A comparative immunohistochemical analysis of cathepsins B and S in human breast cancer

Background: Cancer progression is a complex process consisting of a series of distinct steps. Cysteine proteases, such as cathepsins (Cts), are important molecules that play a central role in cancer progression and metastasis. Previous studies on human and mouse models of pancreatic cancer showed that both Cts B and Cts S are highly expressed in malignant tissues and the infiltrating macrophages. The aim of this study was to investigate the expression pattern of Cts B and S in human breast cancer tissues. Materials and Methods: Twenty-three formalin-fixed paraffin-embedded sections of breast cancer were stained for Cts B, Cts S, and CD206 using immunohistochemistry. Results: Cytoplasmic staining of Cts B and S was observed in tumor cells, endothelial cells, and macrophages. Cts B was preferentially expressed in breast cancer tissues by the different cells types. The majority of tumor samples were Cts B-positive in tumor cells, endothelial cells and macrophages (91%, 87%, and 70%, respectively) in comparison to Cts S (39%, 48%, and 57%, respectively; P < 0.001, P < 0.001 and 0.002). Correlation studies indicated significant relationships between the vascular and macrophage expression of Cts B (P = 0.01) and of Cts S (P = 0.03). However, neither Cts B nor Cts S expression in tumor cells correlated with other cell types (P > 0.05). Only the expression of Cts B in vascular endothelial cells correlated significantly with the tumor grade (P = 0.03). Conclusion: Results suggest that Cts B expression is more prominent than Cts S in breast cancer. Correlation studies imply different mechanisms regulating Cts B/S expression in tumor cells and other stromal components

A challenging case of cutaneous sarcoidosis with unusual findings in a Syrian woman: a case report and review of literature

Sarcoidosis is a granulomatous disease that involves multiple systems. Cutaneous involvement can manifest in patients with sarcoidosis and can present with or without systemic involvement. We present a case of cutaneous sarcoidosis in a Syrian woman that showed improvement after a combination of methotrexate and prednisolone therapy. The patient had unusual chest radiography findings and developed an unexplained fissured tongue after 5 days of receiving methotrexate therapy. In addition, the patient developed indurated erythematous plaque and papules on her upper right arm at the same location as a performed biopsy, which increased the diagnosis of a newly formed scar sarcoidosis although she was receiving her treatment

Xanthogranulomatous pleuritis induced by recurrent biliothorax due to a biliopleural fistula: The first case report in the literature

Xanthogranulomatous pleuritis is an extremely rare pathological entity, characterized by the infiltration of foamy cells and multinucleated giant cells within the pleural space. This condition often mimics infectious and neoplastic processes, presenting significant diagnostic challenges. This report details the first documented case of xanthogranulomatous pleuritis induced by recurrent biliothorax due to a biliopleural fistula, presenting a unique clinical scenario. We describe the clinical presentation, diagnostic hurdles, and both the surgical and medical management of this case. The discovery of biliothorax, evidenced by pleural fluid bilirubin levels that exceed serum bilirubin levels, underscores the importance of considering biliothorax in the differential diagnosis of recurrent pleural effusions, particularly in patients with a history of trauma. This case emphasizes the need for heightened awareness and a multidisciplinary approach in the diagnosis and treatment to effectively manage this complex condition and prevent recurrence

International Variations in Surgical Morbidity and Mortality Post Gynaecological Oncology Surgery: A Global Gynaecological Oncology Surgical Outcomes Collaborative Led Study (GO SOAR1)

Simple Summary Little is known about factors contributing to early post-operative morbidity and mortality in low and middle income countries with a paucity of data limiting global efforts to improve gynaecological cancer care. In this multicentre, international prospective cohort study of women undergoing gynaecological oncology surgery, we show that low and middle versus high income countries were associated with similar post-operative major morbidity. Capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention.Abstract Gynaecological malignancies affect women in low and middle income countries (LMICs) at disproportionately higher rates compared with high income countries (HICs) with little known about variations in access, quality, and outcomes in global cancer care. Our study aims to evaluate international variation in post-operative morbidity and mortality following gynaecological oncology surgery between HIC and LMIC settings. Study design consisted of a multicentre, international prospective cohort study of women undergoing surgery for gynaecological malignancies (NCT04579861). Multilevel logistic regression determined relationships within three-level nested-models of patients within hospitals/countries. We enrolled 1820 patients from 73 hospitals in 27 countries. Minor morbidity (Clavien-Dindo I-II) was 26.5% (178/672) and 26.5% (267/1009), whilst major morbidity (Clavien-Dindo III-V) was 8.2% (55/672) and 7% (71/1009) for LMICs/HICs, respectively. Higher minor morbidity was associated with pre-operative mechanical bowel preparation (OR = 1.474, 95%CI = 1.054-2.061, p = 0.023), longer surgeries (OR = 1.253, 95%CI = 1.066-1.472, p = 0.006), greater blood loss (OR = 1.274, 95%CI = 1.081-1.502, p = 0.004). Higher major morbidity was associated with longer surgeries (OR = 1.37, 95%CI = 1.128-1.664, p = 0.002), greater blood loss (OR = 1.398, 95%CI = 1.175-1.664, p <= 0.001), and seniority of lead surgeon, with junior surgeons three times more likely to have a major complication (OR = 2.982, 95%CI = 1.509-5.894, p = 0.002). Of all surgeries, 50% versus 25% were performed by junior surgeons in LMICs/HICs, respectively. We conclude that LMICs and HICs were associated with similar post-operative major morbidity. Capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention