Lymph Glands Research Articles

Evaluation of Sensitivity and Specificity of Ultrasound-Guided FNA of Suspicious Axillary Lymph Nodes in Patients with Breast Cancer

Background: The axillary lymph node status in breast cancer is a major prognostic factor in survival and establishing a personalized treatment scheme. The ultrasound-guided fine needle aspiration (US-FNA) is a method for taking a lymph node sample. It allows physicians to decide how to manage the axilla. Objectives: This study was conducted to investigate the sensitivity of the US-FNA technique on suspicious axillary lymph nodes with a thickness of 3 to 6 mm in breast cancer patients. Methods: In a cross-sectional study, all the patients were subjected to preoperative ultrasound evaluation of the axilla to determine the presence of lymph nodes suspicious of malignancy. In cases where the suspicious lymph node cortex size was between 3 and 6 mm, US-FNA was performed. After surgery, the frozen section of the biopsy sample was examined histologically and compared with fine needle aspiration (FNA) cytology results. Results: A total of 102 patients were examined in the study. FNA test results indicated that 46 subjects had axillary malignant tissue, and benign cases summed 56. Also, the final results of frozen section surgical histopathology identified 46.1% of patients with involved lymph nodes. The sensitivity and specificity of FNA were 93.62% and 96.36%, respectively. Also, the overall diagnostic accuracy was 95.1%. Conclusions: This study showed that the sensitivity, specificity, and accuracy were more than 90% for the ultrasound-guided FNA test in identifying involved lymph nodes in patients with breast cancer. Therefore, the results of this test can be considered clinically reliable. However, there is still a need to examine the sensitivity and specificity of this method in identifying lymph node involvement.

Participation of the spleen in the neuroinflammation after pilocarpine-induced status epilepticus: implications for epileptogenesis and epilepsy.

Epilepsy, a chronic neurological disorder characterized by recurrent seizures, affects millions of individuals worldwide. Despite extensive research, the underlying mechanisms leading to epileptogenesis, the process by which a normal brain develops epilepsy, remain elusive. We, here, explored the immune system and spleen responses triggered by pilocarpine-induced status epilepticus (SE) focusing on their role in the epileptogenesis that follows SE. Initial examination of spleen histopathology revealed transient disorganization of white pulp, in animals subjected to SE. This disorganization, attributed to immune activation, peaked at 1-day post-SE (1DPSE) but returned to control levels at 3DPSE. Alterations in peripheral blood lymphocyte populations, demonstrated a decrease following SE, accompanied by a reduction in CD3+ T-lymphocytes. Further investigations uncovered an increased abundance of T-lymphocytes in the piriform cortex and choroid plexus at 3DPSE, suggesting a specific mobilization toward the Central Nervous System. Notably, splenectomy mitigated brain reactive astrogliosis, neuroinflammation, and macrophage infiltration post-SE, particularly in the hippocampus and piriform cortex. Additionally, splenectomized animals exhibited reduced lymphatic follicle size in the deep cervical lymph nodes. Most significantly, splenectomy correlated with improved neuronal survival, substantiated by decreased neuronal loss and reduced degenerating neurons in the piriform cortex and hippocampal CA2-3 post-SE. Overall, these findings underscore the pivotal role of the spleen in orchestrating immune responses and neuroinflammation following pilocarpine-induced SE, implicating the peripheral immune system as a potential therapeutic target for mitigating neuronal degeneration in epilepsy.

Developmental characteristics of aggregated lymphoid nodules area in the abomasum of fetal Bactrian camels (Camelus bactrianus)

