It is no longer the time to disregard thyroid metastases from breast cancer: A case report and review of the literature

Background: Metastases to the thyroid gland are more frequent than previously thought, although most of them are occult or not clinically relevant. Overall, only 42 cases of metastases to thyroid from breast cancer have been reported thus far. Here we report the case of a patient with breast cancer metastatic to the thyroid. We also review the 42 previously reported cases (published between 1962 and 2012). This is the first review about metastases to thyroid gland from breast cancer. Case presentation: A 64-year-old woman of Caucasian origin was diagnosed with a lobular invasive carcinoma of the breast (luminal A, stage II). She received adjuvant chemotherapy, followed by endocrine therapy. During follow- up, fine-needle cytology of a thyroid nodule revealed malignant cells that were estrogen-positive, which suggested a diagnosis of metastases to the thyroid. Imaging did not reveal any other metastatic site and showed only enlargement of the left thyroid lobe and an inhomogeneous pattern of colloid and cystic degeneration and calcifications. The patient underwent left hemithyroidectomy. Histology of thyroid tissue showed a colloid goitre containing dispersed small atypical neoplastic cells with eccentric nuclei. Immunohistochemistry showed cytokeratin-19 and oestrogen receptor, but not tireoglobulin, e-cadherin or cytokeratin-7, thereby confirming metastases from a lobular breast carcinoma. Hormonal treatment is ongoing. Conclusion: This case report and first review of the literature on metastases to thyroid from breast cancer highlight the importance of a correct early diagnostic work-up in such cases. Indeed, a primary lesion should be distinguished from metastases given the different treatment protocol related to primary cancer and the clinical impact on prognosis

Genetic variability and evolutionary diversification of membrane ABC transporters in plants

ATP-binding cassette proteins have been recognized as playing a crucial role in the regulation of growth and resistance processes in all kingdoms of life. They have been deeply studied in vertebrates because of their role in drug resistance, but much less is known about ABC superfamily functions in plants. Results: Recently released plant genome sequences allowed us to identify 803 ABC transporters in four vascular plants (Oryza. sativa, Solanum lycopersicum, Solanum tuberosum and Vitis vinifera) and 76 transporters in the green alga Volvox carteri, by comparing them with those reannotated in Arabidopsis thaliana and the yeast Saccharomyces cerevisiae. Retrieved proteins have been phylogenetically analysed to infer orthologous relationships. Most orthologous relationships in the A, D, E and F subfamilies were found, and interesting expansions within the ABCG subfamily were observed and discussed. A high level of purifying selection is acting in the five ABC subfamilies A, B, C, D and E. However, evolutionary rates of recent duplicate genes could influence vascular plant genome diversification. The transcription profiles of ABC genes within tomato organs revealed a broad functional role for some transporters and a more specific activity for others, suggesting the presence of key ABC regulators in tomato. Conclusions: The findings achieved in this work could contribute to address several biological questions concerning the evolution of the relationship between genomes of different species. Plant ABC protein inventories obtained could be a valuable tool both for basic and applied studies. Indeed, interpolation of the putative role of gene functions can accelerate the discovering of new ABC superfamily members. © Andolfo et al.; licensee BioMed Central

Leadless Pacemaker Infection Risk in Patients with Cardiac Implantable Electronic Device Infections: A Case Series and Literature Review

(1) Background: Leadless pacemakers (LPs) have been proposed as a reimplantation strategy in pacing-dependent patients undergoing cardiac implantable electronic device (CIED) extraction for infection. In this study, we analysed the risk of LP infection when this device is implanted before lead extraction. (2) Methods: This was a retrospective study including patients who underwent LP implantation between 2017 and 2022. Patients were divided in two groups according to whether LP was implanted following CIED extraction for infection (Group 1) or other indications (Group 2). The primary aim was to describe the risk of LP infection. (3) Results: We included in this study 49 patients with a median age of 81 [20-94] years, mostly males (36, 73%). In Group 1 patients, 17 cases (85%) showed systemic CIED infections, and 11 (55%) had positive lead cultures. Most Group 1 cases (n = 14, 70%) underwent one stage of LP implantation and CIED extraction. Mortality rate during follow-up was 20% (nine patients). Patients were followed up for a median of 927 [41-1925], days and no cases of definite or suspected LP infections were identified. (4) Conclusions: The risk of LP infection was extremely low. LP appears as a potential option for reimplantation in this setting and should be considered in pacing-dependent patients at a high risk of CIED infection recurrence

Detection of intestinal bacteria in visceral fat from UC and CD patients.

<p>Fluorescent immunodetection of <i>Enterococcus faecalis</i> (red) in omental adipose tissue (OM) and mesenteric adipose tissue (MES) from 1 representative ulcerative colitis (UC) and 1 Crohn's disease (CD) patient by confocal microscopy. Magnification is 40X. Nuclei are counterstained in blue (DAPI, 4',6-diamidin-2-fenilindolo).</p

Validation of microarray data by Real Time quantitative PCR.

<div><p><b>A</b>. Expression of metallothionein 1G (MT1G), metallothionein 1E (MT1E), lipopolysaccharide-binding protein (LBP) mRNA in omental adipose tissue (OM) from Crohn's disease (CD) and ulcerative colitis (UC) patients. </p> <p><b>B</b>. Expression of tumor necrosis factor alpha (TNFA), lipopolysaccharide-binding protein (LBP) and defensin beta 1 (DEF1B) in CD and UC MES.</p> <p>Data were normalized to human ribosomal protein LP0 (RPLP0) and are expressed as arbitrary units (AU) ± SE, *<i>P</i><0.05.</p></div

Gene expression analysis of isolated adipocytes from UC and CD patients.

<div><p><b>A</b>. Clustering of global gene expression in omental adipose tissue (OM) and mesenteric adipose tissue around the involved intestinal tract (MES) in ulcerative colitis (UC) and Crohn's disease (CD) patients.</p> <p><b>B</b>. Numbers of detected genes and percentage of differentially expressed genes in UC OM <i>vs</i>. CD OM and in UC MES <i>vs</i>. CD MES. Details of down- and up-regulated genes are indicated.</p> <p><b>C</b>. Functional annotations of genes differentially expressed in UC OM <i>vs</i>. UC MES, in UC OM <i>vs</i>. CD OM and in UC MES <i>vs</i>. CD MES. GO: Gene Ontology-Biological Process. The first five most significant clusters of up- and down-regulated genes are shown. </p></div