ABSTRACT
INTRODUCTION AND IMPORTANCE: An intramural cyst is a rare lesion that develops in the wall of the gallbladder. Although the acquired cysts originate from the Rokitansky-Aschoff sinus (RAS), the congenital them, such as the duct of Luschka, are rare. Luschka's duct is a unique and specific tissue component that is histologically different from the inherent bile duct and without the communication to the lumen of the gallbladder. CASE PRESENTATION: A woman in her seventies underwent cholecystectomy for the treatment of repeated choledocholithiasis. Pathological examination of the resected specimen revealed multiple cysts in the subserosal tissue of the liver bed. The cysts were lined by cuboidal epithelium and surrounded by hypercellular fibrous tissue. Apart from the Luschka's ducts scattered around the cyst, no other components were observed. Immunohistochemically, the cystic epithelium was different from that of the gallbladder and phenotypically similar to that of the Luschka's duct. DISCUSSION: From histopathological and immunohistological findings, it was suggested that the cysts of the present case are not derived from RAS, which is the most common in the gallbladder, but from the Luschka's duct. CONCLUSION: We report an extremely rare case of intramural cysts that appear to have originated from the Luschka's duct.
ABSTRACT
Adoptive T cell therapy using tumor-specific T cells or TCR-modified T cells is a promising next-generation immunotherapy. The major source of tumor-reactive T cells is PD-1+ tumor-infiltrating lymphocytes (TILs). In contrast, PD-1- TILs have received little attention. Here, we analyzed the TCR-ß repertoires of PD-1- and PD-1+ CD8+ TILs derived from colorectal cancer and breast cancer. Approximately 40-60% of the PD-1+ population consisted of oligoclonal populations in both colorectal cancer and breast cancer. In contrast, approximately 37% of the PD-1- population consisted of an oligoclonal population in colorectal cancer, whereas 14% of them were oligoclonal in breast cancer. In colorectal cancer, the TCR repertoires of PD-1- CD8+ TILs and PD-1+ CD8+ TILs hardly overlapped. Interestingly, clonally expanded CD8+ TILs in primary tumors and the metastases expressing the same clonotypic TCR showed the same phenotype regarding the PD-1-expression. These results suggest that the intrinsic properties of TCRs determine the fate of TILs in terms of whether they become PD-1+ or PD-1- in the tumor microenvironment. Further functional analysis of TCRs in TILs will allow us to better understand the regulatory mechanisms for PD-1 expression on TILs and may contribute to tumor immunotherapy.
