111 research outputs found
Spinal pain due to metastasis of unknown origin
A 58-year-old woman presented with non-radicular pain in the upper thorax. Due to the prolonged duration of symptoms, a bone scintigraphy was made, which showed pathological enhancement in the upper thoracic spine. An MRI demonstrated lesions of the third and fourth thoracic vertebrae. A biopsy showed a metastasis of poorly differentiated carcinoma. A whole-body 18-F-FDG PET scan failed to identify a primary tumour. The patient was given radiotherapy, chemotherapy and analgesic treatment. She died within 3years. In the late stage, the tumour marker CA 19-9 was positive; however, an MRI of the abdomen failed to identify a pancreatic tumour. Metastasis from an unknown primary site can present as cervical spinal disease very similar to degenerative diseas
Bone involvement in patients with lymphoma: the role of FDG-PET/CT
Purpose: To evaluate the diagnostic impact and clinical significance of FDG-avid bone lesions detected by FDG-PET/CT in patients with lymphoma. Methods: The study population comprised 50 consecutive patients (mean age 41.7±15.5years; 27 female, 23 male; 41 staging, 9 restaging) with Hodgkin's disease (n=22) or aggressive non-Hodgkin's lymphoma (n=28) in whom FDG-avid bone lesions were detected by FDG-PET/CT. All patients had either direct biopsy of the FDG-avid bone lesion (n=18), standard bone marrow biopsy at the iliac crest (BMB; n=43) or both procedures (n=11). In 15 patients, additional MRI of the bone lesions was performed. All patients underwent FDG-PET/CT after the end of treatment. All CT images of FDG-PET/CT scans were analysed independently regarding morphological osseous changes and compared with FDG-PET results. Results: In the 50 patients, 193 FDG-avid lesions were found by PET/CT. The mean standardised uptake value was 6.26 (±3.22). All direct bone biopsies (n=18) of the FDG-avid lesions proved the presence of lymphomatous infiltration. BMB (n=43) was positive in 12 patients (27.9%). In CT, 32 of 193 (16.6%) lesions were detected without the PET information. No additional morphological bone infiltration was detected on CT compared with FDG-PET. All morphological bone alterations on CT scans persisted after the end of therapy. Additional PET/CT information regarding uni- or multifocal bone involvement resulted in lymphoma upstaging in 21 (42%) patients compared with the combined information provided by CT and BMB. Conclusion: In patients with FDG-avid bone lesions, FDG-PET is superior to CT alone or in combination with unilateral BMB in detecting bone marrow involvement, leading to upstaging in a relevant proportion of patient
Identification of tumor antigens as potential target antigens for immunotherapy by serological expression cloning
The presence of tumor infiltrating T cells has been shown to be associated with a favorable prognosis in different tumor types. Several strategies have been developed to identify relevant tumor antigens which can be used for active immunotherapy strategies. The SEREX technique (serological analysis of cDNA expression libraries) identifies tumor antigens based on a spontaneous humoral immune response in cancer patients. This technique is not limited to tumor types that can be grown in cell culture or depends on established T cell clones recognizing the autologous tumor. Several steps of analysis are mandatory to evaluate SEREX-defined antigens before they become new target antigens for active immunotherapy: expression analysis; serological analysis with sera from tumor patients and normal individuals; identification of potential peptide epitopes for CD8 T cells and evaluation in T cell assays. This article summarizes our approach of antigen identification and evaluation giving the example of the recently cloned breast cancer antigen NY-BR-
Necrobiotic xanthogranuloma successfully treated with autologous stem cell transplantation
Paraproteinemia can be complicated by necrobiotic xanthogranuloma. Therapeutic options for this progressive disease are limited, and there is no agreement on a single best strategy. We report the case of a patient with a massive periorbital infiltration narrowing the palpebral fissure and blinding the patient. Conventional myeloma therapy had only limited benefit in our patient. However, he was successfully treated with high-dose chemotherapy followed by autologous stem cell transplantation, rendering the patient free of symptoms. This is the first report of autologous stem cell transplantation in a patient with necrobiotic xanthogranulom
Extramedullary manifestations of multiple myeloma in the thyroid gland and in the lungs: excellent response to therapy
Decision-making among experts in advanced Hodgkin Lymphoma.
BACKGROUND
In the treatment of advanced Hodgkin Lymphoma (aHL), based on guidelines a multitude of treatment options are available. The availability of PET guided decision-making and new therapeutic agents increase the complexity of the decision-making process.
METHODS
Thirteen experts of Swiss university and cantonal hospitals in Switzerland were asked to describe their institutional decision-making practice in aHL. Variables influencing the decision-making process were identified, standardized and converted into decision trees for analysis of consent and discrepancies. The algorithms of all participating experts were analyzed with the objective consensus methodology.
