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Fernández AG, Ayestarán NZ, Miguélez SH. Tracheal Inflammatory Myofibroblastic Tumour ALK+ as Cause of Dyspnea in a 10 Years Old Child. Indian J Otolaryngol Head Neck Surg 2023; 75:2511-2514. [PMID: 37636695 PMCID: PMC10447711 DOI: 10.1007/s12070-023-03775-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/03/2023] [Indexed: 08/29/2023] Open
Abstract
Inflammatory myofibroblastic tumours are rare lesions that could occur in airways. We report a 10 years old male who complains about dyspnea after physical exercise. Making CT and RMI images and a biopsy, we make an accurate diagnosis of an inflammatory myofibroblastic tumour ALK+. After treatment with a subtotal resection and crizotinib as adjuvant, we achieve a complete remission. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03775-5.
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Affiliation(s)
- Andrés González Fernández
- Department of Otolaryngology and head and neck surgery, Virgen del Camino Hospital. Pamplona, Calle Atenas 5, 8ºA (Atenas Street 5, 8ºA), 31016 Navarra, Spain
| | - Nerea Zubicaray Ayestarán
- Department of Otolaryngology and head and neck surgery, Virgen del Camino Hospital. Pamplona, Calle Atenas 5, 8ºA (Atenas Street 5, 8ºA), 31016 Navarra, Spain
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2
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Gao SQ, Bao YJ, Luo JS. Inflammatory Myofibroblastic Tumor of the Hilar Bile Duct: A Case Report and Literature Review. Front Surg 2022; 9:928669. [PMID: 36211291 PMCID: PMC9537756 DOI: 10.3389/fsurg.2022.928669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Inflammatory myofibroblastic tumor (IMT) is a very rare tumor and occurs seldom in the biliary tract. IMT can occur in any part of the body and in people of any age; however, it most commonly occurs in children or adolescents. Its etiology and pathogenesis are currently unknown. The clinical manifestations of a hilar inflammatory myofibroblastic tumor are atypical, and the imaging examination is nonspecific. The diagnosis is mainly based on histopathology and immunohistochemistry findings, and surgical resection is the preferred treatment method. Case Description Herein, we report a rare case of hilar bile duct IMT and review the related literature. Our patient was a 54-year-old woman presenting with a 1-day history of upper abdominal pain as the main clinical symptom. She was misdiagnosed as having cholangiocarcinoma before the surgery. She underwent surgery and was ultimately diagnosed with IMT based on histopathology and immunohistochemistry findings. On 1-year follow-up, no tumor recurrence or related complications were noted. Conclusions We hope this case report helps clinicians gain a deeper understanding of biliary IMT of the hilum.
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Song W, Zhu Y. Clinical characteristics and outcomes of 17 cases of inflammatory myofibroblastic tumor at a University Hospital in China. Oncol Lett 2021; 21:51. [PMID: 33281962 PMCID: PMC7709559 DOI: 10.3892/ol.2020.12312] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/28/2020] [Indexed: 12/30/2022] Open
Abstract
The aim of the present study was to explore the clinical and pathological characteristics, diagnosis, and treatment of inflammatory myofibroblastic tumor (IMT). A total of 17 patients with IMT diagnosed between July 2010 and February 2020 were included in the present study, and the clinical characteristics, pathological features, treatment and prognosis were analyzed retrospectively. The cohort consisted of 17 participants, including 12 men and 5 women, with a mean age of 34.76 years. The most common locations of tumors were the bronchi and the lungs (9 cases, including 1 case involving the mediastinum), followed by the colon and bladder (2 cases each), and the omentum majus, mesocolon, stomach and peritoneal cavity (1 case each). Immunohistochemical staining demonstrated that the tumor cells exhibited positive staining for anaplastic lymphoma kinase p80 (13/17), smooth muscle actin (12/17), cytokeratin pan (6/17), vimentin (5/17) and desmin (4/17). The follow-up time was 18-114 months. A patient with epithelial inflammatory myofibroblast sarcoma (EIMS) succumbed to the disease, 1 case was lost to follow-up, 2 cases relapsed and the other 13 cases were considered cured. IMTs may be malignant or low-grade. EIMS is a rare and invasive variant of IMT. The clinical and imaging manifestations are often unique and vary among individuals. Once confirmed by pathology, radical surgery should be the first choice of treatment.
