Gastric schwannoma with giant ulcer and lymphadenopathy mimicking gastric cancer: a case report.

BACKGROUND: Gastric schwannomas are rare benign tumors originating from the intramuscular plexus of the stomach and account for just 2.6% of gastric mesenchymal tumors. Gastric schwannoma (GS) with a surface ulcer is very rare. Herein, we report a rare case of an ulcer-bearing GS, which in conjunction with multiple enlarged regional lymph nodes, readily mimicked gastric cancer (GC). CASE PRESENTATION: A 79-year-old female presented with poor appetite and intermittent vomiting of gastric contents during the past month. Gastroscopy revealed a giant crateriform ulcer within the stomach body (at the angular notch). Its raised and indurated border was fragile and bled easily. GC was thus suspected. Contrast-enhanced computer tomography (CT) revealed a mild enhancement of the corresponding irregularly thickened gastric wall, and an annular zone of mucosal discontinuity. Enlarged regional lymph nodes were also found, making GC with metastases of lymph nodes our primary concern. 18F-fluorodeoxyglueose position emission tomography (18F-FDG PET)/CT was then performed for further staging. Obviously increased FDG uptake was shown in the gastric lesion ((maximum standardized uptake value (SUVmax) 14.6), but no FDG uptake was observed in the enlarged regional lymph nodes. Given the strong suspicion of GC, subtotal gastrectomy was performed. GS was revealed by postoperative pathology, with no evidence of metastasis in the 13 resected lymph nodes. CONCLUSIONS: This was a rare case of GS with a giant surface ulcer and multiple enlarged regional lymph nodes. The uptake of 18F-FDG in the tumor was substantially higher than previously published literature reports. Under these circumstances, it is difficult to be differentiated from GC.

Influx rate constant of 18F-FDG increases in metastatic lymph nodes of non-small cell lung cancer patients.

PURPOSE: Primary tumor (PT) and metastatic lymph node (MLN) status have a great influence on diagnosis and treatment of lung cancer. Our main purpose was to investigate the imaging characteristics of PT or MLN by applying the 18F-FDG PET dynamic modeling approach for non-small cell lung cancer (NSCLC). METHODS: Dynamic 18F-FDG PET scans were performed for 76 lung cancer patients, and 62 NSCLC cases were finally included in this study: 37 with newly diagnosed early and locally advanced lung cancer without distant metastases (group M0) and 25 metastatic lung cancer (group M1). Patlak graphic analysis (Ki calculation) based on the dynamic modeling and SUV analysis from conventional static data were performed. RESULTS: For PT, both KiPT (0.050 ± 0.005 vs 0.026 ± 0.004 min-1, p < 0.001) and SUVPT (8.41 ± 0.64 vs 5.23 ± 0.73, p < 0.01) showed significant higher values in group M1 than M0. For MLN, KiMLN showed significant higher values in M1 than M0 (0.033 ± 0.005 vs 0.016 ± 0.003 min-1, p < 0.01), while no significant differences were found for SUVMLN between M0 and M1 (4.22 ± 0.49 vs 5.57 ± 0.59, p > 0.05). Both SUV PT and KiPT showed significant high values in squamous cell carcinoma than adenocarcinoma, but neither SUVPT nor KiPT showed significant differences between EGFR mutants versus wild types. The overall Spearman analysis for SUV and Ki from different groups showed variable correlation (r = 0.46-0.94). CONCLUSION: The dynamic modeling for MLN (KiMLN) showed more sensitive than the static analysis (SUV) to detect metastatic lymph nodes in NSCLC, although both methods were sensitive for PT. This methodology of non-invasive imaging may become an important tool to evaluate MLN and PT status for patients who cannot undergo histological examination. CLINICAL TRIAL REGISTRATION: The clinical trial registration number is NCT03679936 (http://www.clinicaltrials.gov/).

A Tie2 kinase mutation causing venous malformations increases phosphorylation rates and enhances cooperativity.