BackgroundBactrian camel is one of the important economic animals in northwest China. They live in arid desert, and their gestation period is about 13 months, which is longer than other ruminants (such as cattle and sheep). The harsh living conditions have made its unique histological characteristics a research focus. Aggregated lymphoid nodules area (ALNA) in the abomasum of Bactrian camels, as one of the most important sites for the induction of the immune response, provide a comprehensive and effective protective role for the organism, and their lack of information will affect the feeding management, reproduction and epidemic prevention of Bactrian camels. In this study, the histological characteristics of the fetal ALNA in the abomasum of Bactrian camels at different developmental gestation have been described by using light microscopy and histology .ResultsThe ALNA in the abomasum of the Chinese Alashan Bactrian camel is a special immune structure that was first discovered and reported by Wen-hui Wang. To further establish the developmental characteristics of this special structure in the embryonic stage, the abomasum ALNA of 8 fetuses of Alashan Bactrian camels with different gestational ages (5~13 months) were observed and studied by anatomy and histology. The results showed that the aggregation of reticular epithelial cells (RECs) surrounded by a very small number of lymphoid cells was detected for the first time in the abomasum of fetal camel at 5 months gestation, which was presumed to be primitive ALNA. At 7 months gestation, the reticular mucosal folds region (RMFR) appeared, but the longitudinal mucosal folds region (LMFR) was not significant, and histological observations showed that there were diffusely distributed lymphocytes around the RECs. At 10months gestation, RMFR and LMFR were clearly visible, lymphoid follicles appeared in histological observation, lymphocytes proliferated vigorously. By 13 months, the volume of lymphoid follicles increased, forming the subepithelial dome (SED), and there was a primitive interfollicular area between the lymphoid follicles, which contained high endothelial vein (HEV), but no germinal center (GC) was found. In summary, ALNA of Bactrian camels is not fully mature before birth.ConclusionsGenerally, the small intestine PPs of ruminants (such as cattle and sheep) is already mature before birth, while the ALNA in the abomasum of Bactrian camels is not yet mature in the fetal period. During the development of ALNA in Bactrian camel, the development of lymphoid follicles extends from submucosa to Lamina propria. Interestingly, the deformation of FAE changes with age from simple columnar epithelium at the beginning of pregnancy to Simple cuboidal epithelium, which is opposite to the FAE deformation characteristics of PPs in the small intestine of fetal cattle and sheep. These results are the basis of further research on the specificity of ALNA in the abomasum of Bactrian camels.

Selpercatinib for treating recurrent mixed medullary and follicular cell-derived thyroid carcinoma: a case report

BackgroundMixed medullary and follicular cell-derived thyroid carcinoma (MMFCC) is characterized by the coexistence of follicular and C cell–derived tumour cell populations within the same lesion. Due to its rarity, its etiology and clinical course remain unclear, and treatment for advanced or recurrent cases has not been established.Case presentationWe report a case of MMFCC treated with selpercatinib. The patient was a 69-year-old male presenting with tumors in the right thyroid lobe and in the upper mediastinum. Fine-needle aspiration (FNA) cytology of the right thyroid lobe tumor revealed a medullary carcinoma; germline RET mutations were not detected. After resection of the right thyroid lobe with central node dissection, rapid intraoperative diagnosis of the mediastinal mass confirmed malignancy, leading to total thyroidectomy with excision of the upper mediastinal tumor. Histologically, the tumor in the right thyroid lobe and the pretracheal lymph node revealed a mixture of medullary and follicular carcinoma components, diagnosed as MMFCC. The mediastinal lymph node exhibited only medullary carcinoma components. At 11 months postoperatively, computed tomography scans showed enlargement of the right supraclavicular and upper mediastinal lymph nodes. FNA cytology of the right supraclavicular lymph node suggested the recurrence of medullary thyroid carcinoma. The gene panel testing (The Oncomine Dx Target Test Multi-CDx system®, Thermo Fisher SCIENTIFIC) of metastatic lymph node revealed RET somatic mutation (M918T). Treatment with selpercatinib was initiated, and both the cervical and mediastinal lymph nodes showed a reduction in size.ConclusionsWe report a rare case of selpercatinib use for MMFCC. Since RET mutations may occur frequently in MMFCC, selpercatinib could be effective in treating MMFCC.

