Clinicopathological Characteristics of RET Rearranged Lung Cancer in European Patients.

INTRODUCTION: Rearrangements of RET are rare oncogenic events in patients with non-small cell lung cancer (NSCLC). While the characterization of Asian patients suggests a predominance of nonsmokers of young age in this genetically defined lung cancer subgroup, little is known about the characteristics of non-Asian patients. We present the results of an analysis of a European cohort of patients with RET rearranged NSCLC. METHODS: Nine hundred ninety-seven patients with KRAS/EGFR/ALK wildtype lung adenocarcinomas were analyzed using fluorescence in situ hybridization for RET fusions. Tumor specimens were molecularly profiled and clinicopathological characteristics of the patients were collected. RESULTS: Rearrangements of RET were identified in 22 patients, with a prevalence of 2.2% in the KRAS/EGFR/ALK wildtype subgroup. Co-occurring genetic aberrations were detected in 10 patients, and the majority had mutations in TP53. The median age at diagnosis was 62 years (range, 39-80 years; mean ± SD, 61 ± 11.7 years) with a higher proportion of men (59% versus 41%). There was only a slight predominance of nonsmokers (54.5%) compared to current or former smokers (45.5%). CONCLUSIONS: Patients with RET rearranged adenocarcinomas represent a rare and heterogeneous NSCLC subgroup. In some contrast to published data, we see a high prevalence of current and former smokers in our white RET cohort. The significance of co-occurring aberrations, so far, is unclear.

Emergence of Blastoschizomyces capitatus yeast infections, Central Europe.

We report 5 cases of disseminated infection caused by Blastoschizomyces capitatus yeast in central Switzerland. The emergence of this yeast in an area in which it is not known to be endemic should alert clinicians caring for immunocompromised patients outside the Mediterranean region to consider infections caused by unfamiliar fungal pathogens.

Primary manifestation of small lymphocytic lymphoma in the prostate.

BACKGROUND: Infiltration of non-haematopoietic organs by small lymphocytic lymphoma/chronic lymphocytic leukaemia (SLL/CLL) is not unusual in late-stage disease and thus quite frequently encountered in post-mortem examinations. However, primary manifestation of SLL/CLL in the prostate is rarely diagnosed. PATIENTS AND METHODS: We report two cases of primary prostatic SLL/CLL, in one case in combination with prostate carcinoma, and discuss diagnostic pitfalls, pathophysiological mechanisms and therapeutic management, together with an overview of the literature. CONCLUSIONS: Lymphocytic infiltration of the prostate associated with obstructive symptoms is rare but can already occur in very early disease. Microscopically, SLL/CLL infiltration can be distinguished from chronic prostatitis by its pattern of infiltration and by immunohistochemistry. As the incidence of both SLL/CLL and prostatic carcinoma increases with age, composite tumours might occur more often in the future.

Short-term low-dose heparin plus bedrest impairs bone metabolism in pregnant women.

OBJECTIVE: To assess the osteoporotic risk of short-term low-dose heparin plus bedrest in pregnancy. STUDY DESIGN: In a prospective case-control study, 10 pregnant women on bedrest receiving prophylactic unfractionated heparin 10,000 IU per day for 7-46 days pre-study and 28 days per-study were compared with 6 normal pregnant controls of similar maternal and gestational age and 10 nonpregnant women of similar age. Serum ionised calcium, 1,25-dihydroxyvitamin D(3), osteocalcin, and urinary calcium/creatinine ratio were determined three times at 2-week intervals. RESULTS: 1,25-Dihydroxyvitamin D(3) was lower in the treated group than in pregnant controls throughout (P<0.03). Osteocalcin was lower at study start than end in both pregnant groups (P<0.05), and lower in the treated group than in either pregnant (n.s.) or nonpregnant controls (P<0.005). Calcium/creatinine ratio differences were non significant (n.s.). CONCLUSION: Short-term low-dose heparin plus bedrest suppresses 1,25-dihydroxyvitamin D(3) and osteocalcin levels in pregnancy.