The endothelial receptor tyrosine kinase Tie2 plays an important role in vascular formation and maintenance. Mutations in Tie2 lead to vascular malformations, which are painful vascular lesions that cause disfigurement, bleeding, and thrombosis. R849W Tie2 is the most common mutation implicated in an inherited form of vascular malformations and has been shown to be activating, though little is known about the kinetic features of catalysis. Here we undertake a steady-state kinetic analysis of heterologously expressed and purified wild type (WT) and R849W Tie2. While the catalytic efficiencies of the two forms are not significantly different, the observed maximal rate of phosphorylation, kcat,obs, is > 3-fold higher for R849W Tie2 compared to WT. Notably, steady-state catalysis by R849W Tie2 has more striking sigmoidal features compared to WT, suggesting enhanced positive cooperativity. We propose that activating catalytic features are one important consequence of the R849W mutation, though likely other factors such as increased protein binding affinity also contribute to the phenotypes observed in patients.

Tumor-Induced Osteomalacia Caused by a Parotid Basal Cell Adenoma Detected by 68Ga-DOTANOC PET/CT.

Tumor-induced osteomalacia is a rare paraneoplastic syndrome, usually caused by small benign mesenchymal tumors. The tumors most arise within the extremities, whereas occurrence within the parotid gland is quite rare. A 54-year-old woman who presented with bone pain and muscle weakness for 2 years was clinically suspected of having tumor-induced osteomalacia. A Ga-DOTANOC PET/CT was performed for localization of the causative tumor. The images demonstrated intense radiotracer accumulation in a soft tissue nodule in deep lobe of the right parotid gland. Subsequent surgical resection and pathologic analysis confirmed the diagnosis of parotid basal cell adenoma.

Radiation dosimetry estimation of N-(2-[(18)F]fluoropropionyl)- L-glutamate based on the mice distribution data.

N-(2-[(18)F]fluoropropionyl)-l-glutamate([(18)F]FPGLU) was a recently developed potential amino acid tracer for tumor imaging with positron emission tomography-computer tomography (PET-CT). The absorbed and effective radiation doses resulting from the intravenous administration of [(18)F]FPGLU were estimated using biodistribution data from normal mice. The methodology recommended by Medical Internal Radiation Dose Committee (MIRD) was used to estimate the doses. The highest uptake of [(18)F]FPGLU was found in the kidneys, followed by the liver and lung. The kidneys were the organ received the highest absorbed dose, 58.4µGy/MBq, the brain received the lowest dose, 5.5µGy/MBq, and other organs received doses in the range of 8.3-11.9µGy/MBq. The effective dose was 17.0µSv/MBq. The data show that a 370MBq (10mCi) injection of [(18)F]FPGLU would lead to an estimated effective dose of 6.3mSv, which is within the accepted range of routine nuclear medicine investigations.

Multiple ectopic calcification in subcutaneous tissues detected by bone scintigraphy in a patient with chronic renal failure.

A 56-year-old man presented with swelling bilateral shoulders for 2 months. Plain radiograph and CT demonstrated symmetric masses with plaque calcification in bilateral shoulders. A Tc-MDP bone scintigraphy revealed intense radiotracer uptake not only in the masses of bilateral shoulders but also in the masses of the right buttock and the left thigh. The masses in bilateral shoulders were resected, and the pathological examination confirmed the ectopic calcification. This is a rare case of multiple ectopic calcification in subcutaneous tissues in a patient with chronic renal failure.

[Feasibility study of ¹8F-fluorodeoxyglucose positron emission tomography/computed tomography in proposing selection criteria for patients with hepatocellular carcinoma in liver transplantation].

