Late Graft Rejection in Association With T-Large Granular Lymphocyte Expansion of Recipient Origin After Human Leukocyte Antigen-Haploidentical Stem Cell Transplantation: A Case Report.

BACKGROUND: Large granular lymphocyte (LGL) expansion occasionally occurs after allogeneic stem cell transplantation (allo-SCT), and is thought to be a good prognostic sign that is associated with a lower relapse rate. However, there have been no reports of late graft failure (LGF) due to graft rejection in association with oligoclonal LGL expansion. We herein report a case of LGF associated with the transient expansion of recipient-derived T-LGL after allo-SCT. CASE REPORT: A 65-year-old man underwent peripheral blood stem cell transplantation (PBSCT) from his human leukocyte antigen (HLA)-haploidentical son for the treatment of acute myeloid leukemia, which had evolved from a myelodysplastic syndrome (MDS). Neutrophil engraftment occurred on day 20. A chimerism analysis on day 29 showed both granulocytes and mononuclear cells in the peripheral blood to be completely of donor origin. However, his neutrophil count gradually decreased and a chimerism analysis on day 61 showed that 84% of the patient's T cells were of recipient origin while the granulocytes were 100% donor-derived. His LGLs rapidly increased to 4.01 × 109/L on day 113 and decreased thereafter. The percentage of donor cells in his granulocytes gradually decreased, and the patient's leukocytes were completely replaced by recipient cells on day 177. CONCLUSIONS: The clinical course suggests that the expansion of recipient-derived T-LGLs after allo-SCT can be a sign of graft rejection. Early intervention may be needed if the LGL expansion is recipient-derived.

Determination and confirmation of methyl p-hydroxybenzoate in royal jelly and other foods produced by the honey bee.

Methyl p-hydroxybenzoate (methyl paraben) in foods produced by the Honey Bee was determined by HPLC and confirmed by GC-MS. The compound was detected at a mean concentration of 22.3 +/- 6.8 mg/kg (between 14.2 and 31.9 mg/kg) in commercial royal jelly, but was not detected in honey, propolis or pollen lumps at the detection limit of 1 mg/kg. Fresh royal jelly collected from apiaries contained methyl p-hydroxybenzoate at a concentration of 20.3 +/- 4.7 mg/kg (between 12.5 and 31.7 mg/kg). These results indicate that the methyl p-hydroxybenzoate in royal jelly is not added but is a natural component.

Colitis cystica profunda: report of a case in which differentiation from rectal cancer was difficult.

Colitis cystica profunda is a benign condition that has been confused with carcinoma. This rarely recognized condition is characterized by submucosal cysts. Macroscopically, the ulcerated character of the mass suggests carcinoma. Microscopically, attenuation of the innocuous-appearing cyst linings may give the false impression of a mucus-secreting carcinoma. A case of colitis cystica profunda in which the macroscopic appearance was so suggestive of malignancy that operation was carried out is reported.