Effect of Selenium-Yeast supplementation on gut microbiome, intestinal histomorphology and immunity in broilers

Selenium-yeast was mixed with the basal diet of treatment groups of birds at the dose rate of 0.15 mg/kg diet in treatment-I (T-I), 0.225 mg/kg in treatment-II (T-II) and 0.30 mg/kg in treatment-III (T-III) group. The body weight and weekly weight gain increased and, feed conversion ratio improved significantly (p<0.05) in the T-III group as compared to control group. The number of goblet cells, lymphatic nodules in the intestine was more in treated birds. The villi height and crypts depth and their ratio were significantly highest in T-III group. Bursal morphology significantly improved and the number of Hassall’s corpuscle, macrophages and plasma cells were more frequent in treated birds. Among the lymphoglandular organs, the maximum IL-10 positive cells were found in the caecum and Bursa of Fabricius (BF). Among the groups, T-III group showed weak to nil IL-10 reaction. When compared between the days, BF and spleen showed better IL-10 positive reaction on 7th day but in caecal tonsil and thymus, the better reaction was on 35th day. The expression of IL-10 in the lymphoglandular organs was significantly (p<0.05) lower and T-III had minimum expression. T-II and T-III groups were better than T-I and control groups for enhancing humoral immunity against Newcastle disease virus, reduction of gut Escherichia coli, Salmonella and increased gut Bifidobacterium spp. In conclusion, supplementation of Se-yeast to the poultry diet at the dose rate 0.30 mg/kg improved the growth performance and guts microbial health, and enhanced the immunity of poultry birds.

The Morphology of Nasal Polyps in Different Age Groups: Histopathological Features.

Nasal polyps (NPs) represent the end-stage manifestation of chronic rhinosinusitis (CRS), a relatively common pathological condition encountered in all ages of life. The aim of our study was to evaluate the histological features and inflammatory cellular components of NPs in a retrospective cohort (143 cases) of pediatric, adult and elderly populations in order to discuss the possible morphological age-related differences statistically documented. In the pediatric group, the inflammatory infiltrate presented many eosinophils mixed with lymphocytes, while in the adult population, lymphocytes and plasma cells were mainly evident, frequently with a perivascular distribution or with the formation of subepithelial lymphoid nodules. In the elderly population, inflammation was less evident and was associated with cavernous-like angecthatic structures with thrombotic stratification. Nearly all morphological findings exhibited statistically significant values among differently aged subgroups. Our results support the presence of histological specificities of NPs at different ages of life, providing new insight into the etiopathogenesis of NPs. The future role of biological therapies, mainly in cases refractory to already available standard medical and surgical treatments, may be analyzed by a prospective study using a larger cohort with a long-term evaluation also in relation to a possible relapse.

Determination of the Lymphadenopathy in Child Care

The majority of the time, swollen lymph nodes are a sign that your body is battling a virus or bacterial infection. Immune cells, viruses or bacteria, and fluid fill the nodes, increasing their size. Rarely, other, graver diseases can also result in swollen lymph nodes. Lymphadenopathy is fairly typical. Typically, it is not clinically significant in and of itself. However, it might indicate a serious underlying illness. For clinicians, the challenge is to avoid aggressive examination and biopsy of the majority of children while providing prompt, accurate for kids with serious underlying diseases. Lymphadenopathy is the term for swollen glands or swelling of the lymph nodes. The lymph glands are part of the immune system and help fight infections and other disease. They are enlarged when the body is fighting infection or other diseases. In children its to be able to feel some lymph nodes small, movable lumps under the skin. But if the nodes get bigger than usual, your child may have an infection or other problem. In most cases, lymphadenitis clears up quickly with proper treatment but it may take more time for lymph nodes swelling to go away. Be sure to let your healthcare provider know if your lymphadenitis symptoms come back. The most common treatment for swollen lymph nodes caused by a bacterial infection is antibiotics.

Formation of recurring transient Ca2+-based intercellular communities during Drosophila hematopoiesis

Tissue development occurs through a complex interplay between many individual cells. Yet, the fundamental question of how collective tissue behavior emerges from heterogeneous and noisy information processing and transfer at the single-cell level remains unknown. Here, we reveal that tissue scale signaling regulation can arise from local gap-junction mediated cell-cell signaling through the spatiotemporal establishment of an intermediate-scale of transient multicellular communication communities over the course of tissue development. We demonstrated this intermediate scale of emergent signaling using Ca2+ signaling in the intact, ex vivo cultured, live developing Drosophila hematopoietic organ, the lymph gland. Recurrent activation of these transient signaling communities defined self-organized signaling "hotspots" that gradually formed over the course of larva development. These hotspots receive and transmit information to facilitate repetitive interactions with nonhotspot neighbors. Overall, this work bridges the scales between single-cell and emergent group behavior providing key mechanistic insight into how cells establish tissue-scale communication networks.

