Thymic Carcinoma Presenting as a Mediastinal Mass Resembling a Cardiac Tumor.

Thymoma and thymic carcinomas are a few of the rarest malignancies seen in humankind. They are mostly seen in the Asian population, many of which are reported in the Southeast Asia region like Japan, China, Vietnam, etc. They usually can be a sequela of other underlying conditions such as myasthenia gravis or some unknown mutations that express later in life.   Our patient is a young 41-year-male, a healthy and active individual who presented for evaluation of acute shortness of breath, two months after recovering from SARS-CoV-19 infection. His shortness of breath progressed while on oxygen and diuretics, a Point of Care Ultrasound (POCUS) showed cardiac tamponade and moderate pleural effusion. A Computerized Tomographic (CT) scan of the chest/abdomen/pelvis showed cardiomegaly, pleural effusion, and a mass abutting the heart. A pericardiocentesis revealed malignant cells. Thymic carcinoma was confirmed with a core biopsy and the patient was initiated on treatment rapidly to help improve symptoms and contain the growing mass.  .

Alamar Blue assay optimization to minimize drug interference and inter-assay viability.

Alamar Blue (AB) has become an increasingly popular reagent of choice for cell viability assays. We chose AB over other reagents such as MTT and Cell-Titer Glo due to its cost effectiveness and its ability to be a nondestructive assay. While analyzing the effect of osimertinib, an EGFR inhibitor on the non-small cell lung cancer cell line, PC-9, we noticed unexpected right-shifts of dose response curves as compared to the curve obtained by Cell Titer Glo assay. Here, we describe our modified AB assay method to avoid right shift right shift in dose response curve. Unlike some of the redox drugs that were reported to directly affected AB reading, osimertinib itself did not directly increase AB reading. Yet, the removal of the drug containing medium prior to AB addition eliminated falsely increased reading giving comparable dose response curve as the one determined by Cell Titer Glo assay. When a panel of 11 drugs were assessed, we found that this modified AB assay eliminated unexpected similar right shifts detected in other epidermal growth factor receptor (EGFR) inhibitors. We also found that plate-to-plate variability can be minimized by adding an appropriate concentration of rhodamine B solution to the assay plates to calibrate fluorimeter sensitivity. This calibration method also enables a continuous longitudinal assay to monitor cell growth or recovery from drug toxicity over time. Our new modified AB assay is expected to provide accurate in vitro measurement of EGFR targeted therapies.