Clinical Presentations and Intense FDG-avidity in Pulmonary Angiomatoid Fibrous Histiocytoma with Potential Diagnostic Pitfalls: A Case Report and Literature Review.

INTRODUCTION: Angiomatoid fibrous histiocytoma (AFH) is a borderline tumor usually affecting the the children or young adults. 18F-Fluorodexoyglucose (FDG) positron emission tomography/computed tomography (PET/CT) investigations of pulmonary AFH are rare, and there are currently no reports of intense FDG uptake in AFH. CASE REPORT: We report an AFH that occurred in the lung of a 57-year-old woman. She presented with paroxysmal cough and occasional bloodshot sputum. 18FFDG PET/CT revealed a right parahilar nodule with intense FDG-avidity, middle lobe atelectasis, and several bilateral axillary lymph nodes with mild hypermetabolic activity. This patient underwent a right middle lobe lobectomy via video-assisted thoracoscopy. Histopathologically, the diagnosis was pulmonary AFH. She had an uneventful postoperative course, and the bilateral axillary lymph nodes regressed during postoperative follow-up. CONCLUSIONS: The clinical presentation and image findings of patients with primary pulmonary AFH may be potential diagnosis pitfalls. The diagnosis of lymph nodes or distant metastases should be approached with caution. To avoid misdiagnosis, biopsy with histological examination and immunohistochemichal staining should be performed as early as possible.

The sensitivity and specificity of 18F-FDG PET/CT in spinal leptomeningeal metastases: the synergistic effect of the 18F-FDG PET-CT to gadolinium-enhanced MRI.

Background: Magnetic resonance imaging (MRI) plays an important role in the diagnosis of leptomeningeal metastases (LM); however, some sub-centimeter lesions may be missed. Positron emission tomography/computed tomography (PET/CT) has a high sensitivity and may play a synergistic role with MRI in diagnosing spinal LM (SLM). We aimed to retrospectively evaluate the detection of SLM with 18F-fluorodeoxyglucose PET/CT (18F-FDG PET/CT) compared to that of whole spinal cord MRI in a single center. Methods: Patients with SLM who had undergone 18F-FDG PET/CT and MRI were enrolled. 18F-FDG PET/CT imaging findings were independently reviewed by 2 nuclear medicine physicians. 18F-FDG PET/CT findings of SLMs were described. A consistency test was conducted to assess the patient-based diagnostic results obtained by the 2 physicians. Patient-based sensitivity, accuracy, and specificity in diagnosing SLM between 18F-FDG PET/CT and MRI of the whole spinal cord were compared using the chi-square or Fisher's exact test. A P value of <0.05 was considered statistically significant. The receiver operating characteristic (ROC) curve was obtained to assess the diagnostic performance of maximum standardized uptake value (SUVmax) to diagnose SLM. Results: A total of 16 patients with SLM were included in this study from October 2010 to April 2022. The primary tumor involved the lungs, liver, ovaries, prostate, esophagus, and unknown primary site. The mean age of patients, including 13 males and 3 females, was 57.8±11.2 (range, 34-73) years. Of 16 patients with SLM, 10 had nodular diseases, 2 had linear diseases, and 4 had mixed diseases. The kappa value of the consistency test of the 2 radiologists' diagnostic results was 0.765. The patient-based sensitivity, specificity, and accuracy of 18F-FDG PET/CT in diagnosing SLM were 87.5%, 89.2%, and 88.7%, respectively and those of whole spinal cord MRI were 75.0%, 100.0%, and 92.5%, respectively. There were no significant differences in sensitivity, specificity, and accuracy between the 2 methods, with P values of 0.654, 0.115, and 0.506, respectively. However, more nodular diseases were observed on PET/CT. The area under the ROC curve (AUC) for the prediction of SLM by SUVmax was 0.907 [95% confidence interval (CI): 0.831-0.983]. When SUVmax ≥2.45, the Youden index was the largest, and the sensitivity and specificity were 89.3% and 75.7%, respectively. Conclusions: 18F-FDG PET/CT is a good choice of imaging modality for assessing SLM. In the diagnosis of SLMs, PET/CT and enhanced MRI can play a better synergistic role.

A rare imaging presentation with multisystemic clinicopathological features of Langerhans cell histiocytosis: Case report and literature review.

