A Clinical Diagnostic Dilemma: a Case Report of Primary Hepatic Tuberculosis.

BACKGROUND: Primary hepatic tuberculosis is a very rare clinical form of tuberculosis, with atypical clinical presentations and nonspecific imaging features. This results in great difficulty to reach a correct and timely clinical diagnosis. Traditionally, liver biopsy is the gold standard for its diagnosis. Here we assessed the effectiveness of using a T-SPOT.TB test in the early diagnosis of primary hepatic tuberculosis. METHODS: We report a case of primary hepatic tuberculosis whose location of hepatic lesion renders it hard to perform a biopsy. Instead, a T-SPOT.TB test was utilized to help in the early diagnosis of this rare form of tuberculosis. A conventional fourdrug regimen for anti-tubercular therapy together with vitamin B6 was initiated and maintained for 6 months. RESULTS: The T-SPOT.TB test was highly positive for ESAT-6 (87 > 20) and CFP-10 (89 > 20). Dull pain in the upper right abdomen was gone 2 months post treatment. The abnormal lesions shown in an MRI reduced significantly 4 months post treatment. Spot count for ESAT-6 and CFP-10 decreased 6 months post treatment. CONCLUSIONS: The results of this study suggest the critical role of T-SPOT.TB test in the earlier diagnosis of prima¬ry hepatic tuberculosis for those patients who have difficulties having a hepatic biopsy.

Immunotherapy for Non-small Cell Lung Cancer: Current Agents and Potential Molecular Targets.

From radiation therapy and surgery to chemotherapy and targeted therapy, the treatment of non-small cell lung cancer (NSCLC) has remarkably evolved over the past few decades. In recent years, immunotherapy has become an increasingly attractive area of interest in the treatment of NSCLC, especially those in advanced stages. Cytokine and immune checkpoint inhibitors are among the most studied immunotherapies for many cancer types. Herein, we provide an overview of current popular cytokine and checkpoint inhibitor treatment regimens available for patients with NSCLC. Ongoing clinic trials and novel molecular targets that are discussed here could lead to promising new treatment options for NSCLC. The evidence summarized in this review might be helpful for clinicians to better manage patients with NSCLC.