Publications

The hydrothermal liquefaction (HTL) process offers an energetic advantage over pyrolysis because it does not require prior drying of the biomass feedstock. However, there are significant challenges in simultaneously estimating both the yields and characteristics of products from the HTL of biomass with theoretical support. This study developed a unique element-based kinetic model to predict the yields, higher heating values, and fuel characteristics of solid residue and heavy bio-oil, based on the temperature, residence time, solid loading, and elemental composition (C, H, N, and O) of corn stover. Furthermore, the model predicted the weights of dissolved carbon and nitrogen in …

Harnessing Activated Sludge For The Treatment Of Hydrothermal Liquefaction Wastewater: A Proof-Of-Concept Study, Cyrus Li, Jiefu Wang, Meicen Liu, Yi Zheng, Sandeep Kumar, Isamu Umeda, Chandan Mahata, John Norton

Civil & Environmental Engineering Faculty Publications

Although hydrothermal liquefaction (HTL) is the leading technology in converting wet biomass into bioenergy, the treatment of its toxic-laden aqueous phase wastewater presents a major challenge on its path toward commercial viability. This study presents the first-ever assessment of sewage sludge-fed HTL wastewater (SS-HTLWW) treatment and toxic compound removal using municipal activated sludge (AS) by optimizing its cultivation condition. It was found that AS with optimized pretreatment can remove up to 91.2% of the soluble chemical oxygen demand (sCOD) in SS-HTLWW, of which up to 82% can be attributed to biological mineralization and adsorption of sCOD by AS. Conventional bioprocess …

Coffin–Lowry Syndrome: A Systematic Review Of Rps6ka3 Confirmed Cases And Implications For Diagnosis And Counseling, Sabyasachi Maity, Miranda Montion, Danielle Boothe, Mona Attarpour, Ivy Mageto, Simran Agarwal, Rujul Patel, Chloe Lark, Bharathi Gadad, Nikhilesh Anand

School of Medicine Publications

Background: Coffin–Lowry syndrome (CLS) is a rare X-linked disorder caused by pathogenic variants in RPS6KA3, presenting with intellectual disability, distinctive facial and skeletal features, and variable systemic involvement. Advances in genomic technologies have expanded the mutation spectrum, yet genotype phenotype correlations remain incompletely understood.

Methods: We conducted a systematic review of published cases (n = 72) following PRISMA guidelines. Demographic, phenotypic, and genotypic data were extracted, standardized, and summarized using descriptive statistics. Associations between mutation type and key clinical features were assessed with Chi-square or Fisher’s exact tests. Diagnostic approaches and global distribution were also analyzed.

Results: The cohort …

Spinning-Induced Exertional Rhabdomyolysis Without Acute Kidney Injury, Yolanda V. Gutierrez, Ronald Shaju, Alyssa L. Sepulveda, Joaquin Rivera, Aamir Ahmad

School of Medicine Publications

Rhabdomyolysis is a condition with a myriad of causes, including both traumatic and non-traumatic. Traumatic conditions are observed in crush injuries, compartment syndrome, and fractures, while non-traumatic rhabdomyolysis is commonly seen due to exertional heat stroke, extreme physical exercise, and dehydration. This case report explores two cases of extreme non-traumatic rhabdomyolysis caused by indoor cycling, also known as spinning. A common complication of severe rhabdomyolysis is acute kidney injury (AKI), which increases the risk of renal failure. Rapid interventions such as aggressive intravenous fluids are necessary to prevent kidney function loss. In this case report, two sisters, on two separate …

Repurposing Of Fda-Approved Drugs Identifies Glipizide As A Potent Hmg-Coa Reductase Inhibitor: A High-Throughput Virtual Screening And Molecular Dynamics Approach For Targeting Hypercholesterolemia, Parvej Ahmad, Eswara N. Hanuma Kumar Ghali, Sahir S. Alvi

School of Medicine Publications

Purpose:

