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[PMID]: 29510639
[Au] Autor:Kopácková M; Beránek P; Bydzovská I; Pytlík R; Soukup J; Mrhalová M
[Ti] Title:Non-Hodgkinuv B-lymfom ovarií s nepríznivou prognózou - náhodný nález pri císarském rezu. [Non-Hodgkin´s B-lymphoma of the ovaries with an unfavourable prognosis - incidental finding during caesarean section].
[So] Source:Ceska Gynekol;83(1):45-49, 2018.
[Is] ISSN:1210-7832
[Cp] Country of publication:Czech Republic
[La] Language:cze
[Ab] Abstract:OBJECTIVE: Presentation of a rare finding non-Hodgkin´s B-lymphoma of the ovary in a patient during caesarean section. DESIGN: Case report. SETTINGS: Department of Obstetrics and Gynaecology, Regional Hospital Liberec, a.s.; First Internal Clinic - Clinic of Hematology, First Faculty of Medicine and General University Hospital, Charles University in Prague; Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University in Praque and Motol University Hospital. RESULTS: Pregnant woman, 31-years old, primiparous, with a history of caesarean section was examinated in our department due to nonspecific abdominal pain during her pregnancy. During the caesarean section of fetal indication we found bilateral ovarian tumours. We performed unilateral adnexectomy. Preliminary diagnosis from frozen section was thecoma, but final diagnosis (after definitive histology, imunohistochemistry and molecular investigation) was high-grade B-cell non-Hodgkin´s lymphoma with c-myc and bcl-6 gene rearrangement (double-hit lymphoma) resulting in an unfavourable prognosis. The patient consequently completed 6 cycles of chemotherapy with a biological treatment, and achieved a complete remission. However, after 6 months, an early generalisation to the CNS appeared, leading to intracranial hypertension refractory to anithypertensive and anti-oedematous therapy, consequently leading to death. CONCLUSION: Non-Hodgkin´s lymphoma of the ovary in pregnancy is a rare adnexal tumour whose treatment requires interdisciplinary cooperation.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Data-Review

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[PMID]: 29499871
[Au] Autor:Muronda M; Russell P
[Ad] Address:Douglass Hanly Moir Pathology, Gynaepath, Macquarie Park, NSW, Australia.
[Ti] Title:Combined ovarian serous cystadenoma and thecoma.
[So] Source:Pathology;, 2018 Feb 27.
[Is] ISSN:1465-3931
[Cp] Country of publication:England
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1803
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:Publisher

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[PMID]: 29327766
[Au] Autor:Slimani O; Ben Temim R; Ajroudi M; Makhlouf T; Mathlouthi N; Attia L
[Ti] Title:Contribution of ultrasound in the study of ovarian fibrothecomas: a series of 47 cases.
[So] Source:Tunis Med;95(1):29-36, 2017 Jan.
[Is] ISSN:0041-4131
[Cp] Country of publication:Tunisia
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Ovarian fibro-thecoma are rare presenting 1 to 4, 7%of ovarian organictumors. These tumors are of stromal origin and contain varied proportion of fusiform connective tissue cells and theca cells. They mainly affect menopausal or perimenopausal women. This tumor is benign in most cases and may be responsible for hormone secretion. OBJECTIVES: Study the epidemiological and clinical data of patients with ovarian fibro-thecoma, analyze ultrasonographic characteristics of these tumors,and evaluate the sensitivity and specificity of pelvic ultrasound in ovarian fibro-thecoma approach. METHODS: A retrospective study of 47 patients who underwent surgical treatment for ovarian fibro-thecoma was performed. Data were collected in our department of gynecologyand obstetrics A within Charles Nicole hospital in Tunis, over a period of 18 years between January 1994 and December 2012. For each of our observations, we analyzed the clinical and para-clinical data, including U.S. characteristics and available MRI data with confrontation to the final histological results. RESULTS: The average age of patients was 45.2 years. The average gravidity was 4 and the mean parity was 3. . Thirty-eight of our patients were postmenopausal (80.85%). Ovarian tumor was discovered incidentally in 11 cases and on the occasion of functional symptoms in 36 cases including pelvic pain in 18 cases. Physical examination revealed a pelvic mass in 17 patients and pelvic-abdominal in 14 patients. All patients underwent a pelvic ultrasound. . Ultrasound identified 49 tumors (2 cases of bilateral tumors). Average size of tumors was 10, 05 cm (4 to 30 cm). ) . Ovarian tumor was echogenic in 9 cases (18.36%), hypoechoic in 14 cases (28.47%), mixed in 14 cases (28.47%) and anechoic in 12 cases (24.49%). The tumor was found to be solid in 27 cases (55.1%); cystic in 8 cases (16.3%) and solido cystic in 14 cases (28.6%).It was compartmentalized in 10 cases. Extra cystic vegetations were found in 2 patients. The tumor was nonvascularized at color Doppler in 47 cases (95.9%) and slightly vascularized in 2 cases (4.1%). Intra peritoneal effusion was objectified in 15 cases. The diagnosis of ovarian fibro-thecoma was raised based on U.S in 25 cases (51.02%) before surgery .MRI was performed in four cases. All patients underwent surgery. We performed laparotomy in 36 cases and laparoscopy in 11 cases. By laparotomy were performed a total hysterectomy with bilateral oophorectomy in most cases (26 patients). By laparoscopy we did lumpectomy in all cases. . The final pathologic examination revealed 19 fibromas, 14cystadénofibromas and 14 fibrothecomas. CONCLUSION: The paraclinical exploration of ovarian fibro-thecoma isbased, as all ovarian tumors, on ultrasound examination. The most typical features are images of solid tumors with regular contours, echogenic or mixed with the presence of streakedshadows.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180112
[Lr] Last revision date:180112
[St] Status:In-Data-Review

