Metastatic seminoma and grade 1 follicular lymphoma presenting concurrently in a supraclavicular lymph node: a case report

An asymptomatic 67-year-old man presented with a left supraclavicular lymph node that enlarged over a 2-month period which was biopsied. Pathologic features were consistent with involvement by metastatic seminoma and follicular lymphoma, follicular pattern, grade 1 (of 3). Staging Positron Emission Tomography/Computed Tomography scans indicated several areas of enlarged lymph nodes. The patient completed chemotherapy with bleomycin, etoposide, and cisplatin chemotherapy. This is the first reported case of metastatic seminoma and follicular lymphoma occurring in the same lymph node. No obvious pathophysiologic link exists between these two malignancies and there are no shared common risk factors. Given the natural history of these two malignancies, if this patient develops recurrent lymphadenopathy, it will be difficult to identify whether the enlarged lymph nodes represent recurrent seminoma or follicular lymphoma without a biopsy of each pathologically enlarged node. Similarly, Fluorodeoxyglucose- Positron Emission Tomography is known to be active in both seminoma and follicular lymphoma, making this scan non-specific in this patient. Finally, this patient had no baseline elevation in any germ cell tumor marker. Thus, serum tumor markers cannot be relied upon as surrogates for response to chemotherapy or as identifiers of relapsed seminoma

Meiosis genes in Daphnia pulex and the role of parthenogenesis in genome evolution

<p>Abstract</p> <p>Background</p> <p>Thousands of parthenogenetic animal species have been described and cytogenetic manifestations of this reproductive mode are well known. However, little is understood about the molecular determinants of parthenogenesis. The <it>Daphnia pulex </it>genome must contain the molecular machinery for different reproductive modes: sexual (both male and female meiosis) and parthenogenetic (which is either cyclical or obligate). This feature makes <it>D. pulex </it>an ideal model to investigate the genetic basis of parthenogenesis and its consequences for gene and genome evolution. Here we describe the inventory of meiotic genes and their expression patterns during meiotic and parthenogenetic reproduction to help address whether parthenogenesis uses existing meiotic and mitotic machinery, or whether novel processes may be involved.</p> <p>Results</p> <p>We report an inventory of 130 homologs representing over 40 genes encoding proteins with diverse roles in meiotic processes in the genome of <it>D. pulex</it>. Many genes involved in cell cycle regulation and sister chromatid cohesion are characterized by expansions in copy number. In contrast, most genes involved in DNA replication and homologous recombination are present as single copies. Notably, <it>RECQ2 </it>(which suppresses homologous recombination) is present in multiple copies while <it>DMC1 </it>is the only gene in our inventory that is absent in the <it>Daphnia </it>genome. Expression patterns for 44 gene copies were similar during meiosis <it>versus </it>parthenogenesis, although several genes displayed marked differences in expression level in germline and somatic tissues.</p> <p>Conclusion</p> <p>We propose that expansions in meiotic gene families in <it>D. pulex </it>may be associated with parthenogenesis. Taking into account our findings, we provide a mechanistic model of parthenogenesis, highlighting steps that must differ from meiosis including sister chromatid cohesion and kinetochore attachment.</p

Hypodermic needle to guide Kirschner-wire placement in paediatric supracondylar humerus fractures: A technical trick

PurposeSupracondylar humerus fractures are among the most common injuries in the paediatric population, accounting for 16% of all paediatric fractures and roughly 60% to 70% of all paediatric elbow fractures. Typical treatment for displaced and unstable supracondylar humerus fractures is surgical intervention, often with percutaneous Kirschner-wire (K-wire) fixation. Timing of surgery is dependent on the patient's neurovascular status on presentation, with surgical emergencies being performed at all hours of day and night. Percutaneous fixation of paediatric elbow fractures can be challenging as a result of the propensity for the elbow to become quite swollen with these fractures, particularly in smaller and physiologically more immature elbows.MethodsWe have developed a simple operative technique to guide placement of percutaneous wires for supracondylar humerus fractures using a hypodermic needle as a reference marker.ResultsIn our experience, trainees utilizing this technique demonstrate greater appreciation for start point and trajectory of wires during percutaneous pinning, with better communication amongst surgical team members about necessary adjustment for optimal placement of K-wires.ConclusionUtilization of this technique has the potential to refine surgical technique by minimizing errant wire passes, radiation and operative time when performing percutaneous pinning of reduced type III supracondylar humerus fractures.Level of evidenceV, Novel Surgical Technique