Atherosclerotic cardiovascular disease (ASCVD) is one of the leading causes of mortality worldwide. Several inhibitors of 3-hydroxy-3-methylglutaryl-CoA reductase (HMG-R), the key hepatic cholesterogenic enzyme, are prescribed to treat hypercholesterolemia and ASCVD. Statins, the established HMG-R inhibitors, exhibit promising cholesterol-lowering effects; however, their long-term use has prompted significant concerns, necessitating the search for additional therapeutic candidates with strong HMG-R inhibitory activity. Therefore, this study aims to find potential HMG-R inhibitor/s that may help reduce excess cholesterol levels via targeting HMG-R activity.

Methods: In this study, 1285 FDA-approved small molecules were assessed for their HMG-R inhibitory potential using …

Associations Of Blood Pressure Level And Variability With Cortical Thickness: A Cross-Sectional Analysis From The Maracaibo Aging Study, Romeo De Leon, Shana Garza, Silvia Mejia-Arango, Kristina Vatcheva, Sokratis Charisis, Claudia L. Satizabal, Luis J. Mena, Joseph H. Lee, Joseph D. Terwilliger, Eron Manusov

School of Medicine Publications

Background: Although high blood pressure (BP) level and variability are associated with Alzheimer's Disease (AD), their relationship with cortical thickness in brain regions that are associated with AD is unclear. Furthermore, the role of 24-hour BP has not been examined. We investigated the associations of office and ambulatory BP measures with cortical thickness in brain regions implicated in AD.

Methods: We performed a cross sectional analysis of 304 participants without dementia from a population-based study with office and 24-hour BP and magnetic resonance imaging (MRI) data. We considered cortical thickness values derived from 10 regions throughout the frontal, parietal, and …

Training Tomorrow’S Hand Surgeons: Clinical, Leadership, And Structural Trends In Fellowship Education, Ogonna N. Nnamani Silva, Aaron I. Dadzie, Chinenye Ogbonnah, Lydia A. Helliwell, Abhiram R. Bhashyam, Catherine M. Curtin, Tamara D. Rozental, Krystle R. Tuaño

School of Medicine Publications

Purpose: Hand surgery fellowships include trainees from orthopedic, plastic, and general surgery. These pathways present an opportunity to examine variations in graduate medical education structures, such as program size, sponsoring department, and leadership composition. Limited research exists on the characteristics of these programs. The purpose of this study is to assess the structural and leadership characteristics of the Accreditation Council of Graduate Medical Education-accredited hand surgery fellowships in the United States. We hypothesized that characteristics (ie, faculty-to-fellow ratios and case volume) vary by specialty sponsorship. Leadership, although shaped by merit-based criteria, faces challenges in achieving broader demographic diversity.

Methods: A …

A Position Statement On Endovascular Models And Effectiveness Metrics For Mechanical Thrombectomy Navigation, On Behalf Of The Stakeholder Taskforce For Artificial Intelligence-Assisted Robotic Thrombectomy (Start), Harry Robertshaw, Anna Barnes, Phil Blakelock, Raphael Blanc, Robert Crossley, Rebecca Fahrig, Ameer E. Hassan, Benjamin Jackson, Lennart Karstensen

School of Medicine Publications

Although we are making progress in overcoming infectious diseases and cancer, one of the major medical challenges of the mid-21st century will be the increasing prevalence of stroke. Occlusions in large vessels are especially debilitating, yet effective treatment—needed within hours to achieve best outcomes—remains limited because of geographic accessibility. One solution for improving timely access to mechanical thrombectomy in geographically diverse populations is the widespread deployment of robotic surgical systems. Artificial intelligence assistance may enable the safe and effective upskilling of operators in this emerging therapeutic delivery approach. Our aim was to establish consensus frameworks for developing and validating artificial …