OBJECTIVE: To explore the feasibility of ¹8F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in proposing selection criteria for patients with hepatocellular carcinoma (HCC) in liver transplantation. METHODS: We respectively analyzed 31 cases of HCC patients from our hospital and those accepting no anti-tumor therapy or orthotopic liver transplantation before ¹8F-FDG PET/CT examination. The T/B value was set as a semi-quantitative parameter reflecting the metabolic activities of tumors. And receiver operating characteristic (ROC) curve was plotted to determine the optimal cutoff value of T/B affecting HCC recurrence after transplantation. Their clinicopathological features were analyzed by univariate and multivariate analyses to determine the risk factors for HCC recurrence after transplantation. RESULTS: During the follow-up period, the total incidence of tumor recurrence or metastasis was 51.6%. And the disease-free survival rates of 6 months, 1 year and 2 years post-transplantation were 93.5%, 67.7% and 46.8% respectively. The univariate analysis revealed 4 variables of affecting the recurrence or metastasis of HCC after transplantation, namely T/B value, tumor size, tumor number and preoperative alpha fetoprotein (AFP) level. While multivariate analyses indicated that T/B value and tumor size were independent factors. CONCLUSION: T/B value, tumor number and preoperative AFP level were independent risk factors for tumor recurrence. As a prognostic indicator of tumor biological behavior, ¹8F-FDG PET/CT can identify the eligible transplant HCC candidates.

Adsorption and recognition characteristics of surface molecularly imprinted polymethacrylic acid/silica toward genistein.

In this paper, on the basis of surface-initiated graft polymerization, a new surface molecular imprinting technique is established by molecular design. And molecularly imprinted polymer MIP-PMAA/SiO2 is successfully prepared with genistein as template. The adsorption and recognition characteristics of MIP-PMAA/SiO2 for genistein are studied in depth by using static method, dynamic method and competitive adsorption experiment. The experimental results show that MIP-PMAA/SiO2 possesses very strong adsorption affinity and specific recognition for genistein. The saturated adsorption capacity could reach to 0.36mmolg(-1). The selectivity coefficients relative to quercetin and rutin are 5.4 and 11.8, respectively. Besides, MIP-PMAA/SiO2 is regenerated easily and exhibits excellent reusability.

Risk factors for mediastinal lymph node metastasis in non-small-cell lung cancer by PET/CT.

OBJECTIVE: The aim of this study was to investigate the relationship between mediastinal lymph node metastasis based on fluorine-18 fluorodeoxyglucose ((18)F-FDG) PET/computed tomography (PET/CT) of the primary tumor and various clinical indexes to determine the risk factors for malignant lymph nodes in non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: A total of 130 patients with histologically proven NSCLC who had not received any therapy underwent (18)F-FDG PET/CT for staging. The relationship between node metastasis, sex, age, smoking status, primary tumor maximum standardized uptake value (SUV(max)), size, pathological type, and differentiation was studied by univariate analyses, and risk factors for nodal metastasis in NSCLC were assessed by multivariate logistic regression. RESULTS: Of the 130 patients, 68 were seen to have nodal metastasis on histological analysis. Nodal metastasis was correlated with SUV(max), size, and differentiation of primary lung lesions (P<0.05), and all the other factors were nonsignificant (P>0.05). On multivariate logistic regression analysis, the only independent factor was SUV(max) of the primary tumor, and the optimal cutoff value was 9.3 (sensitivity: 75.41%, 95% confidence interval: 62.7-85.5; specificity: 54.41%, 95% confidence interval: 41.9-66.5). CONCLUSION: The mediastinal lymph node metastasis ratio was correlated with SUV(max), size, and differentiation in primary lung lesions. SUV(max) was the only independent predictor of lymph node metastasis in NSCLC. Video Abstract: http://links.lww.com/NMC/A22.

Expression and distribution of Src in the nucleus of myocytes in cardiac hypertrophy.

