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1.
Zhonghua Zhong Liu Za Zhi ; 42(2): 145-149, 2020 Feb 23.
Artículo en Chino | MEDLINE | ID: mdl-32135650

RESUMEN

Objective: To analyze the characteristics of the second primary tumor affecting the survival of patients with lymphoma, and to explore the risk factors of death from the second primary tumor. Methods: The medical records and related death information of 1 173 lymphoma patients who had already died with known causes were collected. The basic causes of death and the characteristics of patients who died of the second primary tumor were analyzed. Cox regression model was used to analyze the risk factors of lymphoma patients who died of the second primary tumor. Results: Among the 1 173 patients who had died, 94 (8.0%) died of the second primary tumor, 935 (79.7%) died of the primary lymphoma and 144 (12.3%) died of other diseases. The second primary tumor accounted for 17.5% (38/217) of all causes of death in patients with the survival period of more than 5 years, and the second primary tumor accounted for 28.3% (17/60) of all causes of death in patients with the survival period of more than 10 years. Among 94 cases who died of second primary tumors, 31 died of lung cancer, 15 died of gastric cancer, 13 died of liver cancer, 9 died of pancreatic cancer, 6 died of colorectal cancer, 6 died of second primary lymphoma and 14 died of other types of tumors. Univariate Cox regression analysis showed that age, first-line treatment effect, and chest or mediastinal radiotherapy were associated with the death from second primary tumors for lymphoma patients (all P<0.05). Multivariate Cox regression analysis showed that the effect of first-line treatment (P=0.030) and the chest or mediastinal radiotherapy (P=0.039) were independent factors for the death of lymphoma patients from the second primary tumor. Conclusions: The second primary tumor is an important factor affecting the survival of lymphoma patients, and the risk of death from second primary tumors increases significantly over time. The effect of first-line treatment and radiotherapy in the chest or mediastinum are independent factors for the death of lymphoma patients from the second primary tumor.


Asunto(s)
Linfoma/mortalidad , Linfoma/terapia , Neoplasias Primarias Secundarias/mortalidad , Humanos , Factores de Riesgo , Análisis de Supervivencia
5.
Nature ; 579(7798): 291-296, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32103174

RESUMEN

The DNA-dependent protein kinase (DNA-PK), which comprises the KU heterodimer and a catalytic subunit (DNA-PKcs), is a classical non-homologous end-joining (cNHEJ) factor1. KU binds to DNA ends, initiates cNHEJ, and recruits and activates DNA-PKcs. KU also binds to RNA, but the relevance of this interaction in mammals is unclear. Here we use mouse models to show that DNA-PK has an unexpected role in the biogenesis of ribosomal RNA (rRNA) and in haematopoiesis. The expression of kinase-dead DNA-PKcs abrogates cNHEJ2. However, most mice that both expressed kinase-dead DNA-PKcs and lacked the tumour suppressor TP53 developed myeloid disease, whereas all other previously characterized mice deficient in both cNHEJ and TP53 expression succumbed to pro-B cell lymphoma3. DNA-PK autophosphorylates DNA-PKcs, which is its best characterized substrate. Blocking the phosphorylation of DNA-PKcs at the T2609 cluster, but not the S2056 cluster, led to KU-dependent defects in 18S rRNA processing, compromised global protein synthesis in haematopoietic cells and caused bone marrow failure in mice. KU drives the assembly of DNA-PKcs on a wide range of cellular RNAs, including the U3 small nucleolar RNA, which is essential for processing of 18S rRNA4. U3 activates purified DNA-PK and triggers phosphorylation of DNA-PKcs at T2609. DNA-PK, but not other cNHEJ factors, resides in nucleoli in an rRNA-dependent manner and is co-purified with the small subunit processome. Together our data show that DNA-PK has RNA-dependent, cNHEJ-independent functions during ribosome biogenesis that require the kinase activity of DNA-PKcs and its phosphorylation at the T2609 cluster.


