What Is New in Cutaneous T Cell Lymphoma?

Purpose of Review This review focuses on updates in prognosis, pathogenesis, and treatment of cutaneous T cell lymphoma (CTCL). Recent Findings Cohort studies indicate imaging may be necessary in early-stage CTCL. Risk factors for progression of CTCL have been identified. Interactions between malignant cells and the tumor microenvironment (TME) and the skin microbiome advance the understanding of pathogenesis and tumor cell dissemination. Studies support a hypothesis of circulating malignant tumor cells. MicroRNA (miR) influence tumor progression and prognosis; the IL22-STAT3-CCL20 cascade may be a novel target. IL-4, IL-5, and IL-31 cytokines are relevant for pruritus and could be targets for therapeutic interventions. Systemic therapies, such as JAK inhibitors, targeted antibodies, and checkpoint inhibitors, show promise in advanced stages. Allogenic hematopoietic stem cell transplantation provides a potential curative option for patients. Summary Further investigations of prognosis and translational research are necessary to improve stratification of patients for treatment

Correlation of dynamic contrast-enhanced bone perfusion with morphologic ultra-short echo time MR imaging in medication-related osteonecrosis of the jaw

OBJECTIVES: To investigate whether dynamic contrast-enhanced (DCE)-MR bone perfusion could serve as surrogate for morphologic ultra-short echo time (UTE) bone images and to correlate perfusion with morphologic hallmarks in histologically proven foci of medication-related osteonecrosis of the jaw (MRONJ). METHODS: Retrospective study including 20 patients with established diagnosis of MRONJ. Qualitative consensus assessment of predefined jaw regions by two radiologists was used as reference standard using Likert scale (0-3) for standard imaging hallmarks in MRONJ (osteolysis, sclerosis, periosteal thickening). DCE-MRI measurements performed in corresponding regions of the mandible were then correlated with qualitative scores. Regions were grouped into "non-affected" and "pathologic" based on binarized Likert scores of different imaging hallmarks (0-1 vs 2-3). DCE-MRI measurements among hallmarks were compared using Mann-Whitney-U-testing. ROC (receiver-operating-characteristic) analysis was performed for each of the perfusion parameters to assess diagnostic performance for identification of MRONJ using morphologic ratings as reference standard. RESULTS: Median perfusion measurements of "pathologic" regions in wash-in, peak enhancement intensity and integrated area under the curve are significantly higher than those of "non-affected" regions, irrespective of reference imaging hallmark (p < 0.05). No significant perfusion differences were found between "pathologic" regions with and without osteolysis (p = 0.180). ROC analysis showed fair diagnostic performance of DCE-MRI parameters for identification of MRONJ (AUC 0.626-0.727). CONCLUSIONS: DCE bone perfusion parameters are significantly increased in MRONJ compared to non-affected regions, irrespective of osteolysis. Due to certain overlap DCE-MRI bone perfusion cannot serve as full surrogate for UTE bone imaging but may enhance reader confidence

Origin, causes and effects of increased nitrite concentrations in aquatic environments

Literature frequently mentions increased nitrite concentrations along with its inhibitory effect towards bacteria and aquatic life. Nitrite accumulation has been studied for decades, and although numerous causal factors have already been commented on in literature, the mechanism of nitrite accumulation is not always clear. From the broad range of parameters and environmental factors reviewed in this paper, it is obvious that the causes and consequences of nitrite accumulation are not yet completely understood. Among others, pH, dissolved oxygen, volatile fatty acids, phosphate and reactor operation have been found to play a role in nitrite accumulation, which results from differential inhibition or disruption of the linkage of the different steps in both nitrification and denitrification. In the case of nitrification, this differential inhibition could lead to the displacement or unlinking of the ammonia oxidisers and nitrite oxidisers. In this paper, the idea is formulated that the nitrifier population forms a role model for the total microbial community. Increased nitrite concentrations would in this aspect not only signal a disruption of nitrifiers, but possibly also of the total configuration of the microbial community. [KEYWORDS: denitrification, nitrification, nitrite accumulation, nitrite toxicity]