Soluble Factors and Receptors Involved in Skin Innate Immunity—What Do We Know So Far?

The pattern recognition receptors, complement system, inflammasomes, antimicrobial peptides, and cytokines are innate immunity soluble factors. They sense, either directly or indirectly, the potential threats and produce inflammation and cellular death. High interest in their modulation has emerged lately, acknowledging they are involved in many cutaneous inflammatory, infectious, and neoplastic disorders. We extensively reviewed the implication of soluble factors in skin innate immunity. Furthermore, we showed which molecules target these factors, how these molecules work, and how they have been used in dermatological practice. Cytokine inhibitors have paved the way to a new era in treating moderate to severe psoriasis and atopic dermatitis.

Anti-infective and Antineoplastic properties of Green Tea Catechins: Examining the Therapeutic Risk-Benefit ratio

Background: Green tea is a commonly used dietary supplement and food product. Green tea contains many polyphenolic compounds known as green tea catechins (GTCs). There are numerous reports exploring the potential benefit of using green tea catechins as chemotherapeutic agents to treat neoplastic disorders and infectious processes. The prevalence of cancer diagnoses, bacterial infections, and viral diseases that include SARS-CoV-2 have led to increased interest in GTCs as a therapeutic option in patients suffering from these conditions. Objective: This concise review explores the evidence related to the therapeutic use of GTCs to treat neoplastic disorders as well as bacterial and viral infections. Methods: PubMed, NIH, OVID online databases were utilized to retrieve relevant scientific literature that address GTCs role in treating cancer and infectious disease. Results: While there are preliminary data indicating potentially adventitious properties of GTCs, there is a paucity of large prospective clinical trial data to support the use of GTCs in a therapeutic capacity to treat these disease processes. There are documented instances of GTCs interacting with medications indicated to treat neoplastic diseases. Conclusions: Currently, it appears the therapeutic benefit of using GTCs is outweighed by the potential risks.

Survivorship Issues in Adult Patients With Histiocytic Neoplasms

Adult-onset histiocytoses (AOH), primarily Rosai-Dorfman disease (RDD), Erdheim-Chester Disease (ECD), and adult Langerhans cell histiocytosis (ALCH), are a group of related histiocytic neoplastic disorders featuring multisystemic manifestations. The disorders are largely incurable, and are essentially chronic neoplastic diseases with a variable prognosis. Prompt diagnosis and treatment is important to prevent debilitating and even life-threatening complications. Survivorship issues abound in AOH, due to their multisystemic manifestations and the sometimes recalcitrant chronic inflammation, which can lead to other debilitating complications such as fatigue, weakness, and pain. Because these disorders are rare, few healthcare professionals are proficient in their management; therefore the aim of these guidelines is to offer guidance on how to manage patients, and how to create survivorship care plans through the efforts of an interdisciplinary team.

Clinicopathological study of salivary gland disorders in a tertiary care hospital, Lahore.

Objective: To describe the demographic and histological features of salivary gland pathologies at tertiary care hospital. Study Design: Retrospective Descriptive. Setting: Shalamar Institute of Health Sciences, Lahore. Period: February 2012 to February 2017. Material & Method: 17548 surgical specimens were received during this period. Among these, 50 cases were diagnosed as salivary gland disorders. Statistical analysis was carried out using SPSS version 22. Results: 50 cases were diagnosed as salivary gland disorders out of 17548 surgical resections. Salivary gland disorders were divided into non-neoplastic group (n= 15) and neoplastic group (n = 35), which was further divided into: (i) Benign tumors, (n= 26) and (ii) Malignant tumors, (n= 9). Conclusion: Salivary gland disorders are rare diseases to be encountered clinically. Chronic sialadenitis among non-neoplastic disorders, pleomorphic adenoma among benign tumor and mucoepidermoid carcinoma among malignant tumors were the commonest.

Molecular Alterations in Meningioangiomatosis Causing Epilepsy

Meningioangiomatosis (MA) is a rare process at the intersection of cerebral developmental and neoplastic disorders that often results in epilepsy. We evaluated molecular alterations in MA to characterize its biology and pathogenesis. We searched a comprehensive institutional database for patients with MA treated between 2004 and 2019. Demographic, clinical, surgical, and radiographical data were collected. MA and associated meningioma tissues were evaluated using a next-generation sequencing assay interrogating 1425 cancer-related genes. We studied 5 cases: 3 with MA and 2 with MA associated with a meningioma. Of the MAs associated with a meningioma, 1 had deletions in the NF2 gene in both the MA and the meningioma components, whereas the other had an NF2 deletion in only the MA component. Additional mutations were identified in the MA components, suggesting that MA arises from the meningioma rather than the meningioma resulting from a transformation of the MA. The 3 cases of pure MA showed variants of unknown significance with no alterations in known oncogenic drivers. Our findings provide a starting point to a better understanding of the pathogenesis of this rare lesion. Our study indicates that MA-meningiomas have a neoplastic nature that differs from the hamartomatous/developmental nature of pure MA.