Asunto(s)
Proteínas de Unión al Calcio/metabolismo , Hematopoyesis/genética , Autoantígeno Ku/metabolismo , Linfoma/enzimología , Linfoma/fisiopatología , ARN Ribosómico 18S/metabolismo , Proteínas de Unión al Calcio/genética , Dominio Catalítico/fisiología , Reparación del ADN/genética , Activación Enzimática/genética , Células HeLa , Humanos , Linfoma/genética , Modelos Animales , Mutación , Fosforilación , Unión Proteica , Biosíntesis de Proteínas/genética , ARN Ribosómico 18S/genética , ARN Nucleolar Pequeño/metabolismo
6.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(1): 325-328, 2020 Feb.
Artículo en Chino | MEDLINE | ID: mdl-32027297

RESUMEN

Abstract  The Latent infection cansed by Epstein-Barr virus (EBV) closely relates with the occurrence and development of several kinds of lymphoma. Exosome (EXO) is functional bilayer membrane structural corpuscles which are secreted by cells contain proteins, lipids and nucleic acids. In recent years, researches showed that EXO play an important role in the occurrence and development of tumors. Therefore, the resenrches which compare the differences in quantity and contents of EXO secreted by cells between EBV negative lymphoma and EBV positive lymphoma and the clarify the influence of EXO on biological behaviors of lymphoma cells and immune cells have the important, significance for understanding the mechanisms related with effect of latent EBV on the occurrence and development of lymphoma by exosome pathway. This review focuses on research progress about the effect of latent EBV on amounts, contents and functions of EXO secreted by lymphoma cells.


Asunto(s)
Exosomas , Linfoma , Infecciones por Virus de Epstein-Barr , Herpesvirus Humano 4 , Humanos , Linfocitos
7.
Medicina (B Aires) ; 80(1): 81-83, 2020.
Artículo en Español | MEDLINE | ID: mdl-32044744

RESUMEN

Wiskott-Aldrich syndrome is a rare X chromosome-linked primary immunodeficiency syndrome associated with an increased incidence of infections, autoimmune disorders and neoplasms. We present the case of a 41-year-old man with a diagnosis of Wiskott-Aldrich syndrome with ileitis as a form of presentation of a lymphoproliferative syndrome. The ileitis, in the context of the patient, represents a clinical challenge given the large number of differential diagnoses (inflammatory bowel disease, infections, neoplasms and lymphoproliferative diseases), so it usually requires anatomopathological diagnosis and particular considerations regarding the subsequent specific treatment.


Asunto(s)
Neoplasias del Íleon/patología , Ileítis/patología , Linfoma/patología , Síndrome de Wiskott-Aldrich/patología , Adulto , Biopsia , Diagnóstico Diferencial , Humanos , Neoplasias del Íleon/diagnóstico , Ileítis/diagnóstico , Inmunohistoquímica , Linfoma/diagnóstico , Masculino , Síndrome de Wiskott-Aldrich/diagnóstico
9.
Cancer Sci ; 111(3): 807-816, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31908105

RESUMEN

Activation-induced cell death (AICD) mediated by the Fas/Fas ligand (FasL) system plays a key role in regulating immune response. Although normal natural killer (NK) cells use this system for their homeostasis, malignant NK cells seem to disrupt the process. Extranodal NK/T-cell lymphoma, nasal type (ENKL) is a rare but fatal disease, for which novel therapeutic targets need to be identified. We confirmed that ENKL-derived NK cell lines NK-YS and Hank1, and primary lymphoma cells expressed procaspase-8/FADD-like interleukin-1ß-converting enzyme (FLICE) modulator and cellular FLICE-inhibitory protein (c-FLIP), along with Fas and FasL. Compared with Fas-sensitive Jurkat cells, NK-YS and Hank1 showed resistance to Fas-mediated apoptosis in spite of the same expression levels of c-FLIP and the death-inducing signaling complex (DISC) formation. Unexpectedly, the long isoform of c-FLIP (c-FLIPL ) was coimmunoprecipitated with Fas predominantly in both ENKL-derived NK cell lines after Fas ligation. Indeed, c-FLIPL was more sufficiently recruited to the DISC in both ENKL-derived NK cell lines than in Jurkat cells after Fas ligation. Knockdown of c-FLIPL per se enhanced autonomous cell death and restored the sensitivity to Fas in both NK-YS and Hank1 cells. Although ENKL cells are primed for AICD, they constitutively express and efficiently utilize c-FLIPL , which prevents their Fas-mediated apoptosis. Our results show that c-FLIPL could be a promising therapeutic target against ENKL.