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Affiliation(s)
- Wei Song
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Yan Zhu
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
- Correspondence to: Dr Yan Zhu, Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, P.R. China, E-mail:
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Zhao J, Han D, Gao M, Liu M, Feng C, Chen G, Gu Y, Jiang Y. Inflammatory myofibroblastic tumor of the neck with thyroid invasion: a case report and literature review. Gland Surg 2020; 9:1042-1047. [PMID: 32953613 DOI: 10.21037/gs-20-355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Inflammatory myofibroblast tumor (IMT) is a unique intermediate soft tissue tumor, comprising myofibroblasts/fibroblasts, with infiltrating plasma cells, lymphocytes, and/or eosinophils. IMT, first reported in 1939 in the lung or pleura, is most common in children or adolescents and in the lungs; however, it can also occur in other tissues. The exact etiology and pathogenesis of IMT are yet to be clarified. Virus-induced trauma, surgery, autoimmune etiology, inflammation, infection, and abnormal responses to long-standing exogenous stimuli in the body, dominated by myofibroblast proliferation, can lead to IMT development. Most patients with IMT have masses, with or without physical manifestations, including fever, weight loss, and various clinical laboratory abnormalities. Surgical resection is the main treatment. IMT is not common in the head and neck region, and additional thyroid involvement is rare. A male patient presented a rapidly growing neck mass was treated and diagnosed with IMT in the neck and thyroid involvement in our hospital in September 2018 by successful surgical resection. Follow-up for 6 months showed no recurrence or metastasis. We review the etiology, clinical features, pathological features, treatment, and prognosis of IMT, with the aim of improving the diagnosis and treatment of this condition in the head and neck region.
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Affiliation(s)
- Jinlu Zhao
- Department of General Surgery and Bio-Bank of Department of General Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Duoji Han
- Department of General Surgery and Bio-Bank of Department of General Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Meizhuo Gao
- Department of General Surgery and Bio-Bank of Department of General Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ming Liu
- Department of General Surgery and Bio-Bank of Department of General Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chulei Feng
- Department of General Surgery and Bio-Bank of Department of General Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Gang Chen
- Department of General Surgery and Bio-Bank of Department of General Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yue Gu
- Department of General Surgery and Bio-Bank of Department of General Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ying Jiang
- Department of General Surgery and Bio-Bank of Department of General Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
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Poggi C, Pecoraro Y, Carillo C, Anile M, Amore D, Mantovani S, Naldi G, Pagini A, Bassi M, Cagnetti S, Mottola E, D'Agostino F, Vannucci J, Pernazza A, Cimino G, Savi D, Gomellini S, Pugliese F, De Giacomo T, Rendina EA, Venuta F, Diso D. Inflammatory Myofibroblastic Tumor After Lung Transplant-A Rare and Aggressive Complication: A Case Report. Transplant Proc 2019; 51:2991-2994. [PMID: 31611127 DOI: 10.1016/j.transproceed.2019.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 08/21/2019] [Accepted: 08/27/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Malignant diseases are well-known complications after lung transplantation (LT). Among these, inflammatory myofibroblastic tumor (IMT) is a rare neoplasm with a not well-known and often aggressive biological behavior. MATERIAL AND METHODS We hereby describe 2 cases of cystic fibrosis patients who underwent bilateral sequential LT (BSLT) complicated by IMT. RESULTS A 26-year-old man presented a right endobronchial lesion 6 months after BSLT. Two consecutive fiber bronchoscopic biopsies showed granulation tissue. For the persistent lesion growth, the patient underwent a transthoracic biopsy showing histologic diagnosis of IMT. Therefore, he underwent to right pneumonectomy that was unfortunately complicated after 6 months with a late bronchopleural fistula and empyema with exitus 6 months later. A 31-year-old woman 1 year after BSLT presented with a left voluminous pleural-parenchymal lesion; the histologic examination after biopsy revealed an IMT. She underwent a removal of the lesion with a macroscopic R0 resection. Histologic, immunophenotypic, and cytogenetic examinations showed a strong overexpression of anaplastic lymphoma kinase requiring biological adjuvant therapies; however, the patient refused it. Four years later, she presented a recurrence treated with debulking procedure and adjuvant radiotherapy. At last follow-up, the patient was alive with stable disease and optimal graft function. CONCLUSIONS Although IMT is a rare complication after lung transplant, to obtain a careful diagnosis, an early and aggressive treatment is mandatory.
