Primary hepatic lymphoma presenting as fulminant hepatic failure with hyperferritinemia: A case report

<p>Abstract</p> <p>Introduction</p> <p>Primary hepatic lymphoma is an unusual form of non-Hodgkin's lymphoma that usually presents with constitutional symptoms, hepatomegaly and signs of cholestatic jaundice. Diffuse hepatic infiltration is uncommon and presentation with acute hepatic failure even more rare. The presence of markedly elevated ferritin levels can complicate the evaluation process and suggest alternative diagnoses.</p> <p>We present the case of a middle-aged woman exhibiting pancytopenia, hyperferritinemia and rapidly deteriorating to develop acute hepatic failure. Her initial clinical picture led to a working diagnosis of adult onset Still's disease with probable hemophagocytic syndrome before her worsening liver function necessitated a percutaneous liver biopsy and establishment of the final diagnosis of primary hepatic lymphoma.</p> <p>Conclusion</p> <p>Primary hepatic lymphoma is an uncommon malignancy and its manifestation as progressive hepatitis or acute fulminant hepatic failure can be difficult to diagnose. The presence of constitutional symptoms, pancytopenia and high ferritin levels can complicate the evaluation process. A liver biopsy early in the course of liver dysfunction may establish the diagnosis without a higher risk of bleeding complications seen once liver failure sets in.</p

Anti-invasion, anti-proliferation and anoikis-sensitization activities of lapatinib in nasopharyngeal carcinoma cells

Nasopharyngeal cancer (NPC) is a highly prevalent and invasive head and neck cancer in Asia. Disease recurrence and distant metastasis account for major NPC deaths. Therefore, more effective therapy is needed. Lapatinib, a dual tyrosine kinase inhibitor (TKI) against both EGFR and HER-2, has been known to exert potent antitumor activity against several cancer models. Given that both EGFR and HER-2 are co-expressed in NPC, we hypothesized that dual targeting of EGFR and HER-2 by this small molecule EGFR/HER-2 TKI would elicit anti-tumor activity in NPC. Using in vitro models of NPC, we demonstrated that lapatinib was able to efficiently inhibit the phosphorylation of both EGFR and HER-2. This was accompanied by significant growth inhibition of NPC cells (with maximal growth inhibition >90%). For the most lapatinib-sensitive cell line (HK1-LMP1, with IC 50 ∼ 600 nM), which harbored the highest levels of both EGFR and HER-2, inhibition of cell growth was associated G 0/G 1 cell cycle arrest, marked PARP cleavage, caspase-3 cleavage, as well as significant downregulation of several important survival proteins (e.g. survivin, Mcl-1 and cyclin D1). NPC cells are intrinsically invasive. We found that lapatinib was able to inhibit cellular invasion of both HK1-LMP1 and HONE-1 cells. Furthermore, our data demonstrated for the first time that lapatinib harbored potent anoikis-sensitization activity (i.e. sensitizing cancer cells to detachment-induced apoptosis) in human cancer cells overexpressing both EGFR and HER-2 (HK1-LMP1 and HK1). Taken together, our findings suggest that lapatinib is a promising anti-cancer agent for NPC with anti-invasion and anoikis-sensitization activities. © 2010 Springer Science+Business Media, LLC.link_to_subscribed_fulltex

An RNA-directed nucleoside anti-metabolite, 1-(3-C-ethynyl-beta-d-ribo-pentofuranosyl)cytosine (ECyd), elicits antitumor effect via TP53-induced Glycolysis and Apoptosis Regulator (TIGAR) downregulation

1-(3-C-ethynyl-beta-d-ribo-pentofuranosyl)cytosine (ECyd) is a ribose-modified nucleoside analog of cytidine with potent anticancer activity in several cancers. The main antitumor mechanism of this promising RNA-directed nucleoside anti-metabolite is efficient blockade of RNA synthesis in cancer cells. Here, we examined the therapeutic potential of this RNA-directed anti-metabolite in in vitro models of nasopharyngeal cancer (NPC). In a panel of 6 NPC cell lines, ECyd effectively inhibited cellular proliferation at nM concentrations (IC 50:∼13-44nM). Moreover, cisplatin-resistant NPC cells were highly sensitive to ECyd (at nM concentration). The ECyd-mediated growth inhibition was associated with G 2/M cell cycle arrest, PARP cleavage (a hallmark of apoptosis) and Bcl-2 downregulation, indicating induction of apoptosis by ECyd in NPC cells. Unexpectedly, ECyd-induced significant downregulation of TIGAR, a newly described dual regulator of apoptosis and glycolysis. More importantly, this novel action of ECyd on TIGAR was accompanied by marked depletion of NADPH, the major reducing power critically required for cell proliferation and survival. We hypothesized that ECyd-induced TIGAR downregulation was crucially involved in the antitumor activity of ECyd. Indeed, overexpression of TIGAR was able to rescue NPC cells from ECyd-induced growth inhibition, demonstrating a novel mechanistic action of ECyd on TIGAR. We demonstrated for the first time that an RNA-directed nucleoside analog, ECyd, exerts its antitumor activity via downregulation of a novel regulator of apoptosis, TIGAR. Moreover, ECyd may represent a novel therapy for NPC. © 2010 Elsevier Inc.link_to_subscribed_fulltex

Recovery at the terminal ileum of some legume non-nutritional factors in cannulated pigs

In order to exert an effect, either local or systemic, putative beneficial dietary substances have to survive at least to some extent the digestive process within the gastrointestinal tract. For that purpose, five castrated male pigs (100 ± 2 kg mean live b.w.) fitted with T-shaped ileal cannulas were used to determine the recovery up to the terminal ileum of various non-nutritional factors (NNF) from legumes (defatted soybean, raw lupin, raw chickpea and raw or autoclaved kidney beans). Kidney bean lectin (PHA) recovery within the small intestine ranged between 2.5 and 4.8 mg from 5.96 mg ingested. Two different methods were used to determine ileal digestibility of protease inhibitors (PI) in pigs. According to the enzyme-linked immunosorbent assay (ELISA) method, apparent digestibility of Kunitz trypsin inhibitor and Bowman-Birk inhibitor for pigs fed the defatted soybean-based diet were 0 and 58%, respectively. On the other hand, the apparent digestibility of PI along the small intestine, expressed in terms of trypsin inhibitory activity, was 96, 98 and 95% of activity in the diet, while data expressed in terms of chymotrypsin inhibitory activity were 95, 99 and 79% of activity in the diet for defatted soybean, raw chickpea and autoclaved kidney bean diets respectively. Differences found in ileal digestibility values of PI using both methodologies, ELISA and enzymatic inhibition, might be explained by the detection of inactive forms by specific antibodies. Intestinal apparent digestibility of phytate was 0% for defatted soybean and autoclaved kidney bean diets, whereas values for raw lupin and chickpea diets were 4.1 and 24.5%, respectively. In conclusion, significant amounts of several NNF survived the passage through the stomach and small intestine of cannulated pigs, which might have biological relevance. © 2006 Society of Chemical Industry