Presumptive Gnathostoma binucleatum-infection in a Belgian traveler returning from South America.

Gnathostomiasis, caused by third stage larvae of Gnathostoma spp., a zoonotic nematode found in tropical and subtropical regions is an emerging parasitic infection in humans. Once thought to be confined to South East Asia, increasing numbers of cases originating in other regions are being described, both in autochthonous populations and travelers. Gnathostomiasis usually presents with cutaneous manifestations and eosinophilia, appearing weeks to months after consuming raw fish. Visceral and central nervous system involvement may occur, causing substantial morbidity. Although eosinophilia provides a clue to diagnosis, it may be absent in up to 55% of the cases. We describe a case of cutaneous gnathostomiasis in a Belgian traveler returning from South America, with no evident exposure and no blood eosinophilia, finally diagnosed by surgical resection and histological examination of the causative larva

Lymphangiogenesis in COPD: Another link in the pathogenesis of the disease

Background: New lymphatic vessels are associated with tissue injury and repair. Recent studies have shown increased lymphatic follicles formation in the lungs of COPD patients. We hypothesized that lymphatic vascular remodeling could be part of COPD pathogenesis. Aim: To investigate the lymphangiogenetic process in COPD we measured the lymphatic microvessel density (LMVD), the lymphatic invasion (L.I), and their correlation with clinical and laboratory parameters. Methods: Lung tissue from 20 COPD patients and 20 non-COPD smokers was immunohistochemically stained for D2-40 (lymphatic endothelial cell marker), and LYVE-1 (lymphatic endothelial hyaluronan receptor 1). Both groups had similar age and smoking history. Results: D2-40 and LYVE-1 were expressed in all specimens. Lymphatic invasion was presented only in COPD specimens. Lymphatic microvessel density (LMVD) as revealed by D2-40 and LYVE-1 markers was statistically significantly higher in COPD patients when compared with non-COPD smokers. Both markers (D2-40, LYVE-1) were correlated with FEV1 (% pred) (R 2 = 0.415, R 2 = 0.605, respectively). Conclusions: We report for the first time high lymphatic microvessel density and lymphatic invasion in COPD patients, related to the degree of airway obstruction. Our findings could provide novel insights in the pathogenesis of the disease. © 2011 Elsevier Ltd. All rights reserved

Presumptive Gnathostoma binucleatum-infection in a Belgian traveler returning from South America.

Gnathostomiasis, caused by third stage larvae of Gnathostoma spp., a zoonotic nematode found in tropical and subtropical regions is an emerging parasitic infection in humans. Once thought to be confined to South East Asia, increasing numbers of cases originating in other regions are being described, both in autochthonous populations and travelers. Gnathostomiasis usually presents with cutaneous manifestations and eosinophilia, appearing weeks to months after consuming raw fish. Visceral and central nervous system involvement may occur, causing substantial morbidity. Although eosinophilia provides a clue to diagnosis, it may be absent in up to 55% of the cases. We describe a case of cutaneous gnathostomiasis in a Belgian traveler returning from South America, with no evident exposure and no blood eosinophilia, finally diagnosed by surgical resection and histological examination of the causative larva

Real-world EGFR testing practices for non-small-cell lung cancer by thoracic pathology laboratories across Europe

Background: Testing for epidermal growth factor receptor (EGFR) mutations is an essential recommendation in guidelines for metastatic non-squamous non-small-cell lung cancer, and is considered mandatory in European countries. However, in practice, challenges are often faced when carrying out routine biomarker testing, including access to testing, inadequate tissue samples and long turnaround times (TATs). Materials and methods: To evaluate the real-world EGFR testing practices of European pathology laboratories, an online survey was set up and validated by the Pulmonary Pathology Working Group of the European Society of Pathology and distributed to 64 expert testing laboratories. The retrospective survey focussed on laboratory organisation and daily EGFR testing practice of pathologists and molecular biologists between 2018 and 2021. Results: TATs varied greatly both between and within countries. These discrepancies may be partly due to reflex testing practices, as 20.8% of laboratories carried out EGFR testing only at the request of the clinician. Many laboratories across Europe still favour single-test sequencing as a primary method of EGFR mutation identification; 32.7% indicated that they only used targeted techniques and 45.1% used single-gene testing followed by next-generation sequencing (NGS), depending on the case. Reported testing rates were consistent over time with no significant decrease in the number of EGFR tests carried out in 2020, despite the increased pressure faced by testing facilities during the COVID-19 pandemic. ISO 15189 accreditation was reported by 42.0% of molecular biology laboratories for single-test sequencing, and by 42.3% for NGS. 92.5% of laboratories indicated they regularly participate in an external quality assessment scheme. Conclusions: These results highlight the strong heterogeneity of EGFR testing that still occurs within thoracic pathology and molecular biology laboratories across Europe. Even among expert testing facilities there is variability in testing capabilities, TAT, reflex testing practice and laboratory accreditation, stressing the need to harmonise reimbursement technologies and decision-making algorithms in Europe