Intraconal tumor-like mass as first manifestation of IgG4-related disease

A great variety of tumors and tumor-like lesions can involve the orbit. Benign and malignant neoplasms, inflammatory diseases, vascular and congenital lesions take part of this heterogeneous group that creates many challenges for diagnosis, management, and treatment. Obviously, symptoms and clinical history are fundamental to establish a differential diagnosis, and imaging is mandatory to distinguish between lesions that have similar clinical presentations in most cases. With this report, the authors highlight the diagnostic difficulties and the importance to include not only tumors but also vascular inflammatory process into the differential diagnosis of this unilateral orbital lesion type

Single-Cell Profiling Reveals Inflammatory Polarization of Human Carotid Versus Femoral Plaque Leukocytes

Femoral atherosclerotic plaques are less inflammatory than carotid plaques histologically, but limited cell-level data exist regarding comparative immune landscapes and polarization at these sites. We investigated intraplaque leukocyte phenotypes and transcriptional polarization in 49 patients undergoing femoral (n = 23) or carotid (n = 26) endarterectomy using single-cell RNA-Seq (scRNA-Seq; n = 13), flow cytometry (n = 24), and IHC (n = 12). Comparative scRNA-Seq of CD45+-selected leukocytes from femoral (n = 9; 35,265 cells) and carotid (n = 4; 30,655 cells) plaque revealed distinct transcriptional profiles. Inflammatory foam cell-like macrophages and monocytes comprised higher proportions of myeloid cells in carotid plaques, whereas noninflammatory foam cell-like macrophages and LYVE1-overexpressing macrophages comprised higher proportions of myeloid cells in femoral plaque (P \u3c 0.001 for all). A significant comparative excess of CCR2+ macrophages in carotid versus plaque was observed by flow cytometry in a separate validation cohort. B cells were more prevalent and exhibited a comparatively antiinflammatory profile in femoral plaque, whereas cytotoxic CD8+ T cells were more prevalent in carotid plaque. In conclusion, human femoral plaques exhibit distinct macrophage phenotypic and transcriptional profiles as well as diminished CD8+ T cell populations compared with human carotid plaques

Evolving concepts in disseminating medical science and the challenge of COVID-19

Spreading medical science to the scientific community is a must for benefitting the health of the world population. However, it represents, at the same time, an evolution in teaching, an improvement in research capability, and it promotes amelioration of experience and knowledge of doctors and scientists. When this is accomplished, our mission can be considered successful..

Onset of suspected ulcerative colitis after treatment with tocilizumab in patient with celiac disease and juvenile idiopathic arthritis

To the Editors, Celiac disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBD), although their etiopathogenesis appear to be different and there are conflicting data about their association. The humanized anti- interleukin (IL)-6 receptor antibody tocilizumab is used for rheumatoid ar- thritis and sometimes for patients with UC refractory to conventional ther- apies. A few studies have reported that tocilizumab can aggravate pre-existing UC or cause de novo drug-induced IBD, probably because of failure to suppress intestinal IL-6 production. We report the case of a female pa- tient with a family history of CD and UC

Severe rectal prolapse and solitary rectal ulcer in a young anorectic woman with myxoid degeneration of visceral adipose tissue

Rectal prolapse is a disorder in which the rectum protrudes from the anal canal. Solitary rectal ulcer may coexist. Both conditions have been associated with chronic constipation and excessive straining during defecation. Rectal prolapse has been rarely reported in women suffering from anorexia nervosa. Lack of rectal support because of loss of ischiorectal fat has been proposed as one of the possible mechanisms in this condition, together with chronic constipation and abuse of laxative. We report the case of an anorexic woman with a severe rectal prolapse and bleeding requiring urgent Altmeier's procedure. Surgery was complicated by dehiscence of the anastomosis and volvulus, requiring ileostomy and laciniae debridement. Pathological analysis of all the surgical samples taken from different abdominal sites highlighted changes in the visceral adipose tissue consisting in nodular aggregates of small adipocytes dispersed in a myxoid matrix surrounding blood vessels within abundant fibrosis. The morphologic features resemble those observed in primordial fetal fat and are comparable to those observed in cancer associated cachexia. The diffuse myxoid degeneration of visceral adipose tissue may play a role in the pathogenesis of rectal prolapse in patients with anorexia nervosa. Besides starvation, the mechanism sustaining myxoid degeneration of the adipose tissue is not entirely clear. Whenever possible improving nutritional and clinical conditions should be ideal before any surgical approach

Additional file 1 of Combined TP53 status in tumor-free resection margins and circulating microRNA profiling predicts the risk of locoregional recurrence in head and neck cancer

Supplementary Figure 1. Study design and patient features. (a) Two groups of HNSCC patients (n=69 in total), referred to our Institute for surgical resection of their primitives, were consecutively enrolled between 2013 and 2017. Clinical characteristics of our cohort is detailed in Suppl. Tables, sheets 1-3. Analysis of mutational and/or microRNA profiles were performed on selected cohorts. Numbers of patients included in each of them are indicated together with the specific figures describing molecular results. (b) Patient characteristics of the intersection cases (n=28) between group 1 and 2. RMs: resection margins; pts: patients