Extramedullary plasmacytoma of the uterine cervix arising in an asymptomatic 46-year-old female

An extramedullary plasmacytoma is a rare type of plasma cell tumour that can be found in soft tissues throughout the body. The most common location for an extramedullary plasmacytoma is in the head and neck region. Few case reports have previously documented patients with an extramedullary plasmacytoma within the female genital tract. We report a case of a healthy and asymptomatic 46-year-old female who presented to Colposcopy Clinic with a finding of low-grade squamous intraepithelial lesion seen on a routine Pap smear. She was found to have a cervical polyp that was excised. Pathology revealed diffuse sheets of atypical plasma cells with lambda light chain restriction. She was referred to Hematology for extensive work-up as the pathology finding was concerning for a plasma cell neoplasm. Staging investigations, including bone marrow biopsy, skeletal survey, whole body PET-CT scan, serum protein electrophoresis, and serum free light chain testing, were all negative. Surgical resection with a hysterectomy was recommended as the most appropriate course of management. The treatment approach is consistent with guidelines outlined in the literature, whereby extramedullary plasmacytomas, which arise outside of the head and neck region and have clear margins, should undergo surgical resection. Extramedullary plasmacytomas carry a risk of progressing to systemic disease, such as multiple myeloma, making it crucial that these patients be followed with routine surveillance to achieve the most optimal long term survival outcome

Host lipidome and tuberculosis treatment failure

INTRODUCTION: Host lipids play important roles in tuberculosis (TB) pathogenesis. Whether host lipids at TB treatment initiation (baseline) affect subsequent treatment outcomes has not been well characterised. We used unbiased lipidomics to study the prospective association of host lipids with TB treatment failure. METHODS: A case–control study (n=192), nested within a prospective cohort study, was used to investigate the association of baseline plasma lipids with TB treatment failure among adults with pulmonary TB. Cases (n=46) were defined as TB treatment failure, while controls (n=146) were those without failure. Complex lipids and inflammatory lipid mediators were measured using liquid chromatography mass spectrometry techniques. Adjusted least-square regression was used to assess differences in groups. In addition, machine learning identified lipids with highest area under the curve (AUC) to classify cases and controls. RESULTS: Baseline levels of 32 lipids differed between controls and those with treatment failure after false discovery rate adjustment. Treatment failure was associated with lower baseline levels of cholesteryl esters and oxylipin, and higher baseline levels of ceramides and triglycerides compared to controls. Two cholesteryl ester lipids combined in a unique classifier model provided an AUC of 0.79 (95% CI 0.65–0.93) in the test dataset for prediction of TB treatment failure. CONCLUSIONS: We identified lipids, some with known roles in TB pathogenesis, associated with TB treatment failure. In addition, a lipid signature with prognostic accuracy for TB treatment failure was identified. These lipids could be potential targets for risk-stratification, adjunct therapy and treatment monitoring

Iatrogenic immunodeficiency-associated lymphoproliferative disorders in transplant and nontransplant settings

Iatrogenic immunodeficiency-associated lymphoproliferative disorders comprise a group of lymphoid neoplasms that are associated with an immunosuppressed state, either in the posttransplant period, or during the treatment of various autoimmune and rheumatologic disorders by immunomodulatory medications. Their morphologies vary widely but are generally classified according to the lymphomas that they most closely resemble. This group is strongly associated with infections by the Epstein-Barr virus as a result of impaired immune function in the immunosuppressed state. Although further classification may become necessary in the coming years, they are distinguished from lymphomas in immunocompetent hosts because reduction or cessation of immunosuppressive or immunomodulatory therapy can result in complete clinical remission

Metastatic cervical adenocarcinoma to the breast: A case report and literature review

Breast metastases from gynecologic cancers are rare. Cervical cancer most commonly metastasizes to the lung, liver or bone. When cervical cancer metastasizes to the breast, the presentation is usually a solitary breast mass; rarely, however, breast metastases can mimic inflammatory breast cancer. We present a case of metastatic cervical adenocarcinoma presenting clinically as inflammatory breast cancer and review the relevant literature. Keywords: Cervical cancer, Breast metastasis, Inflammatory breast cance