scholarly journals Lymphocyte Predominance in Blood, Pleural Fluid, and Tumour Stroma; A Prognostic Marker in Pleural Mesothelioma

2021 ◽  
Author(s):  
Duneesha Fonseka ◽  
David T Arnold ◽  
Anna J Morley ◽  
Mary Brett ◽  
Nidhi Bhatt ◽  
...  
Keyword(s):  
Pleural Fluid ◽  
Inflammatory Cells ◽  
Pleural Mesothelioma ◽  
Tumour Stroma ◽  
Neutrophil Lymphocyte Ratio ◽  
Novel Treatments ◽  
Biopsy Specimens ◽  
Observational Cohort ◽  
Multivariable Modelling ◽  
Lymphocyte Populations

Abstract Background As promising novel treatments develop for malignant pleural mesothelioma (MPM), early prognostication has become increasingly important. Circulating and local inflammatory cells are known to play a significant role in other tumour types. We assessed the proportion of lymphocyte populations within blood, pleural fluid and tumour stroma to prognosticate patients with MPM at diagnosis. Methods Consecutive patients diagnosed with biopsy-proven MPM were prospectively recruited to an observational cohort study and followed up for a minimum of 7.5 years. Blood and pleural fluid results at presentation were extracted from the medical records. Biopsy specimens were independently reviewed by 2 pathologists who scored the degree of lymphocytic and neutrophilic infiltration. Results Baseline results were available for 184 patients. The predominant pleural fluid cell type was calculable for 84 patients and 118 patients had biopsy specimens available for review. A low blood neutrophil/lymphocyte ratio (NLR < 4) inferred a better prognosis with a median survival of 420 days versus 301 days (p < 0.01). Survival was better for patients with a lymphocyte-predominant pleural effusion (430 vs 306 days, p < 0.01). Lymphocyte infiltration of tumour stroma was also associated with improved survival (n = 92, survival 430 days) compared with neutrophilic or acellular samples (n = 26, survival 342 days p < 0.01). In multivariable modelling lymphocyte predominance in blood, pleural fluid and tumour stroma were all associated with a better prognosis. Conclusions Lymphocyte predominance within tumour stroma, pleural fluid or blood infers a better prognosis in patients with MPM.

Diagnostic utility of BAP1 for malignant pleural mesothelioma in pleural fluid specimens with atypical morphology

Cytopathology ◽  
2021 ◽  
Author(s):  
Amber Louw ◽  
YC Gary Lee ◽  
Nathan Acott ◽  
Jenette Creaney ◽  
Chris Van Vliet ◽  
...  
Keyword(s):  
Pleural Fluid ◽  
Malignant Pleural Mesothelioma ◽  
Pleural Mesothelioma ◽  
Diagnostic Utility

scholarly journals Cellular Inflammatory Indices in Hospitalized Nigerian COVID-19 Patients

2021 ◽  
pp. 19-26
Author(s):  
Jeremiah Adeyemi Akinwumi ◽  
Fabian Victory Edem ◽  
Ganiyu Olatunbosun Arinola
Keyword(s):  
Blood Cell ◽  
Lymphocyte Count ◽  
White Blood Cells ◽  
Calculated Data ◽  
Inflammatory Cells ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Inflammatory Index ◽  
Cell Counts ◽  
The Mean

