Atypical Presentation of an Upper Lip Pleomorphic Adenoma: Case Report

Pleomorfni adenom (PA) ili miješani tumor najčešća je neoplazma žlijezda slinovnica i obično se pojavljuje kao nespecifična klinička histopatološka manifestacija. Usne su drugo najčešće mjesto na kojemu nastaju novotvorine malih žlijezda slinovnica. Svrha ovog članka jest predstaviti slučaj 39- godišnje bjelkinje s oteklinom na desnoj strani gornje usne. U anamnezi je navela traumu u tom području nastalu prije osam godina. Prema mišljenju liječnika otekline su se u regiji pojavile zbog periapikalnog procesa vidljivog na ortopantomogramu. Intraoperativno kirurg je pronašao tvrdi čvorić u području oko labijalnog nabora. Histopatološkom analizom potvrđen je benigni miješani tumor žlijezde slinovnice. U ovom članku raspravlja se o devijaciji miješanog tumora žlijezda slinovnica između gornje i donje usne, zatim o kliničkoj diferencijalnoj dijagnozi i histopatološkom uzorku te o pravilnom liječenju.The pleomorphic adenoma (PA) or mixed tumour is the most common neoplasm of the salivary glands, usually presenting with a non-specific clinical manifestation and a diverse histopathological pattern. The region of the lips is the second most common site for minor gland neoplasms. The aim of this paper is to report the case of a 39 year old Caucasian woman presenting with a swelling on the right side of the upper lip combined with a history of trauma in the region of the upper right central incisor, eight years ago. The swelling was attributed to the periapical lesion of the upper right central incisor that was observed on the panoramic radiograph. Intraoperatively, the surgeon came upon a nodule of firm consistency in the mucolabial fold. The histopathologic diagnosis of this lesion was a benign mixed tumour of the salivary gland. This report discusses the deviation in frequency of mixed salivary gland tumour between upper and lower lip, the clinical differential diagnosis, the histopathological pattern and the appropriate treatment

BTK drives neutrophil activation for sterilizing antifungal immunity

We describe a previously-unappreciated role for Bruton's tyrosine kinase (BTK) in fungal immune surveillance against aspergillosis, an unforeseen complication of BTK inhibitors (BTKi) used for treating B-cell lymphoid malignancies. We studied BTK-dependent fungal responses in neutrophils from diverse populations, including healthy donors, BTKi-treated patients, and X-linked agammaglobulinemia patients. Upon fungal exposure, BTK was activated in human neutrophils in a TLR2-, Dectin-1-, and FcγR-dependent manner, triggering the oxidative burst. BTK inhibition selectively impeded neutrophil-mediated damage to Aspergillus hyphae, primary granule release, and the fungus-induced oxidative burst by abrogating NADPH oxidase subunit p40phox and GTPase RAC2 activation. Moreover, neutrophil-specific Btk deletion in mice enhanced aspergillosis susceptibility by impairing neutrophil function, not recruitment or lifespan. Conversely, GM-CSF partially mitigated these deficits by enhancing p47phox activation. Our findings underline the crucial role of BTK signaling in neutrophils for antifungal immunity and provide a rationale for GM-CSF use to offset these deficits in susceptible patients