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[PMID]: 29257039
[Au] Autor:Tran L; Antic T; Lastra RR
[Ad] Address:Department of Pathology, The University of Chicago Medical Center, Chicago, Illinois.
[Ti] Title:Incidental Gynecologic Tract Neoplasms in Women Undergoing Anterior Pelvic Exenteration for Urothelial Carcinoma.
[So] Source:Int J Gynecol Pathol;, 2017 Dec 18.
[Is] ISSN:1538-7151
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Urothelial carcinoma (UC) invasive into the muscularis propria or tumors unresponsive to treatment are indications for cystectomy. In females, with the goal of achieving complete cancer eradication and for concerns of UC extension into the adjacent pelvic organs, this may also warrant resection of the gynecologic organs. This study is aimed to assess the prevalence of unanticipated gynecologic neoplasms in anterior pelvic exenteration specimens. A retrospective review of pathology reports to identify women undergoing anterior pelvic exenteration for UC was performed (N=221), and incidentally discovered gynecologic tract neoplasms were recorded. Concomitant malignant or premalignant lesions of the gynecologic tract were identified in 8 patients (3.6%). These included endometrial adenocarcinoma [endometrioid type, International Federation of Gynecology and Obstetrics grade 1 (n=2, 0.9%)], cervical high-grade squamous intraepithelial lesion (n=2, 0.9%), Sertoli-Leydig cell tumor of intermediate differentiation (n=1, 0.5%), endometrioid adenocarcinoma of the ovary (n=1, 0.5%), and high-grade serous carcinoma of the ovary (n=1, 0.5%) and fallopian tube (n=1, 0.5%). Benign uterine neoplasms included leiomyomas (n=81, 37%), adenomyoma (n=3, 1.4%), and adenomatoid tumors (n=2, 0.9%). Benign ovarian neoplasms included serous cystadenoma (n=7, 3%), serous cystadenofibroma (n=4, 2%), benign Brenner tumor (n=5, 2.3%), mature teratoma (n=4, 2%), stromal luteoma (n=2, 0.9%), mucinous cystadenoma (n=1, 0.5%), thecoma (n=1, 0.5%), and endometrioid cystadenoma (n=1, 0.5%). Involvement of the gynecologic tract by UC was identified in 11 patients (5%). Spread of UC to the reproductive organs is rare in anterior pelvic exenteration specimens. Coexisting neoplasms of the gynecologic tract are occasionally identified, therefore careful evaluation of these organs is necessary.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171219
[Lr] Last revision date:171219
[St] Status:Publisher
[do] DOI:10.1097/PGP.0000000000000478