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Affiliation(s)
- Camilla Poggi
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I.
| | - Ylenia Pecoraro
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Carolina Carillo
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Marco Anile
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Davide Amore
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Sara Mantovani
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Giuseppe Naldi
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Andreina Pagini
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Massimiliano Bassi
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Sara Cagnetti
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Emilia Mottola
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Federica D'Agostino
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Jacopo Vannucci
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Angelina Pernazza
- Division of Pathology, Sapienza University of Rome, Policlinico Umberto I
| | - Giuseppe Cimino
- Division of Adult Cystic Fibrosis Centre, Department of Public Health and Infectious Diseases, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Daniela Savi
- Division of Adult Cystic Fibrosis Centre, Department of Public Health and Infectious Diseases, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Sara Gomellini
- Division of Oncologic Radiotherapy, AO S. Giovanni Addolorata, Rome
| | - Francesco Pugliese
- Division of Anesthesiology and Intensive Care Unit for Organ's Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Tiziano De Giacomo
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | | | - Federico Venuta
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Daniele Diso
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
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Lisi R, Abate G, D'Urso P, Martinetti MT, Siniscalchi B, Marampon F, Bulzonetti N, Tombolini V. Successful role of adjuvant radiotherapy in a rare case of tracheal inflammatory myofibroblastic tumor: a case report. TUMORI JOURNAL 2019; 105:NP1-NP3. [PMID: 30900517 DOI: 10.1177/0300891619838333] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Inflammatory myofibroblastic tumor (IMT) is a rare benign cancer that can express a more aggressive phenotype related to the genetic mutation of the anaplastic lymphoma kinase receptor (ALK). Involvement of trachea is extremely rare and due to the clinical and radiologic nonspecificity, the definitive diagnosis is based on the histologic evaluation of tissue specimens. Total surgical excision is curative and chemotherapy or radiotherapy has been employed in the treatment of unresectable tumors or as adjuvant therapies. CASE PRESENTATION The case described here is being reported because of the rare tracheal location and the atypical treatment approach used for an ALK-positive IMT. A 7-week pregnant woman voluntary interrupted pregnancy and underwent total surgical excision that resulted to have close margins. Although ALK-positive expression indicated the use of ALK inhibitors, she refused any type of adjuvant therapy that could affect ovarian function. Thus, 3D conformational external beam radiotherapy was performed with a daily dose of 180 cGy, 5 times per week, up to 45 Gy at the level of trachea. A total of 62 months of follow-up showed and no signs of disease recurrence or late radiation therapy-related toxicity. CONCLUSIONS This report describes an extremely rare case of a tracheal IMT, underlying the key role of radiotherapy as adjuvant treatment able to definitively cure IMT, limiting systemic chemotherapy-related toxicity.