A Systematic Review and Meta-Analysis of 29 Studies Predicting Diagnostic Accuracy of CT, MRI, PET, and USG in Detecting Extracapsular Spread in Head and Neck Cancers.

Extracapsular spread (ECS) is the extension of cancer cells beyond the lymph node capsule and is a significant prognostic factor in head and neck cancers. This meta-analysis compared the diagnostic accuracy of CT, MRI, PET, and USG in detecting ECS in head and neck cancers. The authors conducted a systematic review and meta-analysis of studies that compared the diagnostic accuracy of CT, MRI, PET, and USG in detecting ECS in head and neck cancers. They included studies that were published between 1990 and December 2023 and that used histopathology as the reference standard for ECS. The pooled sensitivity and specificity of CT scan were 0.63 (95% CI = 0.53-0.73) and 0.85 (95% CI = 0.74-0.91), respectively. The pooled sensitivity and specificity of MRI were 0.83 (95% CI = 0.71-0.90) and 0.85 (95% CI = 0.73-0.92), respectively. The pooled sensitivity and specificity of PET were 0.80 (95% CI = 0.74-0.85) and 0.93 (95% CI = 0.92-0.94), respectively. The pooled sensitivity and specificity of USG were 0.80 (95% CI = 0.68-0.88) and 0.84 (95% CI = 0.74-0.91), respectively. MRI had significantly higher sensitivity than CT scan (p-0.05). The specificity of CT and MRI was not significantly different (p-0.99). PET scan had the highest specificity among all imaging modalities. MRI is the most accurate imaging modality for detecting ECS in head and neck cancers. CT scan is a reasonable alternative, but PET scan may be considered when high specificity is required. USG may not add any further benefit in detecting ECS.

Diffuse large B-cell lymphoma with DNA copy number changes in a Japanese black calf

A 2-month-old Japanese Black calf exhibited mandibular and superficial cervical lymph node swelling. Fine needle aspiration cytology of the superficial cervical lymph node revealed large lymphoblast-like cells with mitoses. Hematological examination revealed remarkable lymphocytosis with atypical lymphocytes. Increased activities of serum total lactate dehydrogenase and thymidine kinase were detected. At necropsy, generalized swelling of lymph nodes was observed. Histopathological analysis revealed diffuse proliferation of medium-sized round centroblastic neoplastic cells that were positive for CD20, CD79α, PAX5, and BLA-36, and negative for CD3, CD5, CD10, and CD34. The calf was diagnosed with centroblastic diffuse large B-cell lymphoma (DLBCL) based on these findings. Analysis of DNA copy number variation revealed an increased copy number for the GIMAP family relative to that in healthy cattle. Moreover, decreases in copy numbers of GBP-1, MIR3141, OR5P1E, and PTPRG relative to those in healthy cattle were also observed. Because DNA copy number variation represent a major contribution to the somatic mutation landscapes in human tumors, these findings suggest that DNA copy number changes might have contributed to the onset of DLBCL in the present case.

