The Tumor and its Microenvironment in Mesothelioma

__Abstract__ Asbestos is a natural mineral that was, and unfortunately still is, used a lot by mankind because of the outstanding properties of the substance. It is durable, strong, electricand heat-resistant and, last but not least, cheap. The discovery of these properties was made millennia ago in ancient Greek, and thus the mining and use of asbestos was initiated over 2000 years ago. During the middle ages, the use of asbestos declined, but in the documents remaining, several descriptions of asbestos use were described. For example, Charlemagne (2 April 747 or 748 – 28 January 814) convinced his guests that he had supernatural powers by throwing his asbestos tablecloth into a fire, and then pulling it out without any singe mark of burning1. Marco Polo wore fire-resistant clothing made from fibrous material on his travels in the Ural Mountains in the 13th century1. The popularity of the material clearly increased in the 19th century, when asbestos was massively used during the industrial revolution. It further increased in the 20th century; a total of 174 million tons of asbestos was mined during these 100 years2. Despite asbestos bans in a growing number of countries worldwide, in the year 2013, a total of 1.94 million tons of asbestos was mined3. In the Netherlands, the population mainly

Thymoma and Thymic Carcinoma

Malignancies of the thymus are a rare entity and are often without local symptoms. However, paraneoplastic syndromes can give symptoms varying from very mild to life-threatening. The diagnostic workup and management of these tumors warrant a multidisciplinary approach. Treatment choice is mainly decided upon by pathological World Health Organization (WHO) subtype and clinical staging. In contrast to historical belief, biopsy could be considered when indicated. For resectable tumors, surgical approach is advised, with adjuvant radiotherapy for Masaoka-Koga stage III tumors. Whether Masaoka-Koga stage II tumors should be treated with radiotherapy is controversial given different outcomes in multiple studies. In Masaoka-Koga stage III, combinations with induction chemotherapy are the standard. A surgical approach should be considered even in stage IVa disease. If distant metastases are present, the patient can be treated with systemic chemotherapy. Despite many phase II studies having been published, there is no randomized controlled phase III data regarding optimal treatment available. In addition to chemotherapy, sunitinib and octreotide have been described to be effective. Immunotherapy is seen as Pandora’s box given the possibility of immune-related side effects in this immunological organ. All known data regarding immunotherapy will be discussed

Bronchiolitis obliterans organizing pneumonia (BOOP) after thoracic radiotherapy for breast carcinoma

Common complications of thoracic radiotherapy include esophagitis and radiation pneumonitis. However, it is important to be aware of uncommon post-radiotherapy complications such as bronchiolitis obliterans organizing pneumonia (BOOP). We report on two patients with carcinoma of the breast who developed an interstitial lung disease consistent with BOOP. BOOP responds to treatment with corticosteroids and the prognosis is generally good despite of the need for long-term administration of corticosteroids as relapses can occur during tapering of steroids. This report provides guidelines for the evaluation and treatment of patients with pulmonary infiltrates after radiotherapy

Global Patterns of Potential Future Plant Diversity Hidden in Soil Seed Banks

Soil seed banks represent a critical but hidden stock for potential future plant diversity on Earth. Here we compiled and analyzed a global dataset consisting of 15,698 records of species diversity and density for soil seed banks in natural plant communities worldwide to quantify their environmental determinants and global patterns. Random forest models showed that absolute latitude was an important predictor for diversity of soil seed banks. Further, climate and soil were the major determinants of seed bank diversity, while net primary productivity and soil characteristics were the main predictors of seed bank density. Moreover, global mapping revealed clear spatial patterns for soil seed banks worldwide; for instance, low densities may render currently species-rich low latitude biomes (such as tropical rain-forests) less resilient to major disturbances. Our assessment provides quantitative evidence of how environmental conditions shape the distribution of soil seed banks, which enables a more accurate prediction of the resilience and vulnerabilities of plant communities and biomes under global changes