Journal Scan: A review of images in clinical medicine of immediate clinical significance, harvested from major international journals

From the desk of the Editor-in-chief

Images in clinical medicine

(1). Peritoneal Coccidioidomycosis

Hayato Mitaka et al, Published February 18, 2026, N Engl J Med 2026;394:793,VOL. 394 NO. 8

Abstract

A 23-year-old man presented with a 2-month history of unintentional weight loss and worsening abdominal pain and distention. He had recently moved to Arizona from a remote Pacific island.

(2). Expiratory Central Airway Collapse

Hadi Jaradeh et al, Published February 28, 2026,

Abstract

A woman with asthma and obstructive sleep apnea presented with a 1-month history of worsening dyspnea and dry cough.

CT of the chest showed anterior bowing of the posterior wall of the intrathoracic trachea during expiration.

(3). Vulvar Melanoma with Vaginal Extension

Francisco Javier , Published March 7, 2026, N Engl J Med 2026;394:1110,DOI: 10.1056/NEJMicm2509511,VOL. 394 NO. 11

Abstract

A 49-year-old woman presented with a 6-month history of an itchy lump on her vulva. Examination showed a painless purple mass originating in the labia minora on the left side.

(4). Massive Intravascular Hemolysis from Clostridium perfringens Bacteremia

Ann Tran, Published March 11, 2026, N Engl J Med 2026;394: e19, DOI: 10.1056/NEJMicm2514135, VOL. 394 NO. 11

Abstract

A 73-year-old woman presented in shock with a 1-day history of malaise, dyspnea, and confusion. Serum samples could not be processed owing to gross hemolysis. Dehemoglobinized red cells and bacilli were seen on a peripheral-blood smear.

(5). Soft Tick Relapsing Fever

Lisa DePledge, Published March 11, 2026, N Engl J Med 2026;394: e18, DOI: 10.1056/NEJMicm2514982,VOL. 394 NO. 11

Abstract

A 74-year-old man was admitted to the hospital with a 3-week history of intermittent fevers, muscle aches, and vomiting. Thin blood smears showed spirochetes.

(6). JAMA Oncology Clinical ChallengeExtensive Oral Ulcerations After Stem Cell TransplantNavya Kuchibhotla,JAMA Oncol,Published Online: March 12, 2026, doi: 10.1001/jamaoncol.2026.0199

A 69-year-old male patient presented to the oral medicine and oncology clinic with substantial oral discomfort and dysphagia. He reported a 6-day history of new-onset muted taste and oral pain, both of which progressively worsened leading up to his clinic visit. His medical history was notable for myelodysplastic syndrome, for which he underwent an allogeneic hematopoietic stem cell transplant (HSCT) approximately 18 months prior, using a reduced-intensity conditioning regimen. His haplo-identical donor was his daughter. He thereafter received posttransplant cyclophosphamide (PTCy), tacrolimus, and mycophenolate mofetil for graft-vs-host disease (GVHD) prophylaxis. At the time of the visit, the patient was taking ruxolitinib, 5 mg, once daily. Additional medical history included hypertension and hyperlipidemia managed with metoprolol and pravastatin, respectively.

Intraoral examination revealed intense erythema and extensive ulcerations involving the labial and buccal mucosae, lateral borders, the ventrum of the tongue, hard palatal mucosa, and the soft palate, as shown in the Figure.

(7). Trigeminal Trophic Syndrome

Anna Kersh et al, Published March 4, 2026, N Engl J Med 2026;394: e16, DOI: 10.1056/NEJMicm2512031,VOL. 394 NO. 10

Abstract

A woman presented with a 1-year history of a crawling sensation on her chin that caused her to scratch the area. An irregular ulcer was present on the right side of her chin, with reduced sensation around the mouth, lip, and chin.

(8). Pulmonary Mucormycosis

Jonas Lötscher, Published February 11, 2026, N Engl J Med 2026;394:699,DOI: 10.1056/NEJMicm2511883, VOL. 394 NO. 7

Abstract

A 49-year-old man with acute myeloid leukemia was evaluated for prolonged neutropenic fever. On examination, there were crackles at the lung bases. CT of the chest revealed a reversed halo sign.

(9). Aortitis Due to Large-Vessel Vasculitis

Hsien-Tzung Liao, Published January 31, 2026, N Engl J Med 2026;394:588, DOI: 10.1056/NEJMicm2513456, VOL. 394 NO. 6

Abstract

A 63-year-old man presented with a 3-month history of chest tightness, palpitations, and abdominal pain. Laboratory studies showed an elevated erythrocyte sedimentation rate and an elevated C-reactive protein level.

(10). Hepatic Angiosarcoma

Nicola Mumoli, Published February 7, 2026, N Engl J Med 2026;394: e11, DOI: 10.1056/NEJMicm2514897, VOL. 394 NO. 7

Abstract

A 60-year-old man presented with a 15-day history of generalized weakness and right upper abdominal pain. Imaging studies revealed diffuse disruption of the hepatic architecture by hyperechoic nodules and areas of necrosis and hemorrhage.

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