Inflammatory Myofibroblastic Tumor of the Hilar Bile Duct: A Case Report and Literature Review.

Background: Inflammatory myofibroblastic tumor (IMT) is a very rare tumor and occurs seldom in the biliary tract. IMT can occur in any part of the body and in people of any age; however, it most commonly occurs in children or adolescents. Its etiology and pathogenesis are currently unknown. The clinical manifestations of a hilar inflammatory myofibroblastic tumor are atypical, and the imaging examination is nonspecific. The diagnosis is mainly based on histopathology and immunohistochemistry findings, and surgical resection is the preferred treatment method. Case Description: Herein, we report a rare case of hilar bile duct IMT and review the related literature. Our patient was a 54-year-old woman presenting with a 1-day history of upper abdominal pain as the main clinical symptom. She was misdiagnosed as having cholangiocarcinoma before the surgery. She underwent surgery and was ultimately diagnosed with IMT based on histopathology and immunohistochemistry findings. On 1-year follow-up, no tumor recurrence or related complications were noted. Conclusions: We hope this case report helps clinicians gain a deeper understanding of biliary IMT of the hilum.

Neutrophil-lymphocyte ratio: a controversial marker in predicting Crohn's disease severity.

Peripheral blood-derived inflammation-based scores such as the neutrophil-lymphocyte ratio (NLR) have recently been proposed as prognostic markers in ulcerative colitis. In some previous serological markers are commonly used to detect the severity of the Crohn's disease (CD), but their sensitivity and specificity are relatively low. So we want to use simple indicators which are easy to obtain to predict disease severity. Now, we investigated and compared the capacity of NLR and other inflammatory markers in detecting CD activity and differentiating CD patients from healthy controls. These CD patients had not received corticosteroid or immunosuppressive drugs within a defined period of time. Data from our hospital between 2010 and 2012 was used. Neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cells (WBC), platelet count and albumin were measured in 44 patients with active CD, 66 patients with inactive CD, and 55 healthy blood donors. Disease activity was assessed by the Crohn's Disease Activity Index. In the active CD group, NLR values were found to be elevated compared to inactive CD patients and controls (6.00±7.38, 5.53±6.18 and 1.84±0.85, respectively), but statistical difference was not found between active and inactive CD groups. The overall accuracy of NLR (cutoff: 2.13 fl), CRP (cutoff: 10.5 mg/dl), ESR (cutoff: 19.5 mm/hour) and WBC (cutoff: 9.2 × 10(9)/l) in differentiating CD patients from healthy controls was 80.9%, 67.3%, 71% and 60% respectively. NLR values were found to be correlated with WBC and CRP levels. NLR increased in CD patients compared with healthy subjects. NLR had the best accuracy in determination of CD patients and healthy controls. NLR did not show a discriminative value in disease activity.

MicroRNA-155 promotes the proliferation and invasion abilities of colon cancer cells by targeting quaking.

The increasing expression of microRNA­155 (miR­155) and decreasing expression of RNA­binding protein quaking (QKI) in colon cells have been observed previously. In this study, we attempted to establish the correlation between miR­155 and QKI. In addition, we assessed whether the expression of miR­155 and QKI is linked to the proliferation and invasion capabilities of colon cells. Firstly, nineteen tumor samples, divided into two groups according to the presence or absence of lymphatic metastasis, were obtained from colon cancer patients at the First Affiliated Hospital of Wenzhou Medical University, China. The expression level of miR­155 and QKI was measured by quantitative polymerase chain reaction (qPCR). Secondly, the GES­1, SW480 and COLO205 cell lines were cultured and the expression level of QKI and miR­155 was also assessed by qPCR. Thirdly, a luciferase reporter gene assay was performed to detect the association between miR­155 and QKI, and qPCR and western blot analysis were performed to confirm the effects of miR­155 on the expression of QKI at the mRNA and protein level. Subsequently, the SW480 cells were used in the following experiments. Following treatment with miR­155 inhibitor and QKI overexpression vector, western blot analysis, propidium iodide (PI) staining and a cell scratch assay were carried out to assess the effects of miR­155 on the proliferation and invasion potential of colon cancer cells. qPCR findings revealed higher miR­155 expression and lower QKI expression in colon cancer tissues as well as the colon cancer cell lines SW480 and COLO205. The relative luciferase activity of the 3' untranslated region (3'UTR) was decreased by approximately 45% when SW480 cells stimulated by mimic­miR­155 were combined with the wild­type 3'UTR constructs. In addition, when the cells were treated with mimic­miR­155, QKI expression was significantly decreased at the mRNA and protein level. These outcomes revealed that miR­155 decreased the production of QKI by acting on the 3'UTR of the QKI gene. Furthermore, PI staining and the cell scratch assay revealed that miR­155 influenced the cell cycle and invasion abilities of colon cancer cells by directly targeting QKI and decreased the production of QKI by acting on the 3'UTR of the QKI gene. This study has demonstrated the correlation between miR­155 and QKI, in which miR­155 regulates the cell cycle and invasion ability of colon cancer cells via the modulation of QKI expression. Our study provides novel therapeutic strategies for colon cancer therapy.

Intra-thyroid thyroglossal duct cyst: a case report and review of literature.

Thyroglossal duct cyst is the most common congenital cyst in the head and neck, which is defined usually occurring in children. However, intra-thyroid thyroglossal duct cyst in an adult is unusually found. Here we describe a case of a 45-year-old woman who was found neck mass along the midline for 5 years. During the surgery we found a separated nodule in the left inferior pole of the thyroid. Surprisingly the diagnosis of the nodule was confirmed by pathology and histological examination demonstrating that it was the thyroglossal duct cyst. Intra-thyroid thyroglossal duct cyst in an adult is a rare finding, with few cases reported. For it is generally thought that any thyroid tissue found in the lateral aspect of the neck may indicate metastatic deposits from well-differentiated thyroid carcinoma. Although pathogenesis of an alone thyroglossal duct cyst in the left inferior pole of the thyroid remains unknown, our case could suggest thyroglossal duct cyst should not be excluded in the differential diagnosis of lateral neck masses especially when it simulates nodules in the thyroid.