Linfoma de la zona gris con características intermedias entre un linfoma difuso de células B grandes y un linfoma Hodgkin clásico. Reporte de un caso y revisión de la literatura / Grey zone lymphoma with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma. Case report and literature review

Resumen Entre los linfomas de la zona gris (LZG) encontramos neoplasias con características compartidas entre un linfoma difuso de células B grandes (LDCBG) y un linfoma de Hodgkin clásico (LHC). Lo poco habitual de la patología combinado con la heterogenicidad de la enfermedad, su reciente descripción como entidad específica que conlleva a dificultad y reto diagnóstico, así como la falta de suficiente experiencia terapéutica hacen de la enfermedad una entidad compleja de difícil diagnóstico y reto terapéutico que justifica su descripción continua. Se presenta una paciente con fiebre de un mes sin respuesta al manejo inicial, se estudió y realizó biopsia de ganglio inguinal izquierdo con resultado diagnóstico de LZG con características intermedias entre LDCBG y LHC. Aunque no existen guías establecidas para el manejo de esta entidad, la evidencia actual sugiere mejor respuesta en tratamientos dirigidos a LDCBG, misma terapia empleada en esta paciente con la cual se obtuvo respuesta favorable.

Abstract In the grey zone lymphomas (GZL), there are overlapping characteristics between diffuse large B-cell lymphoma (DLBCL) and classic Hodgkin lymphoma (CHL). The unusual nature of the pathology combined with the heterogeneity of the disease, its recent description as a specific entity, its diagnostic difficulty, and the lack of sufficient therapeutic experience justifies its continuous description. The case is presented of a patient with a fever of one month onset, with no response to initial management. A left inguinal lymph node biopsy reported a diagnosis of GZL with intermediate characteristics between DLBCL and CHL. Although there are no established guidelines for the management of this condition, the current evidence suggests a better response in treatments meant for diffuse large B-cell lymphoma. This same therapy was used in this patient, with a favourable clinical outcome.

Expression change of serum total prostate specific antigen with age and its significance in differential diagnosis of prostate cancer / 肿瘤研究与临床

Objective To evaluate the changes of serum total prostate specific antigen (TPSA) with age and its significance in differential diagnosis of prostate cancer (PCa) and prostatic hyperplasia (BPH). Methods TPSA and free prostate specific antigen (FPSA) in 146 cases of PCa, 108 cases of BPH and 210 cases of healthy subjects were detected by electrochemiluminescence. Results There was a positive correlation between age and serum TPSA level (r=0.265, P<0.01). The levels of TPSA in PCa and BPH groups were (85.40 ±56.70) μg/L and (7.90 ±7.00) μg/L, and the difference was statistically significant (t=8.310, P= 0.001); FPSA levels were (5.16±4.90) μg/L, (1.50±1.36) μg/L, and the difference was statistically significant (t= 3.152, P= 0.030). In patients with TPSA levels ranging from 4.0 to 20.0 μg / L (diagnostic gray zone), the levels of TPSA in PCa and BPH groups were (8.82±4.01)μg/L and (8.41±3.95)μg/L, and the difference had no statistical significance (t= 0.198, P= 0.256); The levels of FPSA were (1.18 ±0.91) μg/L and (2.32±1.20) μg/L, the ratio of FPSA/TPSA were 0.12±0.08 and 0.24±0.23, and the differences were statistically significant (t= 23.56, P= 0.020; t= 32.45, P= 0.006). When FPSA/TPSA ratio was 0.16, its sensitivity and specificity for PCa were 84.4%and 79.8%, respectively. Conclusions Serum TPSA levels vary with age, and 95 % of all age groups should be used as the medical criterion to improve the specificity and accuracy of PSA in diagnosing with PCa. The ratio of FPSA/TPSA has a significant clinical value in differential diagnosis of PCa and BPH in patients with TPSA indiagnostic gray zone.

Application of a Grey Zone for HCV and HIV Immunoassays for Blood Donor Screening: Is It still Necessary? / 대한수혈학회지

BACKGROUND: When enzyme immunoassays (EIA) were implemented, considering the limited sensitivity of 1st generation EIAs, the Korean Red Cross (KRC) applied grey zones for detection of weak reactive samples that could lead to false negative results. Despite improved performance of assays, grey zone application is still in practice. We examined whether application of a grey zone to HCV and HIV EIAs is still necessary. METHODS: HCV and HIV EIA results, number of grey zone results, results of further testing done on grey zone samples, and NAT results from 2005 to 2012 were analyzed retrospectively using the Blood Information Management System of the KRC. RESULTS: Among 18,736,094 cases tested, 4,817 HCV (0.03%) and 5,108 HIV (0.05%) cases repeatedly had grey zone results. Twenty-eight (0.58%) HCV grey zone cases were positive on the recombinant immunoblot assay, but negative on NAT. For HIV, 3 cases were diagnosed as indeterminate by the Korea Centers for Disease Control and Prevention (KCDC). However these cases did not seroconvert after several years and were also negative on NAT. CONCLUSION: For HCV, since the grey zone led to detection of true anti-HCV positive cases, not detected by NAT, application of the grey zone should be continued. For HIV, since none of the grey zone cases has been diagnosed as HIV positive by the KCDC, further application of the grey zone is thought not to be necessary. Re-evaluation of the grey zone will save costs for testing, and prevent discard of blood components and loss of donors.

O marciano prateado: normalidade e segregação na peça a bela adormecida na geladeira de primo Levi / A silver martian: normality and segregation in primo Levi's sleeping beauty in the fridge

Em seu testemunho como sobrevivente, na "necessidade" que o levou a tornar-se um escritor e a fazer sua experiência conhecida, Primo Levi transmitiu os efeitos devastadores da experiência desubjetivante dos campos de extermínio. Refletindo sobre as causas e implicações desse "imenso experimento biológico e social", como definiu o Levi contador de histórias, por outro lado pondera sobre o tema da segregação em nosso tempo, sobre a herança que os campos legaram ao presente, estabelecendo uma inquietante continuidade entre as aberrações do passado e a normalidade presente, mostrando além de qualquer dúvida como o presente está sutilmente tecido pela lógica do passado. Em sua peça A Bela Adormecida na geladeira, Levi mostra com grande acurácia e perspicácia a relação entre ciência, novas tecnologias e alienação subjetiva, assim como as formas pelas quais a normalidade e a tranquilidade de uma vida próspera são de fato o produto de uma normatividade biopolítica, universalmente aceita com uma cumplicidade descuidada.

In his testimony as a survivor, in the "necessity" that moved him to become a writer and make his experience known, Primo Levi has transmitted the devastating effects of the de-subjectivising experience in the Extermination Camps. Reflecting upon the causes and the implications of this " immense biological and social experiment," as he defines it, Levi the story teller, on the other hand, ponders on the issue of segregation in our own times, on the heritage the camps have bequeathed on the present, establishing a disquieting continuity between past aberrations and present normality, showing beyond any doubt how the present is subtly interwoven by the logic of the past. In his play Sleeping Beauty in the Fridge, Levi shows with great acumen and perspicacity the strict relationship between science, new technologies, and subjective alienation, as well as the ways in which normality, and the tranquility of a prosperous life, are in fact the product of a bio-political normativity, universally accepted with careless complicity.