Giving birth after fertility-sparing treatment for primary leiomyosarcoma of the fallopian tube.

Primary leiomyosarcoma of the fallopian tube (PLFT) is an extremely rare gynecological malignancy that has only been described in case reports. Fertility-sparing treatment for PLFT has not been reported previously. A 24-year-old nulligravida woman was diagnosed with stage IC1 PLFT in the right fallopian tube after experiencing right lower quadrant pain for 2 weeks. She underwent laparoscopic right salpingectomy to preserve fertility followed by adjuvant chemotherapy with gemcitabine/docetaxel. She subsequently became pregnant spontaneously, delivering a term baby 27 months after treatment. This appears to be the only report of the use of fertility-preserving treatment for PLFT. The success of the treatment provides valuable information on the preservation of fertility in young women with PLFT.

Screening of prognosis-related Immune cells and prognostic predictors in Colorectal Cancer Patients.

OBJECTIVE: To accurately screen potential immune cells that can predict the survival of colorectal cancer (CRC) patients and identify related prognostic predictors. METHODS: The sample data of CRC patients were downloaded from the GEO database as a training set to establish a prognosis-scoring model and screen prognosis-related immune cells. The sample data of CRC patients from the TCGA database were used as the validation set. Simultaneously, cancer tissue samples from 116 patients with CRC diagnosed pathologically in Shanghai Dongfang Hospital were collected to analyze the relationship of prognosis-related immune cells with patients' survival, and clinical and pathological parameters, and to screen prognostic predictors. RESULTS: Prognosis-related immune cells screened from GEO and TCGA databases mainly included Follicular Helper T cells (Tfh), Monocytes and M2 Macrophages. In the training set, the 2,000- and 4,000-day survival rates were 48.3% and 10.7% in the low-risk group (N = 234), and 42.1% and 7.5% in the high-risk group (N = 214), respectively. In the validation set, the 2,000- and 4,000-day survival rates were 34.8% and 8.6% in the low-risk group (N = 187), and 28.9% and 6.1% in the high-risk group (N = 246), respectively. The prognosis of patients in the high-risk group was worse than that in the low-risk group (P < 0.05). Furthermore, the screened primary prognostic predictors were CD163 and CD4 + CXCR5. CD163 protein expression was distributed in Monocytes and M2 Macrophages. The 1,000- and 2,000-day survival rates were 56.1% and 7.0% in the CD163 low-expression group, and 40.7% and 1.7% in the high-expression group (N = 214), respectively, showing a worse prognosis in the high-expression group than that in the low-expression group. Meanwhile, the immune marker CD4 + CXCR5 could identify Tfh. The 1,000- and 2,000-day survival rates were 63.9% and 5.6% in the CD4 + CXCR5 high-expression group, and 33.3% and 2.8% in the low-expression group (N = 214), respectively, with a better prognosis in the high-expression group than that in the low-expression group. CONCLUSION: Prognostic-related immune cells of CRC mainly include Tfh cells, Monocytes and M2 Macrophages. Monocytes and M2 Macrophages correlate negatively, while Tfh cells correlate positively with the prognosis of CRC patients. Immune markers CD163 and CD4 + CXCR5 can be considered as the prognostic predictors of CRC with clinical value of the application.

A young male with chronic nonproductive cough diagnosed with blastomycosis in China: a case report.

BACKGROUND: Blastomycosis is a fungal infectious disease prevalent in North America and rarely reported in Asia. Misdiagnosis of malignancy and other infectious diseases were reported. CASE PRESENTATION: A 24-years-old male patient presented with chronic non-productive cough of 4 months duration. He had been diagnosed with Mycobacterium tuberculosis infection and lung malignancy elsewhere and presented to us as the symptoms persisted. We offered him the biopsy under endobronchial ultrasound-guide sheath-transbronchial lung biopsy and sample specimen were sent for next generation sequencing analysis, returned as Blastomyces Dermatitidis infection. The patient was treated by itraconazole for 6 months, his symptoms decreased significantly and the CT scan showed resolution of the lesion. CONCLUSION: We shared a case of blastomycosis with delayed and difficult diagnosis and reviewed the knowledge regarding differential diagnosis and next generation sequencing technologies.