Eeg And Imu Gait Signal Processing: A Comparative Assessment Of The "Reza" Exponential Filter And Classic Filters, Reza Pousti, Daniel M. Russell, Derek C. Monroe, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Noise degrades both EEG and gait signals, and classical IIR filters (Butterworth, Chebyshev, elliptic) involve trade-offs between passband flatness, ripple, and roll-off. This study compared a novel exponential "Reza" filter with these designs for neural and locomotor data. We analyzed an open-source mobile brain-body imaging dataset with EEG and gait data from 49 healthy adults (EEG: 256-channel, 512 Hz; IMUs: six APDM Opals, 128 Hz). EEG channels were grand-averaged and band-pass filtered at 0.5-50 Hz, while IMU axes were averaged and band-pass filtered at 0.5-5 Hz. The outcomes were signal-to-noise ratio SNR (dB) and band-integrated Welch PSD (EEG:0.5-50 Hz; IMU:0.5-5 …

The Sequence (S) Index As A Marker Of Diminished Step-To-Step Transition Efficiency In Older Adults, Elham Alijanpour, Ashwini Kulkarni, Peter G. Adamczyk, Daniel M. Russell

Rehabilitation Sciences Faculty Publications

Introduction: Age-related declines in walking efficiency are often attributed to musculoskeletal and neuromuscular changes, yet the mechanisms underlying these inefficiencies remain poorly understood. One key contributor is the step-to-step transition (STST), during which the center of mass (CoM) is redirected between limbs. The Sequence (S) index quantifies the temporal overlap between push-off and collision forces during STST, with higher values indicating greater mechanical energy loss. This study investigated whether aging affects STST efficiency, as quantified by the S index, and examined the timing and impulse characteristics underlying observed differences.

Methods: Thirteen young and eleven older healthy adults walked at five …

Nonlinear Differences In Postural Sway Across Attentional Focus Conditions In Individuals With And Without Anterior Cruciate Ligament Reconstruction, Natalie L. Ferguson, Brian L. Cone, Christopher K. Rhea, Anne Beethe, Breanna Studenka

Rehabilitation Sciences Faculty Publications

BACKGROUND: The structure of variability in postural sway reflects the adaptability and health of the postural control system. Entropy quantifies this structure by measuring the regularity of repeated fluctuations over time. Although entropy has been used to examine sway in neurological populations, little is known about how sway complexity changes following anterior cruciate ligament reconstruction (ACLR). Attentional focus may also influence postural control, with external focus typically promoting more efficient and automatic regulation than internal focus.

AIM: To examine how attentional focus (internal vs. external) influences the structure of postural sway in individuals with and without ACLR.

METHODS: Forty-three participants …

We-Making Through Technology: Social Cohesion And Virtual Adaptation In Community Arts Organizations For Artists With Idd During Covid-19 Pandemic, Yumi Shirai, Michelle Boulanger Thompson, Tamara Shetron

Rehabilitation Sciences Faculty Publications

COVID-19 public health restrictions disrupted in-person arts participation, increasing risks of social isolation and reduced community access. Prior research shows that many people engaged in home-based arts and cultural activities during lockdown, supporting emotional regulation, a sense of belonging, and social connection; however, little is known about how these shifts affected community arts organizations that serve artists with intellectual and/or developmental disabilities (IDD), a population disproportionately impacted by the pandemic and longstanding inequities. We examined how community-based arts organizations adapted programming for artists with IDD during the COVID-19 pandemic, including barriers and unanticipated outcomes relevant to equitable access and participation …

Eeg Signatures Of Motor Development In Early Childhood: A Systematic Review, Sonia Khurana, Ashwini Kulkarni, Thomas C. Bulea, Hunter J. Bennett

Rehabilitation Sciences Faculty Publications

Background

Early identification of motor developmental disorders is limited due to lack of objective neural markers that characterize typical neurodevelopmental patterns. This systematic review interprets and synthesizes existing evidence to propose a framework of EEG signatures associated with motor development in children aged 0-5 years, which may help inform future benchmarks for early assessment and intervention.

