RESUMEN
The impact of the coronavirus disease 2019 (COVID-19) vaccination on humoral and cellular immunity in transplant recipients remains unknown. We report the case of a 78-year-old kidney transplant recipient who experienced acute T cell-mediated rejection after receiving the second dose of the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech). She had no history of acute rejection throughout the 13 years after deceased donor kidney transplantation. Fifteen days after receiving the second dose of the BNT162b2 vaccine, the recipient visited our center with a mild headache and fever. Her serum creatinine level had increased from 0.61 to 4.95 mg/dL. Kidney allograft biopsy indicated acute T cell-mediated rejection (grade IB) with no pathologic evidence of antibody-mediated rejection. Anti-severe acute respiratory syndrome coronavirus 2 spike-immunoglobulin G and -immunoglobulin M measurements were weak positive and negative, respectively. Careful monitoring of kidney allograft function is vital for transplant recipients undergoing COVID-19 vaccination.
RESUMEN
Thymic adenocarcinoma is extremely rare. Although its histologic features have been occasionally reported, a lack of description of the cytologic features has hampered the prompt and accurate diagnosis of this condition. Herein, we describe the cytologic findings and histology of four aspiration cytology specimens of thymic adenocarcinoma. The specimens were obtained from primary tumors, metastatic lymph nodes, and pericardial effusions. All four specimens showed three-dimensional glandular clusters with a loss of polarity and nuclear overlapping. One specimen had extensive extracellular mucinous material. Three specimens contained tumor cells with intracytoplasmic vacuoles. While the specimen with extracellular mucin showed relatively mild cytologic atypia, other specimens exhibited more atypical cytologic changes: irregular nuclear membranes, a coarse chromatin pattern, and prominent nucleoli. The cytologic features were correlated with the histologic features in each case of enteric type thymic adenocarcinoma. The differential diagnosis included other thymic carcinomas, yolk sac tumors, and metastatic adenocarcinoma from the lung or colorectum.
RESUMEN
PURPOSE: Deleted in breast cancer 1 (DBC1) is a nuclear protein that was named by its deletion at a region 8p21 in some breast cancers and has been suggested as a poor prognostic indicator of various human cancers. However, the expression level of DBC1 protein and the prognostic role of DBC1 in hepatocellular carcinoma (HCC) have not been reported. METHODS: We investigated the effect of DBC1 protein expression in 199 hepatitis virus-related HCC patients. Immunohistochemical expression of DBC1 were evaluated by tissue microarray. RESULTS: High DBC1 immunoreactivity was observed in 177 (88.9%) of the 199HCC cases and was significantly associated with younger age (P=0.001), higher α-fetoprotein level (P=0.008), hepatitis B virus infection (P=0.001), and liver cirrhosis (P=0.003). High DBC1 expression showed an unfavorable effect on recurrence-free survival (RFS) (P=0.036) and tended to be an independent predictor of shorter RFS (P=0.064). High DBC1 expression did not show an unfavorable effect on overall survival (P=0.575). Five (45.5%) of 11 low grade dysplastic nodules (LGDNs), 8 (80%) of 10 high grade dysplastic nodules (HGDNs), and 10 (83.3%) of 12 early HCCs showed high DBC1 expression. The proportion of high DBC1 expression in LGDN, HGDN, early HCC, and HCC was significantly different, with a stepwise increase (P=0.0002). CONCLUSION: DBC1 protein could be a prognostic marker of shorter RFS in HCC patients after hepatectomy and human hepatocarcinogenesis was a multistep process accompanied by a stepwise increase in high DBC1 expression from LGDN, through HGDN, to HCC. Patients with high DBC1 expression can be considered candidates for adjuvant treatment after hepatectomy.