IgG4-related disease with nasopharyngeal malignancy-like manifestations

BackgroundIgG4-related disease (IgG4-RD) was characterized by single or multiple masses in organs, which may mimic various inflammatory and malignant diseases. Here, we summarize 4 patients with aggressive manifestations of IgG4-RD that mimic nasopharynx cancer to provide some new sights for the diagnosis of IgG4-RD.Case summaryFour patients were included in our series. The age ranged from 53 to 64 years old, and the duration of the disease ranged from 4 to 6 months. The chief complaints included headache, rhinorrhea, or diplopia. All patients had more than 10 IgG4+ plasma cells/HPF in immunohistochemistry with plasma lgG4 levels ranging from 218 mg/dL to 765 mg/dL. All of them met the diagnostic criteria of lgG4-RD.ConclusionThe described case is highly similar to the clinical manifestations of nasopharyngeal carcinoma. Although pathology is the gold standard, there are still limitations. Serological IgG4 can help confirm the diagnosis. Timely diagnosis of IgG4-RD is of great significance in preventing secondary organ damage in patients with active diseases

Pretreatment BMI Is Associated with Aggressive Clinicopathological Features of Papillary Thyroid Carcinoma: A Multicenter Study

Objectives. The aim of the present study was to analyze the association between pretreatment body mass index (BMI) and the aggressiveness of papillary thyroid carcinoma (PTC) along with its clinical outcomes in a Chinese population with BMI classification for Asians. Methods. A retrospective, observational study was conducted on patients from two teaching hospitals in China. 1622 classical PTC patients were categorized into four groups according to BMI. Results. We found that increased BMI was associated with extrathyroidal extension, multifocality, the presence of lymph node (LN) metastasis, and advancing TNM stage in PTC patients. Furthermore, compared to patients with normal weight, those in the overweight and obese group exhibited a significantly increased risk of extrathyroidal extension, multifocality, cervical LN metastasis, and advanced TNM stage. 40 and 37 patients experienced persistent and recurrent disease, respectively. No differences regarding persistent disease or recurrence were observed among the BMI groups. Conclusion. A higher pretreatment BMI has been strongly associated with aggressive features of PTC according to the BMI classification for Asians. Obesity was not found to be associated with a greater risk of recurrence

Integrated Multifunctional Laryngoscope for Medical Diagnosis and Treatment

Laryngeal lesions can cause great inconvenience to patients. Early diagnosis and corresponding treatments are critical to the survival of patients. However, the diagnosis and precise removal of tumors remain a challenge under the use of a white light laryngoscope. In this work, an integrated, multifunctional laryngoscope was designed and tested for the imaging evaluation and precision laser surgery for laryngeal tissue. This integrated diagnostic and therapeutic endoscopic system included two imaging modes (i.e., optical coherence tomography and white light endoscopy) and a laser ablation treatment mode. The endoscope had a common-path design to ensure that the same position could be imaged and treated simultaneously. The ex vivo porcine larynx experimental results showed that the system imaging modes could simultaneously acquire both superficial and cross-sectional images of the sample tissue, and the ablation treatment could be performed under imaging guidance. This multifunctional laryngoscope has great potential for the early diagnosis of and accurate laser ablation surgery for laryngeal tumors

Near complete response to a pembrolizumab-based therapeutic strategy in an abdominal metastatic head and neck squamous cell carcinoma case

Metastasis of head and neck squamous cell carcinoma rarely occurs in hepatic cancer and has a poor prognosis (median survival of 4 months). The efficacy of immunotherapy for these patients remains unknown. Herein, we present a patient with hypopharyngeal carcinoma metastasis to the liver with TERT and TP53 mutations together with a combined positive score of 70. The tumor invaded the abdominal wall, liver, inferior vena cava and retroperitoneal lymph nodes. The patient was treated with pembrolizumab combined with cisplatin and 5-FU for four cycles and has been maintained on pembrolizumab monotherapy until now. The patient achieved a near complete response of hepatic and subcutaneous metastases, and the tumor thrombus disappeared completely. The patient developed grade I rashes on the trunk, which were considered immune-related adverse events; thus, the patient presented a significant tumor response and good tolerance to the therapeutic strategy. On the basis of this observation, pembrolizumab-based therapeutic strategies may be an effective alternative for metastatic hypopharyngeal carcinoma and may prolong overall survival and progression-free survival, which should be confirmed by more patients in the future. Immune-related adverse events also need attention

Next-generation sequencing identified that RET variation associates with lymph node metastasis and the immune microenvironment in thyroid papillary carcinoma

Abstract Background To date, although most thyroid carcinoma (THCA) achieves an excellent prognosis, some patients experience a rapid progression episode, even with differentiated THCA. Nodal metastasis is an unfavorable predictor. Exploring the underlying mechanism may bring a deep insight into THCA. Methods A total of 108 THCA from Chinese patients with next-generation sequencing (NGS) were recruited. It was used to explore the gene alteration spectrum of THCA and identify gene alterations related to nodal metastasis in papillary thyroid carcinoma (PTC). The Cancer Genome Atlas THCA cohort was further studied to elucidate the relationship between specific gene alterations and tumor microenvironment. A pathway enrichment analysis was used to explore the underlying mechanism. Results Gene alteration was frequent in THCA. BRAF, RET, POLE, ATM, and BRCA1 were the five most common altered genes. RET variation was positively related to nodal metastasis in PTC. RET variation is associated with immune cell infiltration levels, including CD8 naïve, CD4 T and CD8 T cells, etc. Moreover, Step 3 and Step 4 of the cancer immunity cycle (CIC) were activated, whereas Step 6 was suppressed in PTC with RET variation. A pathway enrichment analysis showed that RET variation was associated with several immune-related pathways. Conclusion RET variation is positively related to nodal metastasis in Chinese PTC, and anti-tumor immune response may play a role in nodal metastasis triggered by RET variation