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[PMID]: 29132723
[Au] Autor:Young RH
[Ad] Address:James Homer Wright Pathology Laboratories, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States. Electronic address: rhyoung@partners.org.
[Ti] Title:Ovarian sex cord-stromal tumours and their mimics.
[So] Source:Pathology;, 2017 Nov 10.
[Is] ISSN:1465-3931
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Sex cord-stromal tumours of the ovary include many of the most morphologically intriguing ovarian neoplasms and albeit many of them are rare, they factor into the differential diagnosis more often than their frequency might suggest. The most common malignant form, the adult granulosa cell tumour, may grossly simulate various surface epithelial neoplasms. Microscopically, confusion with endometrioid carcinoma may occur because the cords and microfollicles of the granulosa cell tumour may be mimicked by endometrioid carcinoma and the latter may have pale nuclei with nuclear grooves. Thorough sampling generally resolves this differential and if not immunohistochemistry aids. Although the adult granulosa cell tumour typically has cells with scant cytoplasm in some cases the tumour cells are luteinised and others have cells with abundant pale cytoplasm. A reticulum stain may be of great aid in indicating whether cells of the type just noted are of granulosa or theca nature. Variations in the morphology of the juvenile variant of granulosa cell tumour that can be diagnostically challenging include those that have a macronodular pattern with scant follicular differentiation, those with marked sclerosis, and those that are unusually pleomorphic. The uncommon but histologically varied Sertoli-Leydig cell tumour is considered, emphasis being placed on the most recently described variant, the retiform pattern, with its potential to mimic surface epithelial neoplasms and even mixed mesodermal tumours. Considering the usual young age of the patient may be paramount in making this tumour come to the mind of the pathologist. The rare pure Sertoli cell tumour is briefly noted as is the sex cord tumour with annular tubules, well known because of its association in some cases with Peutz-Jeghers syndrome. Most do not have that association, however, but have their own interesting features including a greater than average risk, among sex cord stromal tumours, of nodal metastasis and progesterone production, and an occasional development from them of an otherwise typical Sertoli cell tumour. The stromal family includes the common fibroma which is challenging when it is cellular with some mitotic activity and the approach to such neoplasms is reviewed. Emphasis in the consideration of thecoma is placed on its typical cytological features and the overlap with what may be seen in some adult granulosa cell tumours. The review concludes with three fascinating pure stromal tumours all described within the last several decades: the sclerosing stromal tumour, the unusual luteinised thecoma associated with sclerosing peritonitis and the microcystic stromal tumour. The first is sometimes misdiagnosed when pure stromal neoplasms of other types are vascular and may have pseudolobules and it is essential that the pseudolobules of the sclerosing stromal tumour contain a haphazard admixture of fibroblasts and weakly luteinised cells. The remarkable tumours associated with peritonitis exhibit brisk mitotic activity but appear not to have a metastatic potential; they can cause significant problems because of the sclerosing peritonitis. The microcystic stromal tumour may mimic a steroid cell tumour or thecoma but unlike them is inhibin and calretinin negative, and stains for CD10 and ß-catenin. It often shows bizarre nuclei atypia but limited mitotic activity and appears to be clinically benign on the basis of still limited experience.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1711
[Cu] Class update date: 171114
[Lr] Last revision date:171114
[St] Status:Publisher

  6 / 764 MEDLINE  
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[PMID]: 29106748
[Au] Autor:Yang EJ; Howitt BE; Fletcher CD; Nucci MR
[Ad] Address:Department of Pathology, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA, 94305, USA.
[Ti] Title:Solitary Fibrous Tumor of the Female Genital Tract: A Clinicopathologic Analysis of 25 Cases.
[So] Source:Histopathology;, 2017 Nov 06.
[Is] ISSN:1365-2559
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:AIMS: Solitary fibrous tumor (SFT) is an uncommon spindle cell neoplasm of fibroblastic origin, first described as a tumor of the pleura and now well established at extrapleural sites. However, SFT in the female genital tract is rare and therefore not fully characterized. MATERIAL AND RESULTS: We describe a series of 25 SFTs arising throughout the gynecologic tract, including vulva (14 cases), vagina (1), cervix (1), uterus (6), ovary (2) and fallopian tube (1). The tumors demonstrated classic histology as well as known variant morphologic features, including those with a fatty component, diffuse stromal hyalinization, myxoid stroma, and giant cell angiofibroma-like features. Eleven (11/25, 44%) were considered histologically malignant based on mitotic counts ≥ 4 per 10 high-power field (HPF). Follow-up data was available for 9 (3 to 56 months; mean 25 months). Six patients are alive with no evidence of disease and three are alive with disease. SFT as well as other spindle cell lesions of the gynecologic tract were stained for STAT6. Ninety percent of SFTs showed nuclear expression of STAT6. The majority of other tumor types were negative for STAT6, except in a subset of inflammatory myofibroblastic tumors (1 of 3; 33%), fibroma/thecoma (3 of 56; 5%), and sclerosing stromal tumor (1 of 3; 33%) that demonstrated weak/focal staining. CONCLUSION: Gynecologic SFT can be diagnosed reliably with careful morphologic evaluation and judicious use of immunohistochemical stains, and should be considered in the diagnostic workup of spindle cell tumors of unclear lineage in the female genital tract. This article is protected by copyright. All rights reserved.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171106
[Lr] Last revision date:171106
[St] Status:Publisher
[do] DOI:10.1111/his.13430