171 Not Just a Matter of Retained Embryonic Spinal Cord: Histopathology of the Filum Terminale in Tethered Cord Syndrome

INTRODUCTION: We present a large consecutive series of patients with tethered cord syndrome who underwent resection of the filum terminale (FT) and the histopathologic findings as analyzed by the neuropathologists. METHODS: FT specimens obtained from a consecutive series of 288 pediatric and adult patients that underwent spinal cord releases performed at a single academic institution from 2013-2021 were analyzed retrospectively (IRB #787945). Hematoxylin and eosin (HE) and immunohistochemistry staining was performed to study the spectrum of cells known to reside in connective tissues. RESULTS: The most common structures included peripheral nerves (97.6%), ependymal cells (70.8%), ganglion cells (38.5%), and neuropil (15.3%). Cases with excess ependymal cells were associated with ependymal canals (5.9%), ependymal cysts (3.1%), and one case with extensive ependymal “proliferation” (0.3%). With regards to the inflammatory cellular findings, eleven specimens (3.8%) contained scattered or accumulated lymphocytes, macrophages, mast cells, macrophage-derived giant cells, and a secondary lymph follicle in one patient. 36 patients (12.5%) had increased vascularity with enlarged capillaries. Nine patients (3.1%) had an associated type of vascular malformation. A group of specimens included dystrophic calcification within the FT (7.6%). CONCLUSIONS: Both vascular and inflammatory changes along with calcifications have been overlooked as possible associated histologic secondary to mechanical stress on the FT. Additionally, vascular anomalies could alter the filum’s mechanical properties due to venous congestion.

Cellular Immunity of Drosophila willistoni Reveals Novel Complexity in Insect Anti-Parasitoid Defense.

Coevolution of hosts and their parasites has shaped heterogeneity of effector hemocyte types, providing immune defense reactions with variable effectiveness. In this work, we characterize hemocytes of Drosophila willistoni, a species that has evolved a cellular immune system with extensive variation and a high degree of plasticity. Monoclonal antibodies were raised and used in indirect immunofluorescence experiments to characterize hemocyte subpopulations, follow their functional features and differentiation. Pagocytosis and parasitization assays were used to determine the functional characteristics of hemocyte types. Samples were visualized using confocal and epifluorescence microscopy. We identified a new multinucleated giant hemocyte (MGH) type, which differentiates in the course of the cellular immune response to parasitoids. These cells differentiate in the circulation through nuclear division and cell fusion, and can also be derived from the central hematopoietic organ, the lymph gland. They have a binary function as they take up bacteria by phagocytosis and are involved in the encapsulation and elimination of the parasitoid. Here, we show that, in response to large foreign particles, such as parasitoids, MGHs differentiate, have a binary function and contribute to a highly effective cellular immune response, similar to the foreign body giant cells of vertebrates.

Ditch the stains and the microscope: Clues in an unstained lymph node cytology smear observed with the ×1 objective.

Ditch the stains and the microscope: Clues in an unstained lymph node cytology smear observed with the ×1 objective.

Abstract 3977: Neoadjuvant chemotherapy and radiation shape the local and regional adaptive antitumor immune response in lung squamous cell carcinomas

Abstract Chemotherapy (CT) and radiotherapy (RT) are known for their stimulating as well as inhibiting effects on the anti-tumor immune response. This study aimed to understand how CT and RT change the local immune microenvironment of the tumor and the regional immune response in draining lymph nodes. Evaluations were performed on lung squamous cell carcinomas (LUSC) with a special focus on tertiary lymphoid structures (TLS) and lymph follicles. A cohort of 21 untreated LUSC (naiveLUSC) and 21 matched neoadjuvantly treated LUSC (neoLUSC) was compiled. Digitized H&amp;E whole slide images of the tumor and of two representative probes of a proximal and distal lymph node were assessed. A pathologist blinded to the groups assigned tumors to one of three immunophenotypes (inflamed, excluded, desert) by visual analysis. Tertiary lymphoid structures (TLS) in the tumor area and lymph follicles in the regional lymph nodes were counted and characterized according to their maturation status (with/without germinal center). RNAseq analyses were performed for a subset of tumors. NeoLUSC tended to more frequently have a desert immune phenotype (6/21 versus 1/21, p=0.0931). The mean number of TLS was significantly reduced in neoLUSC compared to naiveLUSC (4 versus 9, p=0.0179). Additionally, neoLUSC had a significantly lower likelihood for the presence of mature TLS with germinal centers (3/21 versus 9/21, p=0.0327). While the mean number of lymph follicles in regional lymph nodes was comparable between neoLUSC and naiveLUSC, neoLUSC had a significantly reduced number of mature lymph follicles (20% versus 41% of lymph follicles, p=0.0376) in distant lymph nodes and showed a similar, but less pronounced trend in proximal lymph nodes. In general, the amount of TLS correlated with the amount of lymph follicles in naiveLUSC patients (p=0.0154), but not in neoLUSC patients. Across the complete cohort, long-term survivors (&amp;gt;2 years) tended to have higher numbers of lymph follicles in lymph nodes than short term survivors (1.6 versus 1.1 lymph follicles/mm2, p=0.0805). RNAseq analysis revealed a significant upregulation of inflammatory gene sets and downregulation of cell cycle associated gene sets in neoLUSC as compared to naiveLUSC. This study demonstrates that CT and RT are potent, but multimodal influencers of the local tumor immune microenvironment as well as the regional immune response of the draining lymph nodes. While gene expression results underline the inflammation promoting effect of CT and RT, histological evaluations suggest that CT and RT negatively affect the adaptive anti-tumor immune response by reducing the development and maturation of TLS and lymph follicles in the lymph nodes. Next steps include an artificial intelligence based cell characterization and spatial evaluation of the tumor immune microenvironment to further unveil functional changes induced by CT and RT. Citation Format: Rosemarie Krupar, Justin Nieder, Johannes Braegelmann, Mareike Haarmann, Torsten Goldmann, Sharon Ruane, Timo Milbich, Cornelius Boehm, Lukas Ruff, Julika Ribbat-Idel, Christian Watermann, Sven Perner, Christiane Kuempers. Neoadjuvant chemotherapy and radiation shape the local and regional adaptive antitumor immune response in lung squamous cell carcinomas [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3977.