Methods

Following PRISMA guidelines, we searched published and gray literature across five databases between 2000 and 2025 (registered protocol). Included studies examined EEG during task-based, resting-state, or sleep studies linked to motor milestones, task performance, or standardized motor assessments. Study quality was assessed using …

The Epidemiology Of Catastrophic Head And Neck Injuries In High School And College Non-Football Sports: A 4-Decade Review, Courtney M. Meyer, Kristen L. Kucera, Samantha E. Scarneo-Miller, Zachary K. Winkelmann, Susan W. Yeargin

Rehabilitation Sciences Faculty Publications

Background:

Catastrophic head and neck injuries (CHNIs) in sport are rare but can have disabling or fatal outcomes. Prior studies have focused on football, equipment-laden sports, or different injury severities, not CHNI in nonfootball sports.

Purpose:

To describe the epidemiology of CHNI across levels (high school vs collegiate) in nonfootball sports and evaluate differences in injury rates (IRs) by sport, sex, and decade.

Study Design

Descriptive epidemiological study.

Methods:

This study utilized 40 academic years (1982-1983 to 2021-2022) of surveillance data from the National Center for Catastrophic Sports Injury Research. Descriptive statistics summarized athlete, event, and injury characteristics. IRs were …

Walking It Off: Habituation Of Gait At Virtual High Elevation, Kelly Poretti, Toby J. Ellmers, Christopher K. Rhea, Tiphanie Raffegeau

Rehabilitation Sciences Faculty Publications

Introduction: Fear and anxiety about falling can disrupt gait control, leading to activity restriction and increased fall risk in older adults. VR can be used to induce postural threat (e.g., by simulating high elevation settings) within a controlled environment, inducing fall-related anxiety and cautious gait (i.e. slower, shorter steps) in young and older adults. However, it is unknown how emotional and motor responses to VR postural threat habituate across time because existing studies feature short exposures (10 seconds or less). Before VR-induced postural threat can be translated into an intervention, it is critical to understand threat-related gait habituation across time. …

Organized Sports-Based Interventions And Motor Outcomes In Children Diagnosed With Autism Spectrum Disorder: A Systematic Review, Kailash Ram, Maeren Hill, Caitlyn Stewart, Kaitlin P. Hardy Md, Sonia Khurana

Rehabilitation Sciences Faculty Publications

Aim

To evaluate the effectiveness of organized sports-based interventions on motor outcomes in children with autism spectrum disorder (ASD).

Method

Four databases were searched from inception to November 2025 for randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) reporting motor outcomes of organized sports-based interventions in children with ASD. Risk of bias was evaluated using ROB-2 (Cochrane Risk of Bias Tool, Version Two) for RCTs and ROBINS-I (Risk Of Bias In Non-randomized Studies - of Interventions) for NRCTs.

Results

Eleven studies (six RCTs, five NRCTs) were included and categorized as martial arts (n = 5), aquatic training (n = …

Technical Skills And Their Roles In Agribusiness Supply Chain Management Education, Ryan Loy, Logan L. Britton, F. Bailey Norwood

Agricultural Economics and Agribusiness Faculty Publications and Presentations

The integration of advanced technical skills and supply chain management (SCM) tools is critical for the evolving demands of agribusiness. This study identifies the technical competencies, software proficiencies, and educational strategies essential for preparing students to excel in modern SCM roles. Through semi-structured interviews with 26 SCM professionals across US agribusiness sectors, the study highlights the demand for expertise in tools such as SAP, Power BI, and SQL alongside capabilities in data-driven decision-making and adaptability. Despite theoretical preparation, graduates often lack practical experience with industry-standard technologies, underscoring a gap in academic curricula. The findings suggest that agribusiness programs should emphasize …

