[Cervical lymphangioma in the adult. A report of 2 cases]. / Linfangioma de cuello en el adulto. Reporte de 2 casos.

BACKGROUND: Cervical lymphangiomas are uncommon benign congenital malformations usually present in children, and are rare in adults. Currently, complete resection is still the standard care. Two cases are presented of a cervical lymphangioma in an adult. The diagnosis and surgical approach is also discussed. CLINICAL CASE: Case 1. The first case is a 23 year old male with chief complaint of a tumour in the posterior triangle of the neck, which showed a substantial increase in size in the last 9 months. No associated signs or symptoms, or any trauma history was reported. CT scan of the neck showed images suggestive of a posterior cervical lymphangioma. Exploratory cervical surgery was performed, with complete resection of a cystic tumour located in the posterior triangle of the neck. Surgery was performed without complications and postoperative care was unremarkable. CASE 2: The second case is a 28 woman with a cystic tumour in submandibular space. She had history of a previous incomplete operation in another institution 2 years ago, with recurrence of the tumour. A second surgery was performed with complete resection without complications, and with a good outcome. CONCLUSIONS: Cervical lymphangioma is a very rare benign disease, surgical treatment is preferred, but sclerotherapy can be used as alternative treatment.

Multiple unit pooled umbilical cord blood is a viable source of therapeutic regulatory T cells.

BACKGROUND: Regulatory T cells (Treg) are potentially a useful therapeutic option for the treatment of immunopathological conditions including graft-versus-host disease. Umbilical cord blood (UCB) offers certain advantages over adult peripheral blood (APB) as a source of Treg for cellular therapy but yields far fewer Treg per unit. Pooling of Treg from multiple donors may overcome this challenge. METHODS: In this study, we assessed the in vitro and in vivo efficacy of multiple donor pooled UCB or APB-derived Treg. RESULTS: In vitro, pooled freshly isolated UCB-derived Treg were as suppressive as APB-derived Treg. However, in a mouse model of human skin allodestruction, pooled UCB-derived Treg were more potent at suppressing alloresponses and prolonging skin survival compared with pooled APB-derived Treg. Improved survival of UCB Treg in an in vivo cell survival assay and their lower expression of human leukocyte antigen-ABC suggested that lower immunogenicity may account for their superior efficacy in vivo. CONCLUSION: Multiple-unit UCB is therefore a viable source of human Treg for cellular therapy, and pooling of Treg from multiple donors offers a useful strategy for achieving required therapeutic doses.

High purity and yield of natural Tregs from cord blood using a single step selection method.

Natural regulatory T cells (Tregs), characterized as CD4 CD25high Foxp3+, have been described as paramount contributors in immuno-regulation and self-tolerance. CD4 and CD25 have been the main markers used for their isolation, resulting in cells with potent suppressive properties. Nevertheless, low purity and yield continue to be an issue when attempting thorough characterizations and/or up scaling to bigger models and for clinical trials. Here we present a single-step methodology optimized for cord blood CD25+ isolation, using magnetic microbeads that achieves a reproducible purity of 89% for CD4 CD25high CD127low. These cells showed a more consistent suppressive effect in mixed lymphocyte cultures. In addition, the proportion of contaminating effector T cells was < 9% whilst the yield of Tregs was doubled compared to the standard protocol. Gating on CD4 CD25high CD127low populations post isolation showed better correlation with suppressive efficacy compared to CD4 CD25+ gate. These data should facilitate the clinical scale-up of this procedure to obtain consistent Tregs for clinical application and research.