RESUMEN
Main pulmonary artery (MPA) involvement of lymphomatoid granulomatosis (LYG) is extremely rare. We described fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) findings in a case with LYG originated from the MPA. Fluorine-18-FDG PET/CT demonstrated nodular hypermetabolic foci in the MPA, corresponding well to the intraluminal filling defects on CT pulmonary angiography, and the secondary right heart dysfunction was observed. Final diagnosis was made after transcatheter MPA biopsies and multi-disciplinary consultation. The patient recovered completely following the steroid therapy and MPA stenting, which was illustrated on the second 18F-FDG PET/CT.
Asunto(s)
Fluorodesoxiglucosa F18 , Granulomatosis Linfomatoide , Tomografía Computarizada por Tomografía de Emisión de Positrones , Arteria Pulmonar , Humanos , Granulomatosis Linfomatoide/diagnóstico por imagen , Arteria Pulmonar/diagnóstico por imagen , Radiofármacos , Resultado del TratamientoRESUMEN
This study aimed to assess the diagnostic efficacy of left ventricular synchrony (LVS) for detecting coronary artery disease (CAD). We explored whether the LVS index derived from phase analysis of D-SPECT provides superior diagnostic value compared to conventional perfusion analysis in identifying obstructive CAD. Patients with suspected or confirmed CAD underwent drug-stress/rest gated D-SPECT myocardial perfusion imaging (MPI) and coronary angiography (CAG). A 50% stenosis was set as the threshold for obstructive CAD. 110 participants were enrolled in this analysis. There were significant differences in phase standard deviation (PSD), phase histogram bandwidth (PHB) and entropy among the four groups. Patients without cardiac disease and those with mild-moderate stenosis exhibited no noticeable contraction asynchrony. However, LVS indices demonstrated a gradual increase with the progression of coronary stenosis when compared to NC (P < 0.001). Obstructive CAD was identified in 43 out of 110 participants (39%). Optimal cutoff values for diagnosing obstructive CAD during stress were determined as 7.6° for PSD, 24° for PHB, and 37% for entropy, respectively. Notably, PSD, PHB, and entropy indices exhibited higher sensitivity compared to MPI. The integration of the stress-induced LVS indices into routine MPI analysis resulted in a significantly greater area under the curve (AUC), leading to improved diagnostic performance and enhanced differential capacity. Stress-induced LVS indices increase with the severity of coronary artery stenosis by D-SPECT phase analysis. Further, the indices-derived phase analysis exhibits superior sensitivity and discriminatory ability compared to MPI in detecting obstructive CAD.
RESUMEN
Melanoma that develops adaptive resistance to MAPK inhibitors (MAPKi) through transcriptional reprograming-mediated phenotype switching is associated with enhanced metastatic potential, yet the underlying mechanism of this improved invasiveness has not been fully elucidated. In this study, we show that MAPKi-resistant melanoma cells are more motile and invasive than the parental cells. We further show that LAMB3, a ß subunit of the extracellular matrix protein laminin-332 is upregulated in MAPKi-resistant melanoma cells and that the LAMB3-Integrin α3/α6 signaling mediates the motile and invasive phenotype of resistant cells. In addition, we demonstrate that SOX10 deficiency in MAPKi-resistant melanoma cells drives LAMB3 upregulation through TGF-ß signaling. Transcriptome profiling and functional studies further reveal a FAK/MMPs axis mediates the pro-invasiveness effect of LAMB3. Using a mouse lung metastasis model, we demonstrate LAMB3 depletion inhibits the metastatic potential of MAPKi-resistant cells in vivo. In summary, this study identifies a SOX10low/TGF-ß/LAMB3/FAK/MMPs signaling pathway that determines the migration and invasion properties of MAPKi-resistant melanoma cells and provide rationales for co-targeting LAMB3 to curb the metastasis of melanoma cells in targeted therapy.