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[PMID]: 28770898
[Au] Autor:Qureshi A; Hassan M; Mamoon N; Ali Z; Ahmed IN
[Ad] Address:Pathology Department, Shifa International Hospital, Islamabad, Pakistan.
[Ti] Title:Sex cord stromal tumours of the ovary, experience at Shifa International Hospital Islamabad.
[So] Source:J Pak Med Assoc;67(7):1107-1108, 2017 Jul.
[Is] ISSN:0030-9982
[Cp] Country of publication:Pakistan
[La] Language:eng
[Ab] Abstract:This descriptive study was carried out at Pathology Department, Shifa International Hospital from 2007 to 2016; all sex cord stromal tumours diagnosed during this time period were included. Epithelial, germ cell and metastatic tumours were excluded from the study. A total of 1254 Ovarian tumours were brought to Shifa of which47 (4%) were labeled as sex cord stromal tumours. Of these 36( 76 %)were granulosa cell tumour (adult33, juvenile3), 7 were labeled as sertoli leydig cell tumours (15%), 3 as thecoma/ fibroma group (7%)and only one case was labeled as microcystic stromal tumour of the ovary (2%). Overall age range for sex cord stromal tumours was 42 (12-71). Immunohistochemistry was done in 41 out of 47 cases. Sex cord stromal tumours of the ovary are rare tumours comprising 4% of the total. Adult Granulosa cell tumour is the commonest tumour seen in our study.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 170803
[Lr] Last revision date:170803
[St] Status:In-Data-Review

  8 / 764 MEDLINE  
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[PMID]: 28700438
[Au] Autor:Buza N; Wong S; Hui P
[Ad] Address:Department of Pathology, Yale School of Medicine, New Haven, Connecticut.
[Ti] Title:FOXL2 Mutation Analysis of Ovarian Sex Cord-Stromal Tumors: Genotype-Phenotype Correlation With Diagnostic Considerations.
[So] Source:Int J Gynecol Pathol;, 2017 Jul 11.
[Is] ISSN:1538-7151
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Correlation of FOXL2 mutation status with morphologic features and reticulin staining patterns was performed in a comprehensive single-institutional cohort of ovarian sex cord-stromal tumors. Fifty-one cases were included, 35 of which were morphologically diagnosed as adult granulosa cell tumor, 4 as Sertoli-Leydig cell tumor, 11 as fibroma/fibrothecoma and 1 as a thecoma. Of the adult granulosa cell tumors, 31 (88.6%) harbored FOXL2 mutation. Abundant pale cytoplasm was seen in 51.6% (16/31) of FOXL2 mutated tumors, compared with 6.7% (1/15) among FOXL2 wild type tumors (P=0.003). Nearly half of FOXL2 negative tumors showed individual pericellular reticulin staining pattern, while none of the FOXL2 positive cases demonstrated this feature (P=0.0001). Nested reticulin pattern was observed in 67.7% of FOXL2 positive tumors, compared with 20% of FOXL2 negative cases (P=0.004). Indeterminate reticulin staining pattern was seen in nearly one third of cases in both groups. Nested reticulin pattern was 87.5% specific and 67.7% sensitive for FOXL2 mutation, while individual reticulin pattern was 100% specific for absence of FOXL2 mutation. No statistical significance was observed between the 2 groups in tumor size, mitotic activity, nuclear atypia, and nuclear grooves. Follow-up was available for 44 patients ranging from 0.3 to 259 months (mean: 67.5 mo). Two patients developed recurrence, both of them harbored FOXL2 mutation. In conclusion, the pathology diagnosis of sex cord-stromal tumors continues to be difficult, and reticulin staining remains a valuable tool as an initial step in the diagnostic work-up. Individual pericellular reticulin pattern essentially rules out adult granulosa cell tumor, while cases with indeterminate or nested patterns can be subjected to FOXL2 mutation testing to aid the diagnosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 170712
[Lr] Last revision date:170712
[St] Status:Publisher
[do] DOI:10.1097/PGP.0000000000000426