Primary malignant melanoma of the lung: a case report and literature review.

BACKGROUND: Malignant melanoma (MM) generally presents as a primary neoplasm of the skin, and most MM cases of the respiratory system are metastatic. Primary MM of the lung (PMML) is quite rare, and its diagnosis is relatively difficult. CASE PRESENTATION: We report the case of a 57-year-old male patient with PMML who denied any history of tumours. His initial complaint was frequent coughs with bloody sputum for 4 days. Chest radiography demonstrated a high-density shadow in the lower lobe of the right lung, which was suspected to be a large space-occupying lesion on subsequent computed tomography (CT) and to be a hypermetabolic tumour by positron emission tomography-CT. To confirm the diagnosis, exploratory surgery was performed. Finally, we confirmed the diagnosis of PMML. CONCLUSIONS: PMML is extremely rare and easily misdiagnosed as lung cancer. Because of its morphological and immunophenotypic variations, the diagnosis of PMML remains difficult. This case report discusses the diagnosis and case management of a patient while referring to the existing literature.

Acute fibrinous and organizing pneumonia: two case reports and literature review.

BACKGROUND: Acute fibrinous and organizing pneumonia (AFOP) is a very rare form of acute or subacute lung injury, which is characterized by patches of "fibrin balls" distributed within the alveoli. Given the lack of typical clinical manifestations, AFOP is often misdiagnosed as pneumonia, tuberculosis, etc. Definitive diagnosis is obtained from a lung biopsy. Corticosteroids are usually effective. CASE PRESENTATION: We report two cases of patients with histopathological manifestations of AFOP, which were significantly improved after corticosteroid therapy. Previous reports of the clinical and pathological characteristics of AFOP were reviewed to improve clinicians' understanding of this disease. CONCLUSIONS: Early identification and diagnosis are very important for AFOP treatment. The prognosis is acceptable after timely and effective treatment.

Glycoprotein M6A Suppresses Lung Adenocarcinoma Progression via Inhibition of the PI3K/AKT Pathway.

Lung adenocarcinoma is the most common subtype of lung cancer and has high morbidity and mortality. Glycoprotein M6A (GPM6A) is a neuronal membrane glycoprotein reported to be related with cancer. However, studies on GPM6A in lung adenocarcinoma are rare. This study aimed to investigate the role of GPM6A in lung adenocarcinoma and its potential mechanism. GPM6A mRNA expression was analysed in 33 types of cancers using The Cancer Genome Atlas (TCGA) datasets. It was compared among normal lung tissues, lung adenocarcinoma tissues, and adjacent tissues using the Oncomine database. Real-time quantitative polymerase chain reaction (RT-qPCR) was performed to detect GPM6A expression in human lung adenocarcinoma cell lines (A549 and H1299) and normal pulmonary epithelial cells (BEAS-2B). When GPM6A was inhibited, cell proliferative capacity was detected by Cell Counting Kit 8 (CCK8), EdU, and colony formation assays. Cell migration ability was detected by wound healing and transwell assays. The expression of epithelial-mesenchymal transition (EMT) markers was detected by Western blotting (WB) and RT-qPCR. When GPM6A was overexpressed, cell proliferation and migration were detected again. Ten nude mice were subcutaneously injected with cells overexpressing GPM6A or empty vector, and the tumor size was recorded on day 14 and then measured every 3 days thereafter. The final tumor weight was measured on day 36. Furthermore, the expressions of phosphoinositide 3-kinase (PI3K), phosphorylated PI3K, AKT, and phosphorylated AKT were detected by WB. Results showed that GPM6A mRNA expression decreased in 15 types of tumors in TCGA dataset. GPM6A expression was lower in lung adenocarcinoma than in normal lung tissues or adjacent tissues in the Oncomine dataset. Similar results were found in lung adenocarcinoma cells. The function study showed that GPM6A downregulation enhanced the proliferation, migration, and EMT of lung adenocarcinoma cells, while GPM6A upregulation inhibited their development. The xenograft results suggested that GPM6A upregulation delayed tumor growth and reduced tumor weight. Moreover, WB showed that GPM6A knockdown activated the PI3K/AKT pathway, while GPM6A upregulation inhibited the activation of the PI3K/AKT pathway. In conclusion, GPM6A suppresses lung adenocarcinoma progression via inhibition of the PI3K/AKT pathway. Thus, GPM6A could be a possible treatment target for lung cancer therapy.

