RESUMO
A 59-year-old patient with multiple myeloma on maintenance chemotherapy presented with fever, weight loss, and night sweats. An F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) computed tomography (CT) showed intra-abdominal lymphadenopathy with a mesenteric mass that led to further workup and diagnosis of histoplamosis. The patient was treated with amphotericin B and subsequently switched to itraconazole. This exemplifies the usefulness of FDG PET CT in diagnosis of infectious complications.
Assuntos
Gastroenteropatias/diagnóstico por imagem , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Histoplasma/isolamento & purificação , Histoplasmose/diagnóstico por imagem , Mieloma Múltiplo/cirurgia , Anfotericina B/administração & dosagem , Anfotericina B/uso terapêutico , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Antineoplásicos/sangue , Antineoplásicos/uso terapêutico , Colonoscopia , Febre/etiologia , Fluordesoxiglucose F18/administração & dosagem , Gastroenteropatias/complicações , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/microbiologia , Histoplasmose/complicações , Histoplasmose/tratamento farmacológico , Histoplasmose/microbiologia , Humanos , Íleo/patologia , Íleo/cirurgia , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Itraconazol/administração & dosagem , Itraconazol/uso terapêutico , Linfadenopatia/diagnóstico por imagem , Linfadenopatia/etiologia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/tratamento farmacológico , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos/administração & dosagem , Tomografia Computadorizada por Raios X , Redução de Peso , beta-Glucanas/sangueRESUMO
OBJECTIVE: To evaluate the expression of programmed cell death-ligand 1 (PD-L1) in anal cancer. PATIENTS AND METHODS: In a retrospective cohort analysis, subjects with squamous cell carcinoma of the anal canal were tested for PD-L1 expression, then followed for recurrence and survival. Crude recurrence rates (CRRs), crude mortality rates (CMRs), and crude event rates (CERs) were assessed for PD-L1-dependent differences using Poisson regression. All 3 types of crude rate were expressed as the number that occurred per hundred person-years (hPY) of follow-up. RESULTS: Samples from 41 subjects were evaluated for PD-L1 expression; 23 (56%) were positive. Subjects with PD-L1-expressing versus PD-L1-negative tumors respectively had CRRs of 30.8 versus 12.1 recurrences/hPY (P=0.082), CMRs of 16.7 versus 12.0 deaths/hPY (P=0.47), and CERs of 39.2 versus 16.9 events/hPY (P=0.069). CONCLUSIONS: PD-L1 positivity was associated with worse CRR and CER, and marginally worse CMR. The effect on progression-free and overall survival needs to be validated in a study with a larger sample size.