Adrenal Gland Incidentaloma: A Rare Case of Extranodal B-cell Lymphoma.

The prevalence of adrenal incidentalomas (i.e., incidental findings) has grown in recent years with the evolution of imaging methods. Adrenal masses can be benign or malignant. Malignant ones are less frequent, but the detection of primary adrenal neoplasms is even less frequent, especially in the case of a diffuse large B-cell lymphoma (DLBCL). This case concerns a 68-year-old man who presented to the emergency department due to fatigue and anorexia. Given his blood test results on admission, he underwent a computed tomography (CT) with angiography that identified a mass in the left adrenal gland with displacement of the ipsilateral kidney. Left tumorectomy, adrenalectomy, and nephrectomy were performed, and the mass corresponded to a nongerminal center-type DLBCL. This case highlights the importance of prompt diagnosis and surgical and pharmacologic treatment of DLBCL.

Dataset on free amino acids contents of Serra da Estrela PDO cheeses determined by UPLC-DAD-MS/MS.

The composition of Serra da Estrela PDO cheeses (total fat, total protein, salt and free amino acids) was assessed using NIR spectrophotometry and UPLC-DAD-MS/MS. In total, 24 cheeses were acquired from 6 certified cheesemakers located in 5 different municipalities within the delimited PDO geographical region. Cheeses were produced from raw ewe milk of two autochthonous Portuguese sheep breeds, between November 2017 and March 2018, and were acquired after 45 days of maturation. The data include the mean (and respective standard deviations) levels of moisture (%), total fat (%), total protein (%) and salt (%), obtained by NIR spectrophotometry. As well the mean (and respective standard deviations) of free amino acids contents (mg/100 g of cheese, in wet basis) evaluated using a UPLC-DAD-MS/MS method are shown. The latter data include information regarding 8 essential free amino acids (histidine, leucine-isoleucine, lysine, methionine, phenylalanine, threonine, tryptophan and valine) and 9 non-essential free amino acids (arginine, asparagine, aspartic acid, cysteine, glutamine, glutamic acid, proline, tyrosine and serine). Leucine and isoleucine, being isomers, were quantified together. Leucine-isoleucine, phenylalanine and serine were the most abundant essential free amino acids and cysteine, proline and asparagine were the most abundant non-essential free amino acids. Free amino acids contents depended on the cheese producer as well as on the production time-period.

Serra da Estrela cheese's free amino acids profiles by UPLC-DAD-MS/MS and their application for cheese origin assessment.

Serra da Estrela cheese is a high-value Portuguese Protected Designation of Origin cheese, produced with raw ewe milk. Thus, information regarding its composition is of utmost relevance for both consumers and certified producers. In this work, the chromatographic profiles of free amino acids in cheeses (45 days of maturation, 6 producers located in 5 municipalities and produced from November 2017 to March 2018) were established by UPLC-DAD-MS/MS. The proposed method allowed detecting 19 free amino acids and cystine with overall limits of detection and quantification lower than 44 µmol/L (1.4 mg/100 g cheese, wet matter) and than 134 µmol/L (4.2 mg/100 g cheese, wet matter), respectively. In all cheeses, 17 free amino acids were quantified including 8 essential amino acids (histidine, leucine-isoleucine, lysine, methionine, phenylalanine, threonine, tryptophan and valine) and 9 non-essential amino acids (arginine, asparagine, aspartic acid, cysteine, glutamic acid, glutamine, proline, serine and tyrosine). The amounts of the free amino acids, essential free amino acids, branched chain free amino acids (leucine, isoleucine and valine) plus the free amino acids ratios (mg/g protein) were further used to identify the producer of Serra da Estrela cheeses. Linear discriminant analysis coupled with the simulated annealing variable selection algorithm was used allowing the correct classification of 96% and 90 ±â€¯8% of the samples, for leave-one-out and repeated K-fold cross-validation procedures, respectively. The satisfactory predictive performance pointed out the possibility of using cheeses' amino acids profiles as origin biomarkers for authenticity control, warranting the correctness identification of the cheese producer/brand, which is quite relevant for ensuring the consumer confidence and satisfaction when purchasing this high-value dairy food.

Tumor maligno da bainha do nervo periférico: relato de caso / Malignant peripheral nerve sheath tumor: case report

JUSTIFICATIVA E OBJETIVOS: O tumor maligno da bainha do nervo periférico (TMBNP), anteriormente chamado de schwannoma maligno, é um tumor raro, representando até 10% dos sarcomas. Em aproximadamente 50% dos casos associam-se à neurofibromatose tipo 1 (NF1) ou doença de von Recklinghausen. São tumores agressivos e frequentemente resistentes à quimioterapia.O objetivo deste estudo foi a exposição de um caso de TMBNP enfatizando a importância da imuno-histoquímica para o diagnóstico. RELATO DO CASO: Paciente do sexo masculino, 54 anos, internado por dor abdominal, desconforto pós-prandial, lombociatalgia com irradiação ao membro inferior direito e lesões nodulares no fígado. A investigação revelou massa retroperitoneal com necrose e lesões líticas no sacro e coluna vertebral. As biópsias do sacro e hepática revelaram células mesenquimatosas, fusiformes, que coravam para S-100 na imuno-histoquímica. Admitido o diagnóstico de TMBNP com origem em massa retroperitoneal com metastatização óssea e hepática. O paciente foi referenciado à oncologia sendo tratado com quimioterapia paliativa. CONCLUSÃO: A raridade do TMBNP explica a importância da divulgação deste caso, informando os clínicos, diminuindo o tempo para o diagnóstico e melhorando substancialmente as probabilidades de cura e a sobrevida. Este caso é interessante também por não estar associado à NF1 e por não se ter determinado o nervo periférico de origem, assentando o diagnóstico no resultadodo estudo anatomo-histológico.

BACKGROUND AND OBJECTIVES: The malignant peripheral nerve sheath tumor (MPNST), previously designated malign schwannoma is a rare tumor, accounting up to 10% of the soft tissues sarcomas. In approximately 50% of the cases there is anassociation with neurofibromatosis -1 (NF1) or von Recklinghausen disease. This tumor is extremely aggressive and frequently resistant to chemotherapy. The purpose of this study is to describe a clinical case of MPNST emphasizing the importance of the immunohistochemistry to accomplish the diagnosis. CASE REPORT: A male patient, 54 years-old, admitted to the hospital with abdominal pain, postprandial epigastric discomfort, lumbosacral pain radiating to the right leg and nodular hepatic lesions. The clinical investigation revealed retroperitoneal mass with areas of necrosis and disperse lytic lesions on the sacrum and vertebral column. The hepatic and sacral biopsies revealed mesenchymal cells, spindled, which stained positively to S-100 in the immunohistochemistry. It was diagnosed MPNST,originated in the retroperitoneal mass metastasized to liver and bone. The patient was oriented to oncology being treated with palliative chemotherapy. CONCLUSION: The rarity of MPNST explains the importance of divulgating this case in order to inform the clinicians, diminishing the time to diagnosis, improving treatment and survival probabilities. This case report is also interesting because there was no association with NF1, and because it wasn't possible to identify the original peripheral nerve. The diagnosis was made due to the histological study performed.