Asunto(s)
Proteína Reguladora de Apoptosis Similar a CASP8 y FADD/metabolismo , Células Asesinas Naturales/metabolismo , Linfoma/metabolismo , Receptor fas/metabolismo , Apoptosis/fisiología , Proteínas Reguladoras de la Apoptosis/metabolismo , Caspasa 8/metabolismo , Caspasas/metabolismo , Muerte Celular/fisiología , Proteína Ligando Fas , Proteína de Dominio de Muerte Asociada a Fas/metabolismo , Humanos , Péptidos y Proteínas de Señalización Intracelular/metabolismo , Células Jurkat , Isoformas de Proteínas/metabolismo , Transducción de Señal/fisiología
10.
Orv Hetil ; 161(3): 103-109, 2020 Jan.
Artículo en Húngaro | MEDLINE | ID: mdl-31928060

RESUMEN

Introduction: Autologous hemopoietic stem cell transplantation remains a promising therapy in certain malignant and non-malignant conditions. The procedure, however, will increase the risk of complications, most notably early and late infections. Aim: To analyze the frequency and spectrum of pathogens in early (<+100 days) post-transplant infections and to evaluate risk factors for mortality. Method: Prospectively collected data from 699 patients undergoing autologous hemopoietic stem cell transplantation between 2007 and 2014 at our center were retrospectively reviewed and analyzed. Results: The median age of 699 patients was 56 (interquartile range: 43-62) years, 54% (376) were male. 25 patients have been transferred to other centers and 19 patients were lost to follow up. Neutropenic fever occurred in 69.8% (488) of patients. In addition, 102 infectious episodes in 96 patients were identified. Most commonly bacteremia occurred (49 episodes) with a median onset of 7 (5-11) days. The majority (33/49) of bacteremias have been observed during the pre-engraftment period. Their incidence proved to be higher in patients with malignant lymphoma compared to individuals with plasma cell disorders (p = 0.0005, OR: 2.41, 95% CI: 1.49-3.99). 12 episodes of viral infections and 8 cases of proven or probable invasive mycoses have been identified. Among the 655 patients with complete follow up, 16 in-hospital deaths (2.4%) occurred, 8 of them were associated with infections. Survival was adversely affected by early infections (p = 0.0001). Conclusion: In autologous stem cell transplantation, microbiologically unconfirmed neutropenic fever is common. Documented early bacteremia, however, is infrequent. Lymphoma patients have a significantly higher chance to develop bloodstream infections compared to individuals with plasma cell disorders. Early infections decrease the chance of survival; thus, an effective prophylaxis and therapy remains of paramount importance. Orv Hetil. 2020; 161(3): 103-109.


Asunto(s)
Infecciones Bacterianas/epidemiología , Infecciones Bacterianas/microbiología , Fiebre/etiología , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Neutropenia/microbiología , Trasplante Autólogo/efectos adversos , Adulto , Infecciones Bacterianas/mortalidad , Fiebre/epidemiología , Humanos , Hungría/epidemiología , Linfoma , Masculino , Persona de Mediana Edad , Neutropenia/epidemiología , Estudios Retrospectivos
11.
World Neurosurg ; 133: 205-211, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31525480

RESUMEN

BACKGROUND: Diverse clinical manifestations have characterized reports of central nervous system involvement in Behcet disease. There is a limited number of published case reports of neuro-Behcet disease mimicking brain tumor. CASE DESCRIPTION: We present a rare case of neuro-Behcet disease exhibiting mixed systemic and neurological symptoms mimicking malignant lymphoma. Delayed presentation of oral aphthae and rapid improvement of symptoms with steroid treatment led to a diagnosis of neuro-Behcet disease without brain biopsy. The patient also underwent surgery for the resection of an arterio-venous fistula. CONCLUSIONS: We recommend management of neuro-Behcet disease based on perceived natural history risks, with the understanding that no data exist on this within patients population. A multidisciplinary team approach is always recommended because neuro-Behcet disease is an uncommon condition, especially in neurosurgical practice.