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[PMID]: 28628256
[Au] Autor:Ho JD; Bhawan J; O'Brien MJ; Goldberg LJ
[Ad] Address:Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
[Ti] Title:Cutaneous involvement in luteinized thecomas with sclerosing peritonitis (LTSP)-A new finding in a rare syndrome.
[So] Source:J Cutan Pathol;44(10):898-902, 2017 Oct.
[Is] ISSN:1600-0560
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Luteinized thecomas with sclerosing peritonitis (LTSP) is a rare disease characterized by ovarian luteinized thecomas and associated fibrosing peritonitis. Cutaneous involvement has never been reported. We report a case of classical LTSP with skin involvement, outlining the clinical and histopathologic features of this novel presentation of a rare syndrome.
[Pt] Publication type:CASE REPORTS
[Em] Entry month:1706
[Cu] Class update date: 170919
[Lr] Last revision date:170919
[St] Status:In-Process
[do] DOI:10.1111/cup.12990

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[PMID]: 28432270
[Au] Autor:Yance VRV; Marcondes JAM; Rocha MP; Barcellos CRG; Dantas WS; Avila AFA; Baroni RH; Carvalho FM; Hayashida SAY; Mendonca BB; Domenice S
[Ad] Address:Unidade de Endocrinologia do DesenvolvimentoLaboratório de Hormônios e Genética Molecular LIM42, Disciplina de Endocrinologia vividosreis@hotmail.com.
[Ti] Title:Discriminating between virilizing ovary tumors and ovary hyperthecosis in postmenopausal women: clinical data, hormonal profiles and image studies.
[So] Source:Eur J Endocrinol;177(1):93-102, 2017 Jul.
[Is] ISSN:1479-683X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: The presence of virilizing signs associated with high serum androgen levels in postmenopausal women is rare. Virilizing ovarian tumors (VOTs) and ovarian stromal hyperthecosis (OH) are the most common etiologies in virilized postmenopausal women. The differential diagnosis between these two conditions is often difficult. OBJECTIVE: To evaluate the contribution of clinical features, hormonal profiles and radiological studies to the differential diagnosis of VOT and OH. DESIGN: A retrospective study. SETTING: A tertiary center. MAIN OUTCOME MEASURES: Clinical data, hormonal status (T, E2, LH and FSH), pelvic images (transvaginal sonography and MRI) and anatomopathology were reviewed. PATIENTS: Thirty-four postmenopausal women with a diagnosis of VOT (13 women) and OH (21 women) were evaluated retrospectively. RESULTS: Clinical signs of hyperandrogenism were more prevalent in the VOT group than the OH group. Although the VOT group showed higher T and E2 levels and lower gonadotropin levels than the OH group, a great overlap occurred among the hormone levels. A pelvic MRI provided an accurate differentiation of these two conditions. CONCLUSION: In this group of patients, the main features contributing to the differential diagnosis of VOT and OH were serum levels of testosterone and gonadotropins and the presence of an ovarian nodule identified on the MRI. Although the association of clinical, hormonal and radiological features contributes to the differential diagnosis of these two conditions, histopathological analysis remains the gold standard for the diagnosis of ovarian hyperandrogenism in postmenopausal women.
[Mh] MeSH terms primary: Estradiol/blood
Hyperandrogenism/etiology
Ovarian Neoplasms/diagnostic imaging
Ovary/diagnostic imaging
Precancerous Conditions/diagnostic imaging
Testosterone/blood
Up-Regulation
[Mh] MeSH terms secundary: Aged
Cohort Studies
Diagnosis, Differential
Down-Regulation
Female
Follicle Stimulating Hormone, Human/blood
Follow-Up Studies
Humans
Hyperandrogenism/epidemiology
Hyperplasia/blood
Hyperplasia/diagnostic imaging
Hyperplasia/pathology
Hyperplasia/physiopathology
Luteinizing Hormone/blood
Magnetic Resonance Imaging
Middle Aged
Organ Size
Ovarian Neoplasms/blood
Ovarian Neoplasms/pathology
Ovarian Neoplasms/physiopathology
Ovary/pathology
Postmenopause
Precancerous Conditions/blood
Precancerous Conditions/pathology
Precancerous Conditions/physiopathology
Prevalence
Retrospective Studies
Thecoma/blood
Thecoma/diagnostic imaging
Thecoma/pathology
Thecoma/physiopathology
Tumor Burden
Ultrasonography
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Follicle Stimulating Hormone, Human); 3XMK78S47O (Testosterone); 4TI98Z838E (Estradiol); 9002-67-9 (Luteinizing Hormone)
[Em] Entry month:1708
[Cu] Class update date: 170803
[Lr] Last revision date:170803
[Js] Journal subset:IM
[Da] Date of entry for processing:170423
[St] Status:MEDLINE
[do] DOI:10.1530/EJE-17-0111


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