S-nitrosylation-triggered unfolded protein response maintains hematopoietic progenitors in Drosophila

The Drosophila lymph gland houses blood progenitors that give rise to myeloid-like blood cells. Initially, blood progenitors proliferate, but later, they become quiescent to maintain multipotency before differentiation. Despite the identification of various factors involved in multipotency maintenance, the cellular mechanism controlling blood progenitor quiescence remains elusive. Here, we identify the expression of nitric oxide synthase in blood progenitors, generating nitric oxide for post-translational S-nitrosylation of protein cysteine residues. S-nitrosylation activates the Ire1-Xbp1-mediated unfolded protein response, leading to G2 cell-cyclearrest. Specifically, we identify the epidermal growth factor receptor as a target of S-nitrosylation, resulting in its retention within the endoplasmic reticulum and blockade of its receptor function. Overall, our findings highlight developmentally programmed S-nitrosylation as a critical mechanism that induces protein quality control in blood progenitors, maintaining their undifferentiated state by inhibiting cell-cycle progression and rendering them unresponsive to paracrine factors.

Histopathological changes in the spleen of rats exposed to N,N-dimethylhydrazine with the following protective input of Au/Ag/Fe

Colon cancer is one of the leading causes of cancer-related deaths worldwide. Despite the growing number of studies on nanoparticles of different metals, there is still a lack of reliable information about their ability to work together as a composition and their antitumor effects. It has been established that the regulation of genes encoding proteins of the Bcl-2 family changes in cancer. Bcl-2 family proteins can be a potential target in cancer diagnosis and have a prognostic value in treating cancer with chemotherapeutic drugs. The tumor microenvironment includes myeloid suppressor cells, tumor-associated neutrophils, and tumor-associated macrophages that promote cancer progression and are derived from splenic hematopoietic stem cells and progenitor cells. The work aimed to ascertain histological changes and expression of Bcl-2 family proteins in the spleen of rats with N,N-dimethylhydrazine-induced carcinogenesis followed by the protective administration of Au/Ag/Fe nanometal composition. The study was conducted on 72 outbred white male rats. Colon adenocarcinoma was modelled by N,N-dimethylhydrazine hydrochloride administration for 30 weeks. Animals received an aqueous dispersion of Au/Ag/Fe nanoparticles intragastrically once a day for 21 days at a dose of 0.842 mg Ag/0.0526 mg Fe/1.625 μg Au per 1 kg of rat body weight. Paraffin sections of the spleen were stained with hematoxylin and eosin. For immunohistochemical analysis, sections were stained with rabbit monoclonal antibodies to Bcl-2. Under conditions of 30-week exposure to N,N-dimethylhydrazine hydrochloride, blood circulation disorders, stasis, thrombosis, reduction in the size of white pulp lymphatic nodules and loss of their zonation were histologically proved in the rat's spleen. The development of sclerotic processes in the organ was noted. It was indicated that using metal nanoparticles under N,N-dimethylhydrazine hydrochloride-induced colon carcinogenesis leads to less evidenced morphological manifestations of structural changes in the spleen. Immunohistochemically, the expression of Bcl-2 protein in the white pulp of the spleen of animals subjected to correction was lower than in animals without the corrective effect of the composition of nanoparticle metals. Administration of the Au/Ag/Fe metal nanoparticle composition to intact white rats does not cause pathological changes in the spleen morphology. The structural components of the red and white pulp match the typical histological structure of the organ.