Asunto(s)
Síndrome de Behçet/diagnóstico por imagen , Neoplasias Encefálicas/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Malformaciones Vasculares del Sistema Nervioso Central/diagnóstico por imagen , Linfoma/diagnóstico por imagen , Adulto , Síndrome de Behçet/complicaciones , Malformaciones Vasculares del Sistema Nervioso Central/complicaciones , Diagnóstico Diferencial , Humanos , Masculino , Tomografía Computarizada por Rayos X
12.
Virchows Arch ; 476(2): 285-293, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31522287

RESUMEN

Helper innate lymphoid cells (ILCs) were recently recognized as lineage-negative lymphoid cells that do not express rearranged receptors and have important effector and regulatory functions in innate immunity. However, to our knowledge, no cases of hematological malignancies arising from helper ILCs have ever been reported in the literature. Here, we report a case of a 17-year-old man with multiple lymphadenopathy who was diagnosed with lineage-negative lymphoma that displayed a helper ILC phenotype. Histological examination showed large monomorphic atypical lymphoid cells with prominent nucleoli and abundant eosinophilic cytoplasms with scattered and patchy distributions. Large amounts of histiocytes and infiltrating lymphocytes were observed in the background. Immunostaining revealed positive LCA and CD79a expression but negative expression of all lineage markers. IG and TCR rearrangement analysis showed no clonal rearrangements. Tumor cells strongly expressed helper ILC phenotypic markers, such as CD127, IL-1R, GATA3, ST2, IL-17Rß, and RANKL, and helper ILC-produced cytokines, such as IL-4 and GM-CSF. PD-L1/PD-L2-positive histiocytes and FOXP3-positive Tregs were observed in the tumor microenvironment. Flow cytometry of bone marrow at recurrence was positive for IL-1R and negative for T, B, NK, and myelogenous lineage markers. TP53 sequencing showed that exon 5 was replaced with an intergenic sequence of chromosome 21. Next-generation sequencing demonstrated a novel IGLV2-14/IGLL5 fusion and mutations or deletions of tumor suppressor genes, such as PTPRB, PPP2CB, and UPK1A. This tumor was very aggressive, resistant to chemotherapy, recurred with bone marrow involvement, and caused the death of the patient within 6 months. To our knowledge, this is the first report of a hematological malignancy potentially arising from helper ILCs. We propose negativity for lineage markers and positivity for CD127/IL-1R in combination with specific transcription factor expression as markers of this tumor. This finding represents a novel addition to the growing spectrum of hematological malignancies.


Asunto(s)
Diferenciación Celular/fisiología , Linfocitos/patología , Linfoma/patología , Recurrencia Local de Neoplasia/patología , Adolescente , Humanos , Inmunidad Innata/inmunología , Linfoma/diagnóstico , Masculino , Fenotipo , Linfocitos T Colaboradores-Inductores/citología , Microambiente Tumoral/fisiología
13.
Hematol Oncol ; 38(1): 12-21, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31486520

RESUMEN

The improvements in magnetic resonance imaging (MRI) technology and the concern related to the increased cancer risk in patients with lymphoma, also due to radiation exposure associated with imaging examinations, have led to the introduction of whole-body MRI (WB-MRI) as a radiation-free alternative to standard imaging procedures. WB-MRI seems a less histology-dependent functional imaging test than 18 F-fluorodeoxyglucose-positron emission tomography/CT (18 F-FDG-PET/CT). In patients with FDG-avid lymphomas, such as diffuse large B-cell lymphoma (DLBCL) and Hodgkin lymphoma (HL), 18 F-FDG-PET/CT remains the imaging reference standard for staging, with WB-MRI potentially being a complementary modality that could replace CT, especially in young patients. On the other hand, WB-MRI is a valuable imaging procedure for lymphoma surveillance and in lymphomas with variable/low FDG avidity and nonfollicular indolent lymphomas. The aim of this paper is to discuss the current state of the art of WB-MRI in lymphoma by evaluating its diagnostic performance in different lymphoma subtypes: Hodgkin, aggressive, and indolent lymphomas.


Asunto(s)
Linfoma/diagnóstico , Imagen por Resonancia Magnética/métodos , Imagen de Cuerpo Entero/métodos , Animales , Humanos , Estadificación de Neoplasias
14.
Ann Hematol ; 99(1): 1-5, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31811361

RESUMEN

This study aimed to systematically review the value of end-of-treatment 18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in improving overall survival (OS) of lymphoma patients. Medline was systematically searched for (1) randomized trials comparing the OS of patients who underwent end-of-treatment FDG-PET to those without and FDG-PET-based end-of-treatment evaluation and for (2) non-randomized studies comparing the OS of patients who underwent end-of-treatment FDG-PET to a (historical) cohort of patients without an FDG-PET-based end-of-treatment evaluation. The Medline search revealed 6284 articles. However, none of these reported data on the value of end-of-treatment FDG-PET in improving OS of lymphoma patients. In conclusion, the present systematic review reveals that there is currently no study at all that evaluates the value of end-of-treatment FDG-PET in improving OS of lymphoma patients. As a result, it remains unknown whether end-of-treatment FDG-PET increases OS and in which lymphoma subtype these examinations are of particular value. Future studies are required to demonstrate its value in this setting before it can be recommended as an evidence-based diagnostic tool by guidelines on the use of imaging in lymphoma.


