The issue of fine needle aspiration cytology in the diagnosis of tuberculous cervical lymphadenitis

BackgroundDue to different reports about the value of fine needle aspiration cytology (FNAC) as a simple and minimal invasive diagnostic tool for extra-pulmonary tuberculosis, we attempted to demonstrate the sensitivity of FNAC in patients with cervical tuberculous lymphadenitis in Iran. We wanted to know if fine needle aspiration (FNA) is an accurate method as a first step in diagnosis or not.Methods This study covered a 14 year period identifying 137 patients with a pathological report of granulomatosis in excisional biopsy of lymphadenopathy in two tertiary referral hospitals of Tehran, Iran. The results of fine needle aspiration cytology (FNAC) in 67 patients with tuberculosis cervical lymphadenitis were evaluated. Results The FNA cytology showed granuloma with background necrosis in five patients (7.46 per cent) and granuloma with or without necrosis in 13 patients (19.40 per cent). Patients with positive results of FNAC had a longer duration of lymphadenopathy compared to other patients.ConclusionIn this study, sensitivity of FNAC was reported to be low. The sensitivity of this method was 7.46 per cent (including pathology granuloma with background necrosis) and 19.40 per cent (total cases of granuloma with or without necrosis). It seems that the sensitivity of FNAC is significantly lower in patients with early cervical tuberculosis (TB) lymphadenitis. Combining acid-fast bacillus (AFB) staining and non-culture methods like polymerase chain reaction (PCR) could increase FNA sensitivity in these patients

Endocarditis caused by Aspergillus fumigatus in a patient 9 months after COVID-19 infection recovery: a case report and review of the literature

Abstract Background Aspergillus spp. are among the fungal pathogens that can cause life-threatening infections in patients with a history of COVID-19. Case presentation We present the case of a 58-year-old Iranian woman with post-COVID-19 Aspergillus fumigatus endocarditis complicated by numerous thromboembolisms. She underwent mitral valve replacement surgery and multiple lower extremity embolectomies and was treated with voriconazole, which led to her final recovery. Conclusions Aspergillus endocarditis should be considered in any patient with suspected endocarditis who has a history of COVID-19 infection and does not respond to routine antibiotic and antifungal therapy, as COVID-19 interferes with proper immune function, and lack of underlying cardiac conditions and immunodeficiencies does not preclude the diagnosis. Culture and histopathological evaluation of vegetations and emboli, as well as PCR, can confirm the diagnosis. Early initiation of antifungal therapy and surgical removal of infected valves and emboli can improve prognosis in patients with Aspergillus endocarditis

The histone methyltransferase DOT1L is required for proper DNA damage response, DNA repair, and modulates chemotherapy responsiveness

Abstract Background Disruptor of telomeric silencing 1-like (DOT1L) is a non-SET domain containing methyltransferase known to catalyze mono-, di-, and tri-methylation of histone 3 on lysine 79 (H3K79me). DOT1L-mediated H3K79me has been implicated in chromatin-associated functions including gene transcription, heterochromatin formation, and DNA repair. Recent studies have uncovered a role for DOT1L in the initiation and progression of leukemia and other solid tumors. The development and availability of small molecule inhibitors of DOT1L may provide new and unique therapeutic options for certain types or subgroups of cancer. Methods In this study, we examined the role of DOT1L in DNA double-strand break (DSB) response and repair by depleting DOT1L using siRNA or inhibiting its methyltransferase activity using small molecule inhibitors in colorectal cancer cells. Cells were treated with different agents to induce DNA damage in DOT1L-depleted or -inhibited cells and analyzed for DNA repair efficiency and survival. Further, rectal cancer patient samples were analyzed for H3K79me3 levels in order to determine whether it may serve as a potential marker for personalized therapy. Results Our results indicate that DOT1L is required for a proper DNA damage response following DNA double-strand breaks by regulating the phosphorylation of the variant histone H2AX (γH2AX) and repair via homologous recombination (HR). Importantly, we show that small molecule inhibitors of DOT1L combined with chemotherapeutic agents that are used to treat colorectal cancers show additive effects. Furthermore, examination of H3K79me3 levels in rectal cancer patients demonstrates that lower levels correlate with a poorer prognosis. Conclusions In this study, we conclude that DOT1L plays an important role in an early DNA damage response and repair of DNA double-strand breaks via the HR pathway. Moreover, DOT1L inhibition leads to increased sensitivity to chemotherapeutic agents and PARP inhibition, which further highlights its potential clinical utility. Our results further suggest that H3K79me3 can be useful as a predictive and or prognostic marker for rectal cancer patients