ENDOMETRIAL BIOPSIES PATTERNS AMONG WOMEN ATTENDING MOI TEACHING AND REFERRAL HOSPITAL, KENYA

Background: Endometrial diseases are among the most common gynecological disorders affecting women both globally and locally;accounting for 60% of global maternal deaths.Kenya is ranked thirteenth out of 181 countries with the highest maternal mortality globally. Endometrial disorders such as hyperplasia's, neoplastic, inflammatory and pregnancy related conditions of the endometrium have been reported to increase with demographic traits such as maternal age and parity. Objective: To determine histopathological patterns of endometrial biopsies among women attending Moi Teaching and Referral Hospital,Kenya. Methods: This was a retrospective laboratory-based study where 121 banked endometrial biopsy blocks collected from participants aged 19 to 70 years between August 2014 and August 2016 were retrieved, re-sectioned and stained using routine histological (Hematoxylin and Eosin) stains in the histology laboratory before being sent to the pathologist for examination. Sociodemographic and reproductive history data were collected from the medical records. Descriptive statistical techniques such as cross-tabulation were used.The median age of all the study participants was 44 years. Results: Most of the study participants (39.2%;n=38) presented with simple endometrial hyperplasia.The endometrial patterns were categorized as Hyperplasias (50.4%; n=61), Inflammatory disorders (7.4%; n=9), Neoplastic Disorders (14.9%;n=18),Pregnancy related disorders (20.7%;n=25) and other patterns (6.6%;n=8) Conclusion: Majority of the study participants presented with simple endometrial hyperplasia followed by complex hyperplasia and adenocarcinoma,respectively.

A 57-year-old man with rapidly progressive pulmonary hypertension

Pulmonary Tumor Thrombotic Microangiopathy (PTTM) is a rare condition associated with neoplastic disorders, predominantly gastric cancer, leading to pre-capillary Pulmonary Hypertension (PH). The pathologic mechanism involved is a fibrocellular intimal proliferation of small pulmonary vessels sustained by nests of carcinomatous cells lodged in pulmonary vasculature. Clinical presentation is nonspecific, including progressive dyspnea and dry cough. Diagnosis of PTTM is extremely challenging ante-mortem and prognosis is poor. Here we describe the case of a middle-aged man, without known previous cancer history. The clinical course was rapidly unfavorable, with progressive dyspnea and PH associated with hemodynamic instability, eventually culminating in patient’s death. PTTM diagnosis was made post-mortem. PTTM should be considered in any patient presenting with unexplained PH, especially if it is rapidly progressive, poorly responsive to standard approaches or there is suspected history of malignancy. A prompt diagnosis of PTTM could help in bringing light into this still under-recognized condition.

Acquired Pure Red Cell Aplastic in one of the Monozygotic Twins with Common Variable Immunodeficiency

BackgroundCommon variable immunodeficiency (CVID) is the most prevalent primary immune defects in adults. It has become clear that most cases of CVID have a polygenic rather than a monogenic inheritance. CVID patients are prone to recurrent infection, and an increased incidence of certain autoimmune and neoplastic disorders. Monozygotic twins share identical genetic basis and may serve as a powerful model for study on genetic defects.Case presentationHere, we report a case of monozygotic twins were diagnosed with CVID at their 30s’. They featured a partly similar profile of clinical manifestations, including severe, recurring infections and bone pain. Interestingly, only the elder brother developed pure red cell aplastic (PRCA), and relieved after 5-month’s treatment with 100 mg/d of cyclosporine treatment. Whole-exome sequencing (WES) was utilized to investigate genetic defects.ConclusionsThe results suggest that a combination effect of deleterious variations maybe the cause, such as VDR, NHEJ1, DOCK5, NOD2 and C3, which were predicted by bioinformatics analysis. The potential combinatorial effects in CVID is inferred from their roles in T and B cell signal pathways activation.

Indolent T-Cell Lymphoproliferative Disorders of the Gastrointestinal Tract (iTLPD-GI): A Review

iTLPD-GI is a low-grade clonal T-cell lymphoproliferative disease arising in GI organs. It is an uncommon disease, and only recently has it been enlisted as a distinct provisional entity in the current WHO Classification. Data from the literature disclose high heterogeneity in terms of pathological and molecular features; on the other hand, establishing an accurate diagnosis of iTLPD-GI is of pivotal importance, since treatment options are different from that of other, more frequent lymphomas that arise in the gastrointestinal tract. In this review, we aimed to better define this novel entity, and to identify useful diagnostic biomarkers; moreover, we provide a biomarker-based approach to the diagnosis and describe the most common issues in differentiating iTLPD-GI from other neoplastic and non-neoplastic disorders.