Primary Hepatic Inflammatory Myofibroblastic Tumor With Synchronous Primary Squamous Cell Lung Cancer in an Elderly Woman.

The hepatic inflammatory myofibroblastic tumor is a spindle cell tumor of the liver that originates from the mesenchymal tissues. It is a rare benign tumor with the potential to degenerate into a malignant and invasive tumor. It can occur anywhere in the body with the most common sites being the lung, mesentery, and omentum. The most common types are myxoid, vascular pattern, fibrous, or hypocellular fibroid type. Immunohistochemistry staining often indicates vimentin, muscle-specific actin, smooth muscle actin, and cytokeratin. These tumors are positive for CD 68 abundant histiocytes but negative for S100. Half of the inflammatory myofibroblastic tumors contain a clonal cytogenetic aberration that activates the ALK gene expression. We present a rare case of HIMT in an elderly female with active primary squamous lung cancer.

Pre-operative cardiopulmonary, metabolic, abdominal, and somatic variations by race in men with obesity resolve after Laparoscopic Roux-en-Y gastric bypass (LRYGB): Dyslipidemia and psychologicals by race persist.

BACKGROUND: Whether/how LRYGB men vary by race in clinical characteristics/post-operative outcomes is unknown. OBJECTIVE: Identify male pre-/post LRYGB clinical/outcomes variations by race. METHODS: Data from 17,734 LYRGB BOLD database men were analyzed in five groups: African American (AA, n = 1310), Caucasian (C, n = 14,168), Asian (A, n = 53), Hispanic (H, n = 1519), and Other (O, Pacific Islander, Native American, or more than one race, n = 684). DATA: demographics, BMI, and 28 weight-related conditions. RESULTS: Pre-LRYGB age, health insurance, unemployment, BMI, and 24/28 obesity related comorbidities varied by race (p < 0.01). Highest pre-LRYGB: AA 4, C 14, A 5, H none, O 1 comorbidity. 12 month BMI and 14 comorbidities varied by race (p < 0.05). 24 months only dyslipidemia, depression, and psychological impairment varied by race (p < 0.05). CONCLUSION: Demographics, BMI and 24 obesity comorbidities vary by race in LRYGB men, but only 3 at 24 months. Caucasians have the greatest cardiopulmonary related comorbidities. This advanced knowledge may facilitate peri-operative management.

Primary Parotid Non-Hodgkin's B-Cell Lymphoma in an Elderly Woman on Pembrolizumab for Metastatic Invasive Papillary Urothelial Cell Carcinoma of the Bladder.

Primary lymphomas of the parotid are rare (4-5%) and seldom appear in patients with pre-existing metastatic cancer from other primary sources. We present a primary marginal zone B-cell lymphoma of the mucosaassociated lymphoid tissue (MALT) in an 84-year-old female with preexisting metastatic bladder cancer. A PET scan that identified positive pelvic/cervical lymphadenopathy and bilateral parotid masses. She underwent transurethral resection of a bladder tumor and started on pembrolizumab chemotherapy. After two years, the left parotid mass decreased in size but the right increased to 3.9cm. Right superficial parotidectomy diagnosed B-Cell Marginal zone lymphoma, staining positive for CD20, PAX5, and Bcl2. pembrolizumab was held and the patient was started on 4 weekly rituximab infusions. A PET scan done 3 months after completion of rituximab showed a good response to chemotherapy. This is the first reported case of a primary parotid gland lymphoma in a patient with active metastatic bladder cancer.