RATIONALE: Langerhans cell histiocytosis (LCH) is a kind of rare disease in which dendritic cells proliferate abnormally. It often occurs in children and can involve any tissue and organ. The affected sites usually include bone, skin, pituitary gland, and lungs, while the thyroid gland and external auditory canal are rarely observed. The perineal and labial involvement of this disease has not been reported yet. PATIENT CONCERNS: A 47-year-old female patient experienced a swelling of the anterior neck area without an obvious inducement. She noticed a quail egg-like mass on the left side, and the mass increased progressively within 3 months. The anterior neck area was found to be swollen, and some flaky red rashes were seen on the scalp and bilateral external auditory canals. DIAGNOSES: Imaging examination showed enlarged thyroid and cervical lymph nodes, multiple low-density nodules in the liver, and reduced signal in the posterior pituitary gland. The biopsy pathological result of the increased left cervical lymph node indicated that LCH was detected. INTERVENTIONS: VP regimen (vincristine, dexamethasone per os) and related supportive treatments were given as inducing chemotherapy for 6 weeks. OUTCOMES: After the second chemotherapy, the rash on the scalp and external auditory canal improved, and the neck mass was significantly reduced. After the third chemotherapy, the rash was mostly disappeared, while the neck lumps increased during chemotherapy. Thus, clatribine chemotherapy was recommended as the follow-up. LESSONS: Imaging examinations played an important role in the diagnosis and follow-up of the disease, especially 18F-FDG PET/CT, which could show multiple involving organs at the same time. When a patient suffering from diabetes insipidus, skin rash, or fever, has a high FDG uptake PET/CT result in multiple tissues and organs throughout the body, it is necessary to consider the possibility of LCH.

Role of 18F-FDG PET/CT in patients affected by pulmonary primary lymphoma.

Background: Primary pulmonary lymphoma (PPL) is defined as clonal abnormal hyperplasia of lung parenchyma or bronchial lymphoid tissue originating from bronchial mucosal tissue. However, PPL is rare, which accounts for approximately 3-4% of extraneurotic lymphomas and 0.5-1% of all primary tumors in the lung. Owing to the lack of any typical clinical symptoms and radiological features, it is challenging to accurately diagnose PPL, which affects its clinical management and prognosis. Considering this, herein, we aim to raise awareness of this disease and help physicians understand the role of 18F-FDG PET/CT in the diagnosis of PPL. Method: A retrospective analysis was performed on the clinical and 18F-FDG PET/CT imaging data of 19 patients diagnosed with PPL by biopsy pathology at our hospital from April 2014 to December 2021. Results: Of the 19 PPL patients, 15 patients showed clinical symptoms with the most common being fever and cough. In addition, there were 4 cases that had no clinical symptoms, and all of them were MALT lymphoma. In fact, 16 patients were misdiagnosed as lobar pneumonia, lung cancer, tuberculosis, and diffuse interstitial inflammation, representing a misdiagnosis rate of 84.2%. Also, 73.7% were MALT lymphomas, representing the most common pathological pattern, along with 3 DLBCL and 2 T-cell lymphomas. With reguard to CT signs, the air-bronchial sign was found to be the most common, followed by the halo sign and the collapsed leaf sign. On the basis of the predominant radiologic features, lesions were categorized as pneumonic consolidation, nodular/mass type, diffuse interstitial type, and mixed type. The average SUVmax of lesions was 7.23 ± 4.75, the ratio of SUVmax (lesion/liver) was 3.46 ± 2.25, and the ratio of SUVmax (lesion/mediastinal blood pool) was found to be 5.25 ± 3.27. Of interest, the different pathological types of PPL showed different values of 18F-FDG uptake. The 18F-FDG uptake of DLCBL was the most prominent with a SUVmax of 15.33 ± 6.30 and was higher than that of MALT lymphoma with a SUVmax of 5.74 ± 2.65. There appeared similarity in 18F-FDG uptake between MALT lymphoma and T-cell lymphoma. For the SUVmax of lesion, we found statistical significance between MALT lymphoma and DLCBL (P value<0.001). In addition, we also found statistical significance (P value < 0.05) in SUVmax of lesions between pneumonic consolidation type and nodal/mass type, I stage, and other stages. Conclusions: On 18F-FDG PET/CT images, certain features of PPL morphology and metabolism can be identified that may contribute to a better understanding of this disease. In addition, 18F-FDG PET/CT whole-body imaging has the potential to refine the staging of PPL. Most importantly, functional 18F-FDG PET/CT imaging can readily reflect tumor cell activity, thus allowing for the selection of an optimal biopsy site.