Asunto(s)
Fluorodesoxiglucosa F18/uso terapéutico , Linfoma , Tomografía de Emisión de Positrones , Estudios de Cohortes , Supervivencia sin Enfermedad , Femenino , Humanos , Linfoma/diagnóstico por imagen , Linfoma/mortalidad , Linfoma/terapia , Masculino , Tasa de Supervivencia
15.
Clin Oral Investig ; 24(1): 133-140, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31041576

RESUMEN

OBJECTIVES: To investigate signs of infection and infection-related complications of apical periodontitis (AP) in patients who underwent chemotherapy for lymphoma. MATERIALS AND METHODS: Data were collected retrospectively from the dental and medical records of patients receiving chemotherapy for lymphoma. Based on the findings from a dental evaluation made in conjunction with chemotherapy, the patients were divided into two groups, patients with or without teeth with AP. RESULTS: Eighty-six of the 213 patients had one or more teeth with AP and received no planned dental treatment for this condition, while 127 patients had no AP-affected teeth. During chemotherapy, seven patients (8%) developed local symptoms related to teeth with AP, while no patients in the control group developed symptoms of AP. No significant differences were found with respect to the administration of antibiotics related to dental infection or hospital admission events due to fever or infection, between the group with AP and the group without AP. CONCLUSIONS: AP is a common finding and exacerbation seems more common in patients diagnosed with chronic AP than in patients without chronic AP. The presence of chronic AP in patients treated with chemotherapy for lymphoma is not linked to additional medical complications that require hospital admission owing to fever/infection. CLINICAL RELEVANCE: Knowledge regarding infection-related complications of AP in patients with lymphoma treated with chemotherapy will guide clinical decision-making by identifying those patients who warrant treatment. This will allow dental interventions to be postponed until completion of chemotherapy, without serious medical complications. The results of this study serve as a basis for larger prospective studies.


Asunto(s)
Antineoplásicos/uso terapéutico , Linfoma/tratamiento farmacológico , Periodontitis Periapical , Protocolos de Quimioterapia Combinada Antineoplásica , Bleomicina , Dacarbazina , Doxorrubicina , Femenino , Enfermedad de Hodgkin , Humanos , Masculino , Estudios Prospectivos , Estudios Retrospectivos , Tratamiento del Conducto Radicular , Vinblastina
16.
Eur Radiol ; 30(1): 110-118, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31372786

RESUMEN

OBJECTIVES: To explore the utility of dynamic contrast-enhanced MRI (DCE-MRI) and readout-segmented diffusion-weighted imaging (RESOLVE-DWI) in the differentiation of nasopharyngeal carcinoma (NPC) and nasopharyngeal lymphoma (NPL). METHODS: Sixty-two patients with NPC and 39 patients with NPL who underwent DCE-MRI and RESOLVE-DWI examinations were evaluated. The time signal-intensity curve (TIC) types, time to peak (TTP), enhancement peak (EP), maximum contrast enhancement ratio (MCER), washout ratio (WR), apparent diffusion coefficient (ADC), and relative ADC (rADC) values were calculated. Statistical analysis between the two groups was performed to determine the statistical significance of each parameter. Receiver operating characteristic (ROC) curve analysis and binary logistic regression analysis were used to assess the diagnostic ability of single and combined metrics for distinguishing NPC from NPL. RESULTS: The most common TIC curve was type III in patients with NPC (n = 26), while the majority of the curves were types I (n = 14) and II (n = 19) in patients with NPL. TTP, EP, MCER, ADC, and rADC were statistically significantly different between NPCs and NPLs (p < 0.05). Among these factors, ADC revealed the most reliable diagnostic performance, followed by rADC, TTP, MCER, and EP. Moreover, the diagnostic efficiency of the combined DCE-MRI parameters was higher than that of TTP, MCER, and EP each alone. In addition, the combination of all DCE-MRI and DWI parameters together demonstrated the highest diagnostic efficiency (area under the curve = 0.961). However, none of the parameters was significantly different between keratinising NPC and non-keratinising NPC or between NK/T lymphoma and diffuse large B cell lymphoma (all p > 0.05). CONCLUSION: DCE-MRI and RESOLVE-DWI are effective in differentiating NPC from NPL. KEY POINTS: • RESOLVE offers high image quality in the head and neck regions. • Dynamic contrast-enhanced MRI and RESOLVE-DWI help clinicians to make the differential diagnosis between NPC and NPL. • The combination of all the DCE-MRI and DWI parameters together demonstrated the highest diagnostic efficiency compared with each parameter alone.


