Burkitt's Lymphoma of the Colon: A Case Report and Review of the Texas Cancer Registry.

Burkitt's lymphoma (BL) is an aggressive form of non-Hodgkin's B-cell lymphoma with gastrointestinal (GI) involvement, but very few cases report primary colonic findings. We report one case of primary sporadic BL of the colon with non-specific GI symptoms, and its morphologic and immunohistochemical features. In addition, we reviewed and analyzed data from the Texas Cancer Registry between the years 1995 and 2016 in order to provide insight into the demography and epidemiology of BL originating in the colon. This paper reports a 69-year-old male who presented with a history of irritable bowel syndrome, was diagnosed with BL in the colon, and subsequently developed abdominal compartment syndrome. Biopsies derived from the colon tumor at three different sites showed infiltrating malignant lymphoma of the lamina propria. Immunohistochemistry stains of lymphoma cells were positive for CD20, CD79a, CD10, MUM1, BCL6, C-MYC, and negative for BCL2, cyclin D1, CD5, and CD3. Ki-67 demonstrated a high proliferative index of 100%. Forty-nine cases of primary BL of the colon were reported to the Texas Cancer Registry between 1995 and 2016. The unadjusted incidence of BL originating in the colon in persons 18 years old and over was 1.32 per 10 million, and the majority of the cases involved non-Hispanic white males with cecum being the most common primary site. BL is a rapidly growing malignancy, hence, reporting cases of BL and its presenting symptoms can improve assessment and management. Our analysis from the Texas Cancer Registry further supports the rarity of primary sporadic BL in the colon.

Lipoprotein particle concentrations in children and adults following Kawasaki disease.

OBJECTIVE: To test the hypothesis that children and adults with a history of Kawasaki disease (KD) are more likely to have abnormal lipoprotein particle profiles that could place them at increased risk for developing atherosclerosis later in life. STUDY DESIGN: Fasting serum samples were obtained from 192 children and 63 adults with history of KD and 90 age-similar healthy controls. Lipoprotein particle concentrations and sizes were measured by nuclear magnetic resonance spectroscopy (LipoScience Inc, Raleigh, North Carolina), and serum was assayed for total cholesterol (TC), triglycerides, and high-density lipoprotein (HDL) cholesterol (HDL-C). Low-density lipoprotein (LDL) cholesterol was estimated using the Friedewald formula. Data were analyzed in a least-square means model, with adjustment for age and sex and with the use of Holm correction for multiple comparisons. RESULTS: Compared with respective control groups, both adult and pediatric subjects with KD had significantly lower mean very low-density lipoprotein-chylomicron particles, intermediate-density lipoproteins, triglycerides, and TC concentrations. Pediatric subjects with KD had significantly lower LDL particle and LDL cholesterol concentrations and lower mean TC/HDL-C ratio (P < .001). In contrast, the adult subjects with KD had significantly lower HDL particle, small HDL particle, and HDL-C concentrations (P < .001), but HDL-C was within normal range. CONCLUSIONS: Nuclear magnetic resonance lipoprotein particle analysis suggests that pediatric and adult subjects with KD, regardless of their aneurysm status, are no more likely than age-similar, healthy controls to have lipid patterns associated with increased risk of atherosclerosis.

Cardiovascular biomarkers in acute Kawasaki disease.

BACKGROUND: Endomycocardial biopsies have demonstrated that subclinical myocarditis is a universal feature of acute Kawasaki disease (KD). METHODS: We investigated biochemical evidence of myocardial strain, oxidative stress, and cardiomyocyte injury in 55 acute KD subjects (30 with paired convalescent samples), 54 febrile control (FC), and 50 healthy control (HC) children by measuring concentrations of cardiovascular biomarkers. RESULTS: Levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and soluble ST2 (sST2) were elevated in acute vs. convalescent KD, FC, and HC (p≤0.002), while γ-glutamyl transferase and alanine amino transferase as measures of oxidative stress were increased in acute vs. FC (p≤0.0002). Cardiac troponin I (cTnI) levels, using a highly sensitive assay, were elevated in 30% and 40% of paired acute and convalescent KD subjects, respectively, and normalized within two years of disease onset. NT-proBNP and sST2 negatively correlated with deceleration time, but only NT-proBNP correlated with MV E:A ratio and internal diameter of the coronary arteries (RCA/LAD Zworst). CONCLUSIONS: NT-proBNP and sST2 were elevated in acute KD subjects and correlated with impaired myocardial relaxation. These findings, combined with elevated levels of cTnI, suggest that both cardiomyocyte stress and cell death are associated with myocardial inflammation in acute KD.