Spleen white pulp structural and cellular composition in experimental furosemide-­induced hypomagnesemia

Relevance. Magnesium deficiency in the blood (hypomagnesemia) is due to many reasons, among which loop diuretics (furosemide) occupy acertain place. The role of the spleen in this process has not been determined. The aim of the work was to elucidate the effect of furosemide-­induced hypomagnesemia on the immune structures of the white pulp of rat spleen. Materials and Methods. Furosemide (Lasix® Aventis Pharma Ltd, India) was injected daily intraperitoneally at adose of 30 mg/kg to the experimental group of white outbred rats for 6 days, animals of the control group received an injection of 0.9% NaCl. Investigated: blood serum for the content of magnesium, calcium, sodium and iron; serial sections of the white pulp of the spleen after staining with hematoxylin and eosin to assess the structure and azure-­II-eosin to assess the cellular composition. With amicroscope magnification of 280 times, the ratio (in%) of primary (PLNS) and secondary lymphoid nodules of the spleen (SLNS) was calculated, the following were measured (µm): the diameter of the germinal center (GC), the width of the mantle and marginal zone, the diameter of the periarteriolar lymphoid sheath (PALS). In GC, the peripheral zone of lymphoid nodules, PALS at amagnification of 1500 times per field of view (100 μm2) was counted and presented as apercentage of the number of lymphocytes; macrophages; cells, mitotic and apoptotic elements. Morphometric analysis was carried out using Image ProPlus6.0 software (Media Cybernetics, USA). Statistical processing was carried out using the Statistica 10.0 software package with the determination of the arithmetic mean (M) and its error (m). Results and Discussion. The administration of furosemide led to adecrease in magnesium in the blood serum by 1.6 times (p0.05). In the white pulp of the spleen of animals of the experimental group, the proportion of SLNS decreased by 18.14%, the number of SLNS increased by 42.5% (p0.05). The diameter of SLNS increased insignificantly, the diameter of GC and the width of the marginal zone significantly increased by 27.1 and 24.8%, respectively. The proportion of macrophages increased by 20.6% in GC SLNS, and by 17.0% in PALS. The highest increase in the proportion of cells with signs of apoptosis was found in the periarteriolar lymphoid sheath of experimental animals - 34.6% (p0.05). Conclusion. Furosemide loading causes the development of dyselementosis, with the most significant loss of magnesium (hypomagnesemia) and has apronounced effect on the immune parameters of the spleen, represented by white pulp structures. Therefore, correction of the elemental status and monitoring of the state of the spleen in hypomagnesemia caused by the use of loop diuretics is anecessary element in the prevention of complications associated with the use of diuretic drugs.

Subcapsular sinus macrophages maximize germinal center development in non-draining lymph nodes during blood-borne viral infection.

Lymph node (LN) germinal centers (GCs) are critical sites for B cell activation and differentiation. GCs develop after specialized CD169+ macrophages residing in LN sinuses filter antigens (Ags) from the lymph and relay these Ags into proximal B cell follicles. Many viruses, however, first reach LNs through the blood during viremia (virus in the blood), rather than through lymph drainage from infected tissue. How LNs capture viral Ag from the blood to allow GC development is not known. Here, we followed Zika virus (ZIKV) dissemination in mice and