Effect of carrier materials on the properties of the andrographolide solid dispersion

Abstract In the work the andrographolide (AG)-solid dispersions (SDs) were prepared by the spray-drying method, using polyethylene glycol 8000 (PEG8000), Poloxamer188, polyvinylpyrrolidone K30 (PVPK30), Soluplus® as carrier materials. The effect of different polymers as carrier materials on the properties of the AG-SDs were studied. The results showed obvious differences in intermolecular interaction, thermal stability, drug state, powder properties, dissolution behavior, and so on of AG-SDs prepared using different polymers as carrier materials. AG-PEG8000-SD was a partial-crystalline and partial-amorphous powder with smaller surface area and pore volume, but it was easy to wetting and did not swell in contact with dissolved medium. AG-Soluplus®-SD was completely amorphous powder with larger specific surface area and pore volume, but it swelled in contact with water. Therefore, the dissolution profile of AG in AG-PEG8000-SD was similar to that in AG-Soluplus®-SD. Soluplus® and PEG8000 were suitable polymers to design AG-SDs, considering both physicochemical properties and dissolution behaviors. The results of this reseach showed that when selecting carrier materials for SD, we should not only consider the state of drugs in SD and the powder properties of SD, but also consider whether there is swelling when the carrier materials are in contact with the dissolution medium.

Chrysophanol exhibits anti-cancer activities in lung cancer cell through regulating ROS/HIF-1a/VEGF signaling pathway.

In the present study, we explored the anti-tumor and anti-angiogenesis effects of chrysophanol, and to investigate the underlying mechanism of the chrysophanol on anti-tumor and anti-angiogenesis in human lung cancer. The viability of cells was measured by CCK-8 assay, cell apoptosis was measured by Annexin-FITC/PI staining assay, and the cell migration and invasion were analyzed by wound-healing assay and transwell assay. ROS generation and mitochondrial membrane potential were analyzed by DCFH-DA probe and mitochondrial staining kit. Angiogenesis was analyzed by tube formation assay. The expression of CD31 was analyzed by immunofluorescence. The levels of proteins were measured by western blot assay. The anti-tumor effects of chrysophanol in vivo were detected by established xenograft mice model. In this study, we found that the cell proliferation, migration, invasion, tube formation, the mitochondrial membrane potential, and the expression of CD31 were inhibited by chrysophanol in a dose-dependent manner, but cell apoptotic ratios and ROS levels were increased by chrysophanol in a dose-dependent manner. Furthermore, the effects of chrysophanol on A549, H738, and HUVEC cell apoptotic rates were reversed by the ROS inhibitor NAC. Besides, the effects of chrysophanol on HUVEC cell tube formation were reversed by the HIF-1α inhibitor KC7F2 and the VEGF inhibitor axitinib in vitro. Moreover, tumor growth was reduced by chrysophanol, and the expression of CD31, CD34, and angiogenin was suppressed by chrysophanol in vivo. Our finding demonstrated that chrysophanol is a highly effective and low-toxic drug for inhibition of tumor growth especially in high vascularized lung cancer.

RETRACTED: Physcion 8-O-ß-glucopyranoside inhibits clear-cell renal cell carcinoma bydownregulating hexokinase II and inhibiting glycolysis.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor-in-Chief and the authors. Panels from Figure 2A appear similar to panels from Figure 3A of the article published by Xiangyang Dou, Meihua Wang, Tao Zhang and Jiapei Yao in The Anatomical Record (2019) https://doi.org/10.1002/ar.24324, Figures 2B and 6B of the article published by C.-L. Xue, H.-G. Liu, B.-Y. Li, S.-H. He and Q.-F. Yue in the Eur. Rev. Med. Pharmacol. Sci. 23 (2019) 5101-5112 https://doi.org/10.26355/eurrev_201906_18174 and Figure 3B of the article published by Bo Liu and Shuo Yu in Biomedicine & Pharmacotherapy 107 (2018) 243-253 https://doi.org/10.1016/j.biopha.2018.07.177. Panels from Figure 6D appear similar to panels from Figure 8D of the article published by The Anatomical Record (2019) https://doi.org/10.1002/ar.24324, Figure 7E of the article published by Ying Niu, Jinping Zhang, Yalin Tong, Jiansheng Li and Bingrong Liu in Life Sciences 237 (2019) 116893 https://doi.org/10.1016/j.lfs.2019.116893 and Figure 7F of the article published by Xiaoping Pan, Chen Wang, Yan Li, Lida Zhu and Ti Zhang in Life Sciences 214 (2018) 124-135 https://doi.org/10.1016/j.lfs.2018.10.064. Although this article was published earlier than the other articles, the Editor decided to retract this article given concerns about the reliability of the data.