From Reactionary To Anticipatory Integrated Action: Novel Environmental Health Surveillance For Mass Gatherings, Benjamin J. Ryan, Michael Donahoo, Danielle Esler, Paul Barach, Benjamin Coghlan, Shelby Garner, Laura M. Langan, John Piispanen, Bryan W. Brooks

College of Population Health Faculty Papers

Advances in AI-driven analytics, human-in-the loop techniques, and wastewater monitoring provide the foundation needed to shift from reactive to anticipatory actions for mass gatherings. Traditional surveillance systems focus on clinical and laboratory-based notification pathways, which often result in tardy actions being implemented. Thus, traditional surveillance is becoming outdated. Mass gatherings pose heightened public health risks and hazards, including trauma; injury and substance misuse; deliberate poisoning; and infectious diseases such as food and waterborne illnesses, sexually transmitted infections, and respiratory diseases. There is also a heightened concern due to reduced vaccination coverage. As a result, future international events such as the …

Personality Assessment Inventory Profiles In Adults Seeking Autism Spectrum Disorder Assessment, Emily Kinsey

Murray State Theses and Dissertations

The current study aimed to examine differences in interpersonal functioning and response validity among adults presenting for autism spectrum disorder (ASD) assessment compared to those seeking services for other clinical concerns. The study used archival data from 238 client files collected in an outpatient clinical setting. Interpersonal functioning was assessed using the Dominance (DOM), Warmth (WRM), and Nonsupport (NON) subscales of the Personality Assessment Inventory (PAI; Morey, 1991). Response validity was evaluated using the Negative Impression Management (NIM) and Positive Impression Management (PIM) scales. A multivariate analysis of variance (MANOVA) showed no significant group differences across DOM, WRM, and NON …

Parent And Family Engagement In Middle Schools: A Qualitative Exploration Of Parent Perspectives And Student Success In West Tennessee, Angela Y. Searcy

Murray State Theses and Dissertations

Abstract

Parent and family engagement in middle school has been demonstrated to increase students' academic achievement; however, barriers often prevent parental participation. This study focused on parents' and teachers' perceptions of the parents' role in the educational process and sought to answer research questions about parents' perceptions, parents as equal partners in the educational process, and barriers to parental participation. A qualitative research design was used for the study. Teachers and parents from a middle school in West Tennessee participated in interviews to generate data used in this study. Teachers and parents identified common themes affecting the parent-school partnership, including …

Barriers To Mental Healthcare Among Men, Adrienne White

Murray State Theses and Dissertations

Men are consistently less likely than women to seek professional mental health services despite experiencing significant rates of depression and psychological distress. Traditional masculine norms and depression-related stigma have been proposed as major contributors to this disparity. The present study examined the relationships among depression stigma, conformity to masculine norms, depression severity, perceived barriers to care, and attitudes toward seeking professional mental health treatment among adult men with current or past depression. Seventy participants completed measures of depression severity (PHQ-9), conformity to masculine norms (CMNI-30), depression stigma (DSS), attitudes toward help seeking (MHSAS), and perceived barriers to care (BMHS). Contrary …

Tuberculosis Presenting As Multiple Pulmonary Nodules Mimicking Malignancy, Abdel Martinez Borrego, Fatimah Bello, Brandon Cantazaro, Luisa Montoya, Frank Mediola

School of Medicine Publications

Multiple pulmonary nodules often raise concern for metastatic malignancy; however, the differential diagnosis is broad and includes infectious, inflammatory, granulomatous, vascular, and benign etiologies. Tuberculosis (TB), although uncommon, can present with multiple nodules that closely mimic metastatic disease on advanced imaging, requiring careful clinicoradiologic and microbiologic correlation. We describe a woman in her 50s who presented with dyspnea and new-onset heart failure, in whom imaging revealed mediastinal lymphadenopathy and bilateral pulmonary nodules concerning for malignancy. Evaluation was limited by concurrent COVID-19 infection, and CT-guided biopsy demonstrated necrotizing granulomas without evidence of malignancy or infection. She later re-presented with fever and …