Rare common bile duct metastasis of breast cancer: A case report and literature review.

BACKGROUND: Breast cancer is the most common tumor in women, and about one-third of cases develop metastatic disease. However, metastatic breast cancer rarely invades the common bile duct (CBD) directly without involving the liver, and involvement of the gastrointestinal tract is rare. Cases of such metastases pose a particular diagnostic challenge. CASE SUMMARY: A 55-year-old female presented to the Department of Gastroenterology with complaint of a 2 mo history of right upper abdominal pain accompanied by pain in the right back, aggravated after eating greasy diet. The patient had received a diagnosis of breast cancer 3 years prior. Physical examination showed obvious superficial protuberant erythema on the left neck and chest skin, with slight tenderness and burning sensation. Endoscopic retrograde cholangiopancre-atography showed an obstruction at the end of the CBD. Histopathology of the CBD and symptomatic skin biopsies showed positivity for cytokeratin 7 and trans-acting T-cell-specific transcription factor breast cancer biomarkers. A cancer embolus was also found in the skin vasculature. Accordingly, the diagnosis of breast cancer metastases to the skin and biliary ducts was made. A plastic biliary sent was placed, which relieved the right upper abdominal pain and protected against unnecessary hepatectomy surgery. CONCLUSION: Although rare, biliary metastasis should be considered in patients with bile duct stenosis and a history of breast cancer.

Expression of neuro-oncological ventral antigen-1 in small-cell lung cancer and its value in pathological diagnosis.

BACKGROUND: To investigate the expression of neuro-oncological ventral antigen-1 (Nova1) in small-cell lung cancer (SCLC) and its value in clinical pathological diagnosis of SCLCs. METHODS: Nova1 expression in the SCLC cell line H446, lung adenocarcinoma cell line A549, squamous cell carcinoma (SCC) cell line H226 and bronchial epithelial cell line BEAS-2B were examined by RT-PCR. It's expression in paraffin specimens of 100 SCLC cases, 15 specimens of lung adenocarcinoma cases and 15 specimens of lung SCC cases, as well as adjacent normal tissue was determined by immunohistochemistry. The positive rate of Nova1 in SCLC tissue was compared with those of traditional neuroendocrine markers CD56, Syn and CgA. RESULTS: Nova1 expression in SCLC cell line H446 was significantly higher than that of bronchial epithelial cell line BEAS-2B and lung adenocarcinoma cell line A549 and SCC cell line H226. The positive rate of Nova1 in SCLC tissue was similar to that of CD56 but higher than those of Syn and CgA. Nova1 was neither expressed in the cancer tissue nor in the adjacent normal tissue of the 15 cases of SCC and the 15 cases of adenocarcinoma. In all six cases of combined SCLC, Nova1 was expressed in the SCLC component, whereas markers of SCC or adenocarcinoma were absent. CONCLUSIONS: Nova1 can be used as a novel neuroendocrine marker for pathological diagnosis of SCLC in clinical practice with high sensitivity and specificity, in addition to its role as an independent prognostic marker of overall survival and tumour recurrence, as suggested by previous studies.

NOVA1 expression is associated with clinicopathological characteristics and prognosis in patients with small cell lung cancer.