The pandemicity of coronavirus disease 2019 (COVID-19) necessitated its novel biomarkers in prognosis and monitoring in low resource settings. Changes in total white blood cell counts have been associated with the progression of diseases. This study determined the prognostic value of some cellular inflammatory cells and their indices in relation to duration of hospital admission, gender, and age of COVID-19 patients. This longitudinal and case–control study determined blood cell components (total white blood cells (TWBC), neutrophil, lymphocyte, monocyte, and platelet) and inflammatory indices (neutrophil lymphocyte ratio [NLR], lymphocyte monocyte ratio [LMR], platelet lymphocyte ratio [PLR], derived NLR [DNLR], and systemic immune inflammatory index [SII]) in 95 symptomatic hospitalized COVID-19 patients and 45 COVID-19 free controls. These parameters were related to age, sex, and days of admission of the patients. Blood samples obtained were analyzed using hematological autoanalyzer (Sysmex XN-450) and indices calculated. Data were analyzed using the Statistical Package for the Social Sciences (SPSS Inc., USA) version 20.0. The mean platelet count (P = 0.016) and PLR (P = 0.000) were significantly lower while TWBC counts (P = 0.013) were significantly increased in COVID-19 patients compared with control. The mean TWBC count (P = 0.030) and SII (P = 0.029) were significantly increased while lymphocyte count (P = 0.015) and LMR (P = 0.026) were significantly decreased in COVID-19 patients at discharge compared with COVID-19 patients at admission. The mean neutrophil count (P = 0.048), PLR (P = 0.015), and SII (P = 0.022) were significantly lower while mean lymphocyte count (P = 0.026) was significantly higher in COVID-19 patients aged <40 years compared with patients aged ?40 years. This study concluded that inflammatory response is a phenomenon in COVID-19 patients especially in patients ?40 years of age and that this inflammation persist till discharge, though gender has no influence on cellular inflammatory indices of COVID-19 patients.

scholarly journals P3.03-034 Comprehensive Immunophenotyping of the Blood and Pleural Fluid from Patients with Malignant Pleural Mesothelioma by Flow Cytometry

2017 ◽  
Vol 12 (1) ◽  
pp. S1365-S1366
Author(s):  
Tobias Peikert ◽  
Virginia Van Keulen ◽  
Svetlana Bornschlegl ◽  
Allen Dietz ◽  
Mike Gustafson
Keyword(s):  
Flow Cytometry ◽  
Pleural Fluid ◽  
Malignant Pleural Mesothelioma ◽  
Pleural Mesothelioma

Intrapleural cisplatin and mitomycin for malignant mesothelioma following pleurectomy: pharmacokinetic studies.

1992 ◽  
Vol 10 (6) ◽  
pp. 1001-1006 ◽  
Author(s):  
V W Rusch ◽  
D Niedzwiecki ◽  
Y Tao ◽  
C Menendez-Botet ◽  
A Dnistrian ◽  
...  
Keyword(s):  
Pleural Fluid ◽  
Malignant Pleural Mesothelioma ◽  
Plasma Levels ◽  
Peak Plasma ◽  
Systemic Absorption ◽  
Pharmacokinetic Studies ◽  
Logarithmic Scale ◽  
Pleural Mesothelioma ◽  
Intrapleural Chemotherapy ◽  
The Mean

PURPOSE Intrapleural cisplatin-based chemotherapy has been used in the treatment of patients with malignant pleural mesothelioma and malignant pleural effusions, but the pharmacokinetics of this form of chemotherapy have not been previously evaluated. We performed pharmacokinetic studies on 12 patients who received both intrapleural cisplatin and mitomycin immediately following pleurectomy/decortication for malignant pleural mesothelioma. PATIENTS AND METHODS Simultaneous pleural fluid and plasma samples were collected at 15 and 30 minutes, and at 1, 2, 3, 4, and 24 hours after administration of the intrapleural chemotherapy (cisplatin 100 mg/m2 and mitomycin 8 mg/m2), and after cisplatin (total and free) and mitomycin levels were measured. The mean peak levels, the areas under the concentration-time curve (AUC) and the drug half-lives (t1/2s) in plasma and pleural fluid were compared using the paired t test. Differences were considered significant if P less than or equal to .05. RESULTS Systemic absorption was rapid, with peak plasma levels being reached within 1 hour of administration of the intrapleural chemotherapy. Peak plasma levels measured after intrapleural chemotherapy approximated those reportedly attained during systemic administration of these drugs at similar doses. However, the mean peak cisplatin and mitomycin levels, and their mean AUCs, were significantly higher in the pleural fluid than in the plasma. There was a three- to fivefold advantage (on a logarithmic scale) for pleural to plasma AUCs for both cisplatin and mitomycin. The mean t1/2s for cisplatin and mitomycin were significantly longer in the plasma than in the pleural fluid. CONCLUSIONS The pharmacokinetics of intrapleural cisplatin-based chemotherapy are analogous to those of intraperitoneal chemotherapy. Our findings show that intrapleural cisplatin-based chemotherapy has a distinct local pharmacologic advantage, but also produces significant and sustained drug plasma levels.