The Src kinase is involved in signaling events leading to cardiac hypertrophy. The exact effects of tyrosine phosphorylation and subnuclear distribution on cardiac hypertrophy and failure remain to be investigated. In this study, we examined the intranuclear expression and distribution of c-Src, Src phosphorylated at tyrosine 529 (Src[pY529]), Src phosphorylated at tyrosine 418 (Src[pY418]) and Src phosphorylated at tyrosine 215 (Src[pY215]) in the myocardial nuclei of the left ventricle (LV) from 2-, 6-, 12- and 18-month-old spontaneously hypertensive heart failure (SHHF) rats and age-matched Wistar-Kyoto (WKY) rats as normotensive controls by western blot analysis, immunofluorescent labeling and immunoprecipitation. Cellular Src (c-Src) expression in the myocardial nuclei of the LV of the 2-, 6-, 12- and 18-month-old SHHF rats was not significantly different from that in the myocardial nuclei of the LV of the age-matched WKY rats. Although there were no significant differences observed between the levels of Src[pY529] and Src[pY418] in the myocardial nuclei of the LV of the 2-month-old SHHF and WKY rats, the expression of Src[pY529] significantly decreased, while that of Src[pY418] significantly increased in the myocardial nuclei of the LV of the 6-, 12- and 18-month-old SHHF rats compared to the age-matched WKY controls. Furthermore, as demonstrated by double labeling with antibodies against fibrillarin and Src-associated in mitosis 68 kDa (Sam68), c-Src was co-localized with both Sam68 and fibrillarin in the nuclei; Src[pY529] co-localized with fibrillarin, but Src[pY418] co-localized with Sam68. The results from the present study suggest that the dephosphorylation of Src tyrosine kinase 529, the phosphorylation of tyrosine 418 and their subnuclear redistribution are involved in endonuclear signal transduction in cardiac myocytes, which regulates the development and progression of LV eccentric hypertrophy induced by hypertension.

Expression and redistribution of ß-catenin in the cardiac myocytes of left ventricle of spontaneously hypertensive rat.

Beta-catenin is not only an adhering junction protein, but also the central player of the canonical Wnt signalling pathway. In order to investigate the roles of ß-catenin in the mechanism of myocardial hypertrophy, we determined the expression and distribution of ß-catenin in the cardiomyocytes of spontaneously hypertensive heart failure (SHHF) rats and age-matched Wistar-Kyoto (WKY) rats. We identified the reducing of ß-catenin expression in the membrane protein fraction but increasing in the nuclear protein in the 6 and 12 month-old SHHF rats as compared with the age-matched WKY rats by Western blotting. Immunolabeling of ß-catenin colocalized with cadherin at the intercalated disc sites and showed nuclear accumulation in myocytes of SHHF rats. We also revealed that the association between glycogen synthase kinase-3ß and ß-catenin had weakened in the 6 month-old SHHF rats as compared with the age-matched WKY rats by immunoprecipitation. These findings suggested that nuclear translocation of ß-catenin might play important roles in regulating signal transduction in the decompensated hypertrophy stage.

Adsorption properties of polyvinyl-alcohol-grafted particles toward genistein driven by hydrogen-bond interaction.

The adsorption properties of polyvinyl alcohol (PVA)-grafted silica gel particles PVA/SiO2 toward genistein are researched in this paper. The effects of the main factors on the adsorption properties are investigated, the adsorption mechanism is explored in depth, and the adsorption thermodynamics is researched. The experimental results show that the conventional hydrogen bond is formed between the hydroxyl groups with high density on the surfaces of PVA/SiO2 and the phenolic hydroxyl groups in genistein, while π-type hydrogen bond is formed between the hydroxyl groups of PVA/SiO2 and the conjugated aromatic rings. It is the two types of hydrogen bond that make the functional composite particles PVA/SiO2 produce very strong physical adsorption toward genistein. The competitive adsorption of the solvent can have severe negative impact on the adsorption capacity of genistein. Increasing temperature will weaken the hydrogen-bond interaction between PVA/SiO2 particles and genistein. The existence of electrolytes in the protic solvent will affect the adsorption negatively. The adsorption process of PVA/SiO2 particles toward genistein is exothermic and driven by enthalpy. The adsorption isotherm data matches the Langmuir model.