BACKGROUND: Small cell lung cancer (SCLC) is a highly aggressive lung malignancy which is characteristic of rapid tumor proliferation, metastasis as well as paraneoplastic neurological syndromes (PNS). Recent studies have shown that neuro-oncological ventral antigen-1 (NOVA1) plays a crucial role in the progression of various tumors. However, its effect on SCLC is still exclusive. This study was aimed to explore NOVA1 expression in tumor tissues of SCLC patients as well as its correlation with clinicopathological characteristics and cancer-specific overall survivals. METHODS: In this study, the patients pathologically diagnosed with new primary SCLC were enrolled. Firstly, we compared NOVA1 expression in SCLC tissues and adjacent normal tissues by immunohistochemistry. We further investigated the association of NOVA1 expression with clinicopathological markers (especially the categories of PNS) and survival time in SCLC patients. RESULTS: Our finding exhibited that NOVA1 was remarkably expressed in SCLC tumorous tissues compared with adjacent normal lung tissues (P<0.001). Additionally, NOVA1 expression was closely associated with clinicopathological characteristics in SCLC patients in terms of tumor staging(χ2=15.833; P<0.001), lymph node metastasis (χ2=9.624; P=0.002), brain metastasis (χ2=9.624; P=0.002) and PNS (χ2=5.004; P=0.024). With the COX proportional hazard regression model, we detected that high expression of NOVA1 (HR =0.445; 95% CI: 0.213-0.934; P=0.032) was an independent factor for shorter survival time. CONCLUSIONS: High expression of NOVA1 is closely associated with aggressive clinicopathological characteristics including PNS as well as poor survival in SCLC patients. NOVA1 can be served as a promising predictive factor for prognosis in SCLC.

Inflammatory pseudotumor-like follicular dendritic cell sarcoma: a rare presentation of a hepatic mass.

Follicular dendritic cell (FDC) sarcoma is a rare, low-grade malignant tumor originating from follicular dendritic cells in germinal centers that accounts for 0.4% of all soft tissue sarcomas. FDC sarcoma is classified into two types, the classic FDC sarcoma and inflammatory pseudotumor (IPT)-like follicular dendritic cell (FDC) sarcoma, the latter of which is rarer. IPT-like FDC sarcoma mainly involves the spleen and liver with non-specific clinical and imaging manifestations. It is often misdiagnosed as an inflammatory disease such as a liver abscess or a malignant tumor such as hepatocellular carcinoma, with a pathological morphology similar to inflammatory pseudotumors. IPT-like FDC sarcoma mainly consists of a large number of inflammatory and round, oval and spindle cells with less pleomorphism. These tumor cells are arranged in a whorled, storiform, or sheet pattern. The immunophenotype of IPT-like FDC sarcoma is the same as that of FDC sarcoma and is positive for CD21, CD23, and CD35, and positive for EBER in situ hybridization (ISH). This disease is easily misdiagnosed because it is so rare that clinicians and pathologists may not consider it in diagnosis. Here, a case of IPT-like FDC sarcoma in the liver was reported, and the related literature was reviewed to summarize the clinicopathological features, treatment, and prognosis of this rare new type of FDC sarcoma, providing new knowledge of this rare neoplasm.

A new adsorbent of a Ce ion-implanted metal-organic framework (MIL-96) with high-efficiency Ce utilization for removing fluoride from water.

A novel Ce(iii) ion-implanted aluminum-trimesic metal-organic framework (Ce-MIL-96) was synthesized for the first time via alcohol-solvent incipient wetness impregnation. Compared to previously reported Ce-contained adsorbents, the fluoride adsorption performance of the new ion-implanted metal-organic framework demonstrated much higher adsorption capacity and more efficient regeneration of Ce. In a wide pH range of 3 to 10, Ce-MIL-96 maintained constant adsorption performance for fluoride, and the residual Ce and Al in the treated solution were below the safe limits in drinking water. The maximum adsorption capacity of Ce-MIL-96 was 38.65 mg g-1 at 298 K. Excluding the contribution of MIL-96, the maximum adsorption capacity of Ce ions was 269.75 mg g-1, which demonstrated that the service efficiency of cerium in Ce-MIL-96 is about 6 times that in Ce2O3, nearly 10 times that in Ce-mZrp, and double that in Mn-Ce oxides. There was no significant influence on fluoride removal by Ce-MIL-96 due to the presence of chloride, nitrate, sulfate, bicarbonate or phosphate. Moreover, the adsorption capacity of Ce-MIL-96 remained at more than 70% after nine cycles of adsorption-desorption. Due to this excellent adsorption performance and its regeneration properties, Ce-MIL-96 is a promising adsorbent for the removal of fluoride from groundwater.