Subcutaneous Panniculitis-Like T-Cell Lymphoma With Hemophagocytic Lymphohistiocytosis.

Subcutaneous panniculitis-like T-cell lymphoma (SPTLP), a unique variant of primary cutaneous T-cell lymphomas, clinically mimics subcutaneous panniculitis. It is typified by the development of multiple plaques or subcutaneous erythematous nodules, predominantly on the extremities and trunk. Epidemiological findings reveal a greater incidence in females than males, affecting a wide demographic, including pediatric and adult cohorts, with a median onset age of around 30 years. Diagnosis of SPTLP is complex, hinging on skin biopsy analyses and the identification of T-cell lineage-specific immunohistochemical markers. Treatment modalities for SPTLP are varied; while corticosteroids may be beneficial initially for many patients, a substantial number require chemotherapy, especially in cases of poor response or relapse. Generally, SPTLP progresses slowly, yet approximately 20% of cases advance to hemophagocytic lymphohistiocytosis (HLH), often correlating with a negative prognosis. We report a case of a young male patient presenting with prolonged fever, multiple skin lesions accompanied by HLH, a poor clinical course, and eventual death, diagnosed postmortem with SPTLP. In addition, we also present a literature review of the current evidence of some updates related to SPTLP.

Extrahepatic biliary tract tuberculosis: A case report and literature review.

INTRODUCTION: Tuberculosis is a chronic infectious disease that often has a latent period after the initial infection. Tuberculosis most often affects the lungs but it can also affect other parts of the body. Vietnam is in pandemic area of tuberculosis. CASE REPORT: We present a rare case of a 42-year-old male patient admitted to the hospital with a history of progressive jaundice. Magnetic resonance imaging (MRI) revealed a 26 × 33 mm tuberculous mass located at the intersection between the cystic duct and the common hepatic duct, leading to dilation of the intrahepatic biliary ducts on both sides. Initially diagnosed with a Klatskin type II tumor, the patient underwent surgery to remove the mass and create a biliary-enteric anastomosis. However, the pathological report of the postoperative specimens concluded a diagnosis of necrotizing granulomatous inflammation caused by tuberculosis. CASE DISCUSSION: Obstructive jaundice secondary to tuberculosis is a rare condition that can be caused due to the tuberculous enlargement of the pancreatic head, tuberculous lymphadenitis, tuberculous biliary strictures, or a tuberculous retroperitoneal mass. Extrapulmonary tuberculosis usually results from hematogenous dissemination or contiguous spread from adjacent organs. Symptoms vary depending on the affected organ but typically include fever, fatigue, and weight loss. Hepatobiliary tuberculosis is usually secondary to pulmonary or gastrointestinal tuberculosis. CONCLUSION: Hepatobiliary tuberculosis is a rare disease that affects the liver and bile duct system. It is difficult to diagnose because it does not have any specific symptoms and can be easily misdiagnosed with other diseases.

Ovary metastasis from lung cancer mimicking primary ovarian cancer: A rare case report.

Introduction: Ovarian metastasis from lung cancer is very rare, which might lead to a misdiagnosis as primary ovarian cancer. Case presentation: We report a 49-year-old woman presenting to our hospital because of a painful mass in the lower abdomen, with no respiratory symptoms. Her initial diagnosis was stage IVB ovarian cancer with pulmonary metastasis. Therefore, the patient underwent neo-adjuvant Paclitaxel - Carbolatin chemotherapy followed by interval debulking surgery. However, postoperative histopathology and immunohistochemistry findings confirmed the diagnosis of primary lung cancer with ovarian metastases. EGFR exon 19 deletion mutation was found by tumor analysis. Therefore, she was then treated with erlotinib and the disease achieved the partial response and remained stable for 7 months. Conclusion: Diagnosis of lung cancer in the context of ovarian and peritoneal metastases can be difficult. In this circumstance, thorough systemic assessment and immunohistochemistry are essential to confirm the primary.