RESULTS
Four decision criteria (age, fertility preservation, fitness, interim PET) and 12 unique treatment regimens were identified. Consensus for the treatment of aHL for young and fit, as well as for older patients without comorbidity was found. Large heterogeneity was identified with use of a variety of different regimens for unfit patients with aHL and for young female patients with a desire of fertility preservation.
CONCLUSION
Four major decision criteria were identified allowing the representation of expert's approach to first-line treatment of aHL. Among Swiss experts, consensus for a PET guided curative treatment of aHL was identified. The use of a multitude of treatment regimens was observed for older and comorbid (unfit) aHL patients, highlighting the need for clinical trials and recommendations for this group of patients
Liquid metal nanodroplet dynamics inside nanocontainers
Here we report direct observations of spatial movements of nanodroplets of Pb metal trapped inside sealed
carbon nanocontainers. We find drastic changes in the mobility of the liquid droplets as the particle size
increases from a few to a few ten nanometers. In open containers the droplet becomes immobile and readily
evaporates to the vacuum environment. The particle mobility strongly depends on confinement, particle
size, and wetting on the enclosed surface. The collisions between droplets increase mobility but the tendency
is reversed if collisions lead to droplet coalescence. The dynamics of confined nanodroplets could provide
new insights into the activity of nanostructures in spatially constrained geometries
Observations of 4U 1626-67 with the Imaging X-ray Polarimetry Explorer
We present measurements of the polarization of X-rays in the 2-8 keV band
from the pulsar in the ultracompact low mass X-ray binary 4U1626-67 using data
from the Imaging X-ray Polarimetry Explorer (IXPE). The 7.66 s pulsations were
clearly detected throughout the IXPE observations as well as in the NICER soft
X-ray observations, which we use as the basis for our timing analysis and to
constrain the spectral shape over 0.4-10 keV energy band. Chandra HETGS
high-resolution X-ray spectra were also obtained near the times of the IXPE
observations for firm spectral modeling. We find an upper limit on the
pulse-averaged linear polarization of <4% (at 95% confidence). Similarly, there
was no significant detection of polarized flux in pulse phase intervals when
subdividing the bandpass by energy. However, spectropolarimetric modeling over
the full bandpass in pulse phase intervals provide a marginal detection of
polarization of the power-law spectral component at the 4.8 +/- 2.3% level (90%
confidence). We discuss the implications concerning the accretion geometry onto
the pulsar, favoring two-component models of the pulsed emission.Comment: 19 pages, 7 figures, 7 tables; accepted for publication in the
Astrophysical Journa
X-ray pulsar GRO J100857 as an orthogonal rotator
X-ray polarimetry is a unique way to probe geometrical configuration of
highly-magnetized accreting neutron stars (X-ray pulsars). GRO J100857 is
the first transient X-ray pulsar observed at two different flux levels by the
Imaging X-ray Polarimetry Explorer (IXPE) during its outburst in November 2022.
The polarization properties were found to be independent of the source
luminosity, with the polarization degree varying between non-detection to about
15% over the pulse phase. Fitting the phase-resolved spectro-polarimetric data
with the rotating vector model allowed us to estimate the pulsar inclination
(130 deg, which is in good agreement with the orbital inclination), the
position angle (75 deg) of the pulsar spin axis, and the magnetic obliquity (74
deg). This makes GRO J100857 the first confidently identified X-ray pulsar
as a nearly orthogonal rotator. The results are discussed in the context of the
neutron star atmosphere models and theories of pulsars' axis alignment.Comment: 11 pages, 7 figures, submitted to A&A. arXiv admin note: text overlap
with arXiv:2209.0244
X-ray polarimetry of the accreting pulsar GX 301-2
The phase- and energy-resolved polarization measurements of accreting X-ray
pulsars (XRPs) allow us to test different theoretical models of their emission,
as well as to provide an avenue to determine the emission region geometry. We
present the results of the observations of the XRP GX 301-2 performed with the
Imaging X-ray Polarimetry Explorer (IXPE). GX 301-2 is a persistent XRP with
one of the longest known spin periods of ~680 s. A massive hyper-giant
companion star Wray 977 supplies mass to the neutron star via powerful stellar
winds. We do not detect significant polarization in the phase-averaged data
using spectro-polarimetric analysis, with the upper limit on the polarization
degree (PD) of 2.3% (99% confidence level). Using the phase-resolved
spectro-polarimetric analysis we get a significant detection of polarization
(above 99% c.l.) in two out of nine phase bins and marginal detection in three
bins, with a PD ranging between ~3% and ~10%, and a polarization angle varying
in a very wide range from ~0 deg to ~160 deg. Using the rotating vector model
we obtain constraints on the pulsar geometry using both phase-binned and
unbinned analysis getting excellent agreement. Finally, we discuss possible
reasons for a low observed polarization in GX 301-2.Comment: 10 pages, 10 figures, submitted to A&
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