Nerve Involvement in Granuloma Annulare

2012 ◽  
Vol 16 (6) ◽  
pp. 428-432 ◽  
Author(s):  
Michelle Longmire ◽  
David J. Dicaudo ◽  
Mark V. Dahl
Keyword(s):  
Correct Diagnosis ◽  
Granulomatous Inflammation ◽  
Inflammatory Cells ◽  
Granuloma Annulare ◽  
Clinical Correlation ◽  
Biopsy Specimens ◽  
Nerve Involvement ◽  
S 100 ◽  
Patient Atteint ◽  
Hematoxylin Eosin

Background: Nerve involvement developed in a patient with granuloma annulare, as evidenced by a perineural infiltrate of histiocytes in the dermis. The histopathologic pattern was suggestive of leprosy. No mycobacteria were observed, and neurologic testing was normal. Objective: To determine whether inflammation of the nerves or perineural tissue is common in granuloma annulare, we studied the cutaneous nerves in skin biopsy specimens from 14 patients with granuloma annulare. Methods: Sections were stained with hematoxylin-eosin to highlight inflammatory cells and with S-100 to identify cutaneous nerves. Results: No inflammation around nerves was found in 12 specimens, abutting granulomatous inflammation was found in 1 specimen, and enveloping granulomatous inflammation was found in 1 specimen. No nerves were infiltrated by inflammatory cells. Conclusion: Perineural granulomatous inflammation resembling the perineural infiltrate of leprosy appears to be an uncommon characteristic of granuloma annulare. Clinical correlation and acid-fast stains can assist in establishing the correct diagnosis. Contexte: Une atteinte nerveuse est apparue chez un patient atteint de granulome annulaire, comme en témoignait un infiltrat périneural d'histiocytes dans le derme. Les signes histopathologiques étaient évocateurs de la lèpre, mais aucune mycobactérie n'a été observée, et l'examen neurologique était normal. Objectif: L'étude visait à déterminer si l'inflammation des nerfs ou du tissu périneural est fréquente dans le granulome annulaire; pour ce faire, nous avons examiné les nerfs cutanés dans des prélèvements biopsiques de la peau, effectués sur 14 patients atteints de granulome annulaire. Méthodes: Les coupes ont été colorées à l'hématoxyline-éosine pour mettre en évidence des cellules inflammatoires, ainsi qu'au S-100 pour repérer les nerfs cutanés. Résultats: Aucune inflammation autour des nerfs n'a été observée sur 12 prélèvements, mais il y avait présence d'inflammation granulomateuse contiguë sur un prélèvement et d'inflammation granulomateuse enveloppante, sur un autre prélèvement. Les nerfs n'ont pas été infiltrés par les cellules inflammatoires. Conclusion: L'inflammation granulomateuse périneurale qui ressemble à l'infiltration périneurale observée dans la lèpre semble un signe peu fréquent du granulome annulaire. L'établissement de corrélations cliniques et des colorations résistantes à l'acide peuvent faciliter la pose du bon diagnostic.

scholarly journals Pleural tuberculosis

2016 ◽  
Vol 65 (1) ◽  
Author(s):  
B. Chakrabarti ◽  
P.D.O. Davies
Keyword(s):  
Pleural Fluid ◽  
Diagnostic Yield ◽  
Western World ◽  
Pleural Effusions ◽  
Pleural Biopsy ◽  
Biopsy Specimens ◽  
Tuberculous Pleurisy ◽  
The Impact ◽  
Antituberculous Chemotherapy

Pleural effusions in tuberculosis are commonly seen in young adults as an immunological phenomenon occurring soon after primary infection. However, the epidemiology and demographics of tuberculous pleurisy are changing due to the impact of HIV co-infection and the increasing number of pleural effusions seen as part of re-activation disease. Pleural biopsy for histology and culture is the mainstay of diagnosis with closed needle biopsy adequate in the majority of cases. Techniques such as PCR of biopsy specimens and the role of pleural fluid ADA are still being evaluated as a diagnostic aid. Tuberculous empyema is less commonly seen in the western world and the diagnostic yield from pleural fluid here is greater than in “primary” effusions. Treatment with appropriate antituberculous chemotherapy is generally successful though there is currently insufficient evidence to recommend the routine use of corticosteroids in this condition.

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