Rectal metastasis originating from breast cancer: A rare case report.

Introduction: Gastrointestinal tract involvement in breast cancer is rarely encountered clinically. Data about this condition is limited and mostly from case reports. Case presentation: We report a case of rectal metastasis originating from breast cancer, which presents after a long-term latency of initial diagnosis. The patient had a history of diagnosis and treatment of stage II triple-negative breast cancer with mastectomy and adjuvant chemotherapy and radiotherapy. She showed no signs of recurrence up to eleven years, then presented with hematochezia and mild constipation. A rectal lesion was found on colonoscopy, which raise the initial suspicion of primary rectal cancer, but surprisingly, immunohistochemistry staining of the rectal specimen confirmed the origin of breast cancer. Clinical discussion: Breast cancer with rectal metastasis is very rare. Immunohistochemistry combined with medical history is essential for definitive diagnosis in this situation. Mammaglobin and GCDFP-15, CDX2, CK20, and CK7 help differentiate the origin from the breast or the rectum. Conclusion: Though breast cancer metastasizing to the rectum is a rare event, physicians should be aware of this differential diagnosis, even in patients with a remote history of breast cancer.

A new and efficient approach for construction of uridine/uracil auxotrophic mutants in the filamentous fungus Aspergillus oryzae using Agrobacterium tumefaciens-mediated transformation.

Aspergillus oryzae is a filamentous fungus widely used in food industry and as a microbial cell factory for recombinant protein production. Due to the inherent resistance of A. oryzae to common antifungal compounds, genetic transformation of this mold usually requires auxotrophic mutants. In this study, we show that Agrobacterium tumefaciens-mediated transformation (ATMT) method is very efficient for deletion of the pyrG gene in different Aspergillus oryzae wild-type strains to generate uridine/uracil auxotrophic mutants. Our data indicated that all the obtained uridine/uracil auxotrophic transformants, which are 5- fluoroorotic acid (5-FOA) resistant, exist as the pyrG deletion mutants. Using these auxotrophic mutants and the pyrG selectable marker for genetic transformation via A. tumefaciens, we could get about 1060 transformants per 106 fungal spores. In addition, these A. oryzae mutants were also used successfully for expression of the DsRed fluorescent reporter gene under control of the A. oryzae amyB promoter by the ATMT method, which resulted in obvious red transformants on agar plates. Our work provides a new and effective approach for constructing the uridine/uracil auxotrophic mutants in the importantly industrial fungus A. oryzae. This strategy appears to be applicable to other filamentous fungi to develop similar genetic transformation systems based on auxotrophic/nutritional markers for food-grade recombinant applications.

The construction and use of versatile binary vectors carrying pyrG auxotrophic marker and fluorescent reporter genes for Agrobacterium-mediated transformation of Aspergillus oryzae.

Aspergillus oryzae is a safe mold widely used in food industry. It is also considered as a microbial cell factory for production of recombinant proteins and enzymes. Currently, genetic manipulation of filamentous fungi is achieved via Agrobacterium tumefaciens-mediated transformation methods usually employing antibiotic resistance markers. These methods are hardly usable for A. oryzae due to its strong resistance to the common antifungal compounds used for fungal transformation. In this study, we have constructed two binary vectors carrying the pyrG gene from A. oryzae as a biochemical marker than an antibiotic resistance marker, and an expression cassette for GFP or DsRed reporter gene under control of the constitutive gpdA promoter from Aspergillus nidulans. All components of these vectors are changeable to generate new versions for specific research purposes. The developed vectors are fully functional for heterologous expression of the GFP and DsRed fluorescent proteins in the uridine/uracil auxotrophic A. oryzae strain. Our study provides a new approach for A. oryzae transformation using pyrG as the selectable auxotrophic marker, A. tumefaciens as the DNA transfer tool and fungal spores as the transformation material. The binary vectors constructed can be used for gene expression studies in this industrially important filamentous fungus.