Asunto(s)
Linfoma/diagnóstico , Imagen por Resonancia Magnética/métodos , Carcinoma Nasofaríngeo/diagnóstico , Neoplasias Nasofaríngeas/diagnóstico , Adulto , Anciano , Medios de Contraste , Diagnóstico Diferencial , Imagen de Difusión por Resonancia Magnética/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Curva ROC , Estudios Retrospectivos
17.
Hematol Oncol ; 38(1): 34-37, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31872890

RESUMEN

This report summarizes a closed workshop cosponsored by the American Association for Cancer Research, the European School of Oncology, and the 15th-International Conference on Malignant Lymphoma to discuss critical open questions on liquid biopsy in lymphoid malignancies, develops a roadmap for their analytical and clinical validation, and prioritizes research areas.


Asunto(s)
Biomarcadores de Tumor/genética , ADN Tumoral Circulante/sangre , Biopsia Líquida/métodos , Linfoma/sangre , ADN Tumoral Circulante/genética , Congresos como Asunto , Humanos , Linfoma/diagnóstico , Linfoma/genética , Linfoma/terapia , Manejo de Especímenes
18.
J Clin Ultrasound ; 48(1): 19-28, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31609458

RESUMEN

OBJECTIVES: To summarize the contrast-enhanced ultrasound (CEUS) features of mediastinal lymphomas and thymic epithelial tumors (including thymomas and thymic carcinomas) and to explore the value of CEUS in the differential diagnosis of lymphomas and thymic epithelial tumors. METHODS: Sixty-nine patients with 69 mediastinal lesions who underwent CEUS and had disease confirmed by histopathology were enrolled in the study. There were 33 cases of lymphoma, 19 cases of thymic carcinoma, and 17 cases of thymoma. CEUS features, including the enhancement pattern, enhancement distribution, enhancement time, inner necrosis status, wash out pattern, and vascular morphology, were evaluated in each group. RESULTS: Thymomas often presented with homogeneous (88.2%, 15/17) and late (88.2%, 15/17) enhancement and a low rate of inner necrosis (17.6%, 3/17). Late (73.7%, 14/19), heterogeneous (68.4%, 13/19), and centripetal (63.2%, 12/19) enhancement were more often observed in thymic carcinoma, as was a high rate of inner necrosis (78.9%, 15/19). Lymphomas showed a homogeneous enhancement rate of 57.6% (19/33) and a late enhancement rate of 54.5% (18/33). The rate of inner necrosis for lymphomas was 45.5% (15/33). The diagnostic accuracy of this finding for distinguishing thymic epithelial tumors from lymphomas was 63.8%, the sensitivity was 80.6%, and the specificity was 45.5%. Enlarged blood vessels were a feature specific to lymphomas, while small vessels arranged in a comb shape was a feature specific to thymic epithelial tumors. CONCLUSION: This study describes the CEUS features of common mediastinal tumors and may stimulate further studies in this field.


Asunto(s)
Linfoma/diagnóstico por imagen , Neoplasias del Mediastino/diagnóstico por imagen , Neoplasias Glandulares y Epiteliales/diagnóstico por imagen , Timoma/diagnóstico por imagen , Neoplasias del Timo/diagnóstico por imagen , Adulto , Anciano , Medios de Contraste , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Ultrasonografía
19.
Bone Joint J ; 101-B(12): 1557-1562, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31786990

