ABSTRACT
The ongoing COVID-19 pandemic required a firm and prompt effort in the development of an effective vaccine. Reports of adverse reactions are increasing. Lichen planus, as well as its oral variant, is a condition that has previously been reported to be associated with vaccines. This is one of the first reports of oral lichen planus (OLP) arising after any COVID-19 vaccine. Here the authors present 2 cases of OLP that occurred after BNT162b2 mRNA COVID-19 vaccination (Comirnaty, Pfizer, New York, NY, USA; BioNTech, Mainz, Germany).
Subject(s)
COVID-19 Vaccines , COVID-19 , Lichen Planus, Oral , BNT162 Vaccine , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Humans , Pandemics , RNA, MessengerSubject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Melanoma/secondary , Skin Neoplasms/secondary , Aged, 80 and over , Combined Modality Therapy , Dermoscopy , Disease Progression , Drug Substitution , Epidermis/pathology , Fibrosis , Humans , Imidazoles/administration & dosage , Indoles/administration & dosage , Male , Melanoma/drug therapy , Melanoma/surgery , Melanosis/etiology , Mutation, Missense , Neoplasm Proteins/antagonists & inhibitors , Neoplasm Proteins/genetics , Oximes/administration & dosage , Protein Kinase Inhibitors/administration & dosage , Proto-Oncogene Proteins B-raf/antagonists & inhibitors , Proto-Oncogene Proteins B-raf/genetics , Pyridones/administration & dosage , Pyrimidinones/administration & dosage , Remission Induction , Skin Neoplasms/drug therapy , Skin Neoplasms/surgery , Substrate Specificity , Sulfonamides/administration & dosage , Vemurafenib , Melanoma, Cutaneous MalignantABSTRACT
INTRODUCTION: Stage IIIA non-small cell lung cancer (NSCLC) with ipsilateral mediastinal lymph node metastases (N2) is a heterogeneous disease with differing prognoses. In this study, we retrospectively investigated the prognostic value of the expression of 10 molecular markers in 87 patients with stage IIIA pN2 NSCLC treated with radical surgery. METHODS: Primary tumor tissue microarrays (TMAs) were constructed and sections used for immunohistochemical analysis of epidermal growth factor receptor, ErbB-2, c-kit, cyclooxygenase-2, survivin, bcl-2, cyclin D1, cyclin B1, metalloproteinase (MMP)-2, and MMP-9. Univariate and multivariate analyses and unsupervised hierarchical clustering analysis of clinical pathologic and immunostaining data were performed. RESULTS: Bcl-2 (p < 0.0001) and cyclin D1 (p = 0.015) were more highly expressed in squamous cell carcinoma (SCC), whereas MMP-2 (p = 0.009), MMP-9 (p = 0.005), and survivin (p = 0.032) had increased expression in other histologic subtypes. In univariate analysis, SCC histology and cyclin D1 expressions were favorable prognostic factors (p = 0.015 and p < 0.0001, respectively); by contrast, MMP-9 expression was associated with worse prognosis (p = 0.042). In multivariate analysis, cyclin D1 was the only positive prognostic factor (p < 0.0001). Unsupervised hierarchical clustering analysis of TMA immunostaining data identified five distinct clusters. They formed two subsets of patients with better (clusters 1 and 2) and worse (clusters 3, 4, and 5) prognoses, and median survival of 51 and 10 months, respectively (p < 0.0001). The better prognosis subset mainly comprised patients with SCC (80%). CONCLUSIONS: Hierarchical clustering of TMA immunostaining data using a limited set of markers identifies patients with stage IIIA pN2 NSCLC at high risk of recurrence, who may benefit from more aggressive treatment.
Subject(s)
Adenocarcinoma/metabolism , Biomarkers, Tumor/metabolism , Carcinoma, Large Cell/metabolism , Carcinoma, Non-Small-Cell Lung/metabolism , Carcinoma, Squamous Cell/metabolism , Lung Neoplasms/metabolism , Adenocarcinoma/pathology , Adult , Aged , Carcinoma, Large Cell/pathology , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Squamous Cell/pathology , Cluster Analysis , Cyclin B1/metabolism , Cyclin D1/metabolism , Cyclooxygenase 2/metabolism , ErbB Receptors/metabolism , Female , Humans , Immunoenzyme Techniques , Inhibitor of Apoptosis Proteins , Lung Neoplasms/pathology , Male , Matrix Metalloproteinase 2/metabolism , Matrix Metalloproteinase 9/metabolism , Microtubule-Associated Proteins/metabolism , Middle Aged , Neoplasm Staging , Prognosis , Prospective Studies , Proto-Oncogene Proteins c-bcl-2/metabolism , Receptor, ErbB-2/metabolism , Retrospective Studies , Survival Rate , Survivin , Tissue Array AnalysisABSTRACT
Patients with a left atrial thrombus are considered as being at high risk for thromboembolic events. Although embolization may be asymptomatic, embolic events related to large thrombi are usually clinically manifest and tend to be associated with a worse prognosis. We describe the very unusual case of a patient with atrial fibrillation in whom two-dimensional echocardiography revealed a large, pedunculated, highly mobile left atrial thrombus attached by a thin stalk to the interatrial septum. Because of the high risk of embolism the patient was submitted to urgent surgery. At surgery, only the stalk was found. No mass was visualized at intraoperative transesophageal echocardiography. The patient had an uneventful postoperative course without signs of embolism. Computed tomography of the brain did not reveal any cerebral infarction.