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Affiliation(s)
- Roberto Lisi
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Gessica Abate
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Pasqualina D'Urso
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Maria Teresa Martinetti
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Benedetta Siniscalchi
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Francesco Marampon
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Nadia Bulzonetti
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Vincenzo Tombolini
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
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Reddy S, Swamy R, Irugu DVK, Ramji KVV. Transtracheal endoscopic-assisted resection of a rare inflammatory myofibroblastic tumour in adult trachea: a case report. ACTA ACUST UNITED AC 2018; 38:170-173. [PMID: 29967553 DOI: 10.14639/0392-100x-1278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 11/25/2016] [Indexed: 11/23/2022]
Abstract
SUMMARY Inflammatory myofibroblastic tumours (IMTs) are rare and clinically benign in childhood, and malignant in adults. The aetiology of IMTs is not clear, and recent studies report it as true neoplasm rather than a reactive or inflammatory lesion. IMTs can involve any part of the body, but are usually common in lungs. These are rarely seen in adults and tracheal involvement is also rare in both adults and children. We describe an 18-year-old woman who presented with respiratory difficulty to the emergency department. On clinical examination, the patient had complete absence of breath sounds on the right side of the chest. CT of the chest and virtual bronchoscopy revealed a polypoidal soft tissue mass lesion involving the carina with occlusion of right main bronchus. Endoscopic-assisted resection was performed under general anaesthesia and the final pathological diagnosis was tracheal IMT.
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Affiliation(s)
- S Reddy
- Department of Otorhinolaryngology & Head and Neck Surgery, Govt ENT Hospital, Osmania Medical College, Hyderabad, India
| | - R Swamy
- Department of Otorhinolaryngology & Head and Neck Surgery, Govt ENT Hospital, Osmania Medical College, Hyderabad, India
| | - D V Kumar Irugu
- Department of Otorhinolaryngology & Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - K V V Ramji
- Department of Otorhinolaryngology & Head and Neck Surgery, Govt ENT Hospital, Osmania Medical College, Hyderabad, India
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Saoud M, Patil M, Dhillon SS, Pokharel S, Picone A, Hennon M, Yendamuri S, Harris K. Rare airway tumors: an update on current diagnostic and management strategies. J Thorac Dis 2016; 8:1922-34. [PMID: 27621844 DOI: 10.21037/jtd.2016.07.40] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Marwan Saoud
- Department of Medicine, Critical Care and Sleep Medicine, Department of Medicine, State University of New York, Buffalo, New York, USA
| | - Monali Patil
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, State University of New York, Buffalo, New York, USA
| | - Samjot Singh Dhillon
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, State University of New York, Buffalo, New York, USA;; Department of Medicine, Interventional Pulmonary Section, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Saraswati Pokharel
- Department of Pathology, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Anthony Picone
- Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Mark Hennon
- Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York, USA;; Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Sai Yendamuri
- Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York, USA;; Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Kassem Harris
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, State University of New York, Buffalo, New York, USA;; Department of Medicine, Interventional Pulmonary Section, Roswell Park Cancer Institute, Buffalo, New York, USA
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Yan Q, Hu XL. Inflammatory myofibroblastic tumor of the larynx: report of a case and review of the literature. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:13557-13560. [PMID: 26722573 PMCID: PMC4680518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 09/14/2015] [Indexed: 06/05/2023]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm, most commonly seen in children and adolescents. It can occur in nearly every part of the body. Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm mostly seen in the lungs, but also in extrapulmonary sites. But it may rarely be seen in the vical cord. We report a case of a 73-year-old men presented with hoarseness and cough. Laryngoscopy reveals a large non-ulcerated, red subepithelial mass arising from the right vical cord. Magnetic resonance imaging (MRI) scan revealed a mass in the right vical cord, and magnetic resonance imaging (MRI) enhanced scan showed the mass of the right vical cord inhomogeneous enhancement. The patient underwent right cordectomy with KTP laser, and further assessment of the tissue demonstrated a pathologic diagnosis of IMT.
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Affiliation(s)
- Qian Yan
- Department of Emergency, Affiliated Hospital of Hangzhou Normal University Hangzhou, 310015, PR China
| | - Xue-Ling Hu
- Department of Emergency, Affiliated Hospital of Hangzhou Normal University Hangzhou, 310015, PR China
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