RESUMEN

AIMS: The aim of this study was to present the long-term surgical outcomes, complications, implant survival, and causes of implant failure in patients treated with the modified Harrington procedure using antegrade large diameter pins. PATIENTS AND METHODS: A cohort of 50 consecutive patients who underwent the modified Harrington procedure for periacetabular metastasis or haematological malignancy between January 1996 and April 2018 were studied. The median follow-up time for all survivors was 3.2 years (interquartile range 0.9 to 7.6 years). RESULTS: The five-year overall survival rate was 33% for all the patients. However, implant survival rates were 100% and 46% at five and ten years, respectively. Eight patients survived beyond five years. There was no immediate perioperative mortality or complications. A total of 15 late complications occurred in 11 patients (22%). Five patients (10%) required further surgery to treat complications. The most frequent complication was pin breakage without evidence of acetabular loosening (6%). Two patients (4%) underwent revision for aseptic loosening at 6.5 and 8.9 years after surgery. Ambulatory status and pain level were improved in 83% and 89%, respectively. CONCLUSION: The modified Harrington procedure for acetabular destruction has low complication rates, good functional outcome, and improved pain relief in selected patients Cite this article: Bone Joint J 2019;101-B:1557-1562.


Asunto(s)
Acetábulo/cirugía , Artroplastia de Reemplazo de Cadera/métodos , Clavos Ortopédicos , Neoplasias Óseas/cirugía , Neoplasias Hematológicas/cirugía , Falla de Prótesis , Adulto , Anciano , Anciano de 80 o más Años , Artroplastia de Reemplazo de Cadera/instrumentación , Artroplastia de Reemplazo de Cadera/mortalidad , Neoplasias Óseas/mortalidad , Neoplasias Óseas/secundario , Carcinoma/mortalidad , Carcinoma/secundario , Carcinoma/cirugía , Femenino , Estudios de Seguimiento , Neoplasias Hematológicas/mortalidad , Humanos , Linfoma/mortalidad , Linfoma/cirugía , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Análisis de Supervivencia
20.
Int J Nanomedicine ; 14: 9647-9663, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31824157

RESUMEN

Background: Primary central nervous system lymphomas (PCNSL) are extranodal malignant non-Hodgkin lymphomas (NHL) that arise exclusively in central nervous system (CNS). Diffuse large B-cell lymphoma (DLBCL) is the most common histological subtype. Purpose: To evaluate whether nano drug-loading system-mediated magnetic-targeted thermochemotherapy could produce a better therapeutic effect than single chemotherapy while reducing the use of chemotherapeutic drugs. Methods: Six groups (control, Fe3O4, MTX, Fe3O4@MTX, Fe3O4 with hyperthermia and Fe3O4@MTX with hyperthermia) were set. Tumor cell apoptosis in each treatment group was detected by flow cytometry. Apoptosis-related gene expressions Caspase-3, Bax and Bcl-2 were detected by qPCR and Western blot; intracranial tumor model of PCNSL was established by intracranial injection of OCI-LY18 tumor cells into BALB/c-Nude mice. Magnetic resonance imaging (MRI) was used to monitor tumor progression and H&E staining was used to observe pathological changes of the tumor tissue. Results: In vitro, compared with chemotherapy alone, apoptosis rate of Fe3O4@MTX mediated thermochemotherapy group was significantly increased, and expression of apoptosis-inducing gene Caspase-3 and Bax were significantly upregulated in OCI-LY18 cells, while expression of apoptosis-inhibiting Bcl-2 gene was significantly downregulated. In vivo, MRI showed successful generation of intracranial tumor, and tumor volume was significantly smaller in combined thermochemotherapy group than in single chemotherapy group. H&E staining result of tumor tissues in each group was consistent with MRI; tumor cells were significantly reduced in thermochemotherapy group. Expression of apoptosis-related gene Caspase-3 and Bax were significantly upregulated in tumor tissues, while expression of Bcl-2 gene was significantly downregulated. Conclusion: These results demonstrated in vivo and in vitro that the combined thermochemotherapy of Fe3O4@MTX MNPs was superior to the single MTX chemotherapy with less dosage, which may promote apoptosis of DLBCL cells through the mitochondrial apoptotic pathway and provided a new way for the treatment of PCNSL.


Asunto(s)
Neoplasias del Sistema Nervioso Central/terapia , Compuestos Férricos/química , Hipertermia Inducida , Linfoma/terapia , Nanopartículas de Magnetita/química , Metotrexato/uso terapéutico , Células 3T3 , Animales , Apoptosis/efectos de los fármacos , Línea Celular Tumoral , Modelos Animales de Enfermedad , Sistemas de Liberación de Medicamentos , Liberación de Fármacos , Femenino , Humanos , Nanopartículas de Magnetita/ultraestructura , Masculino , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , Temperatura Ambiental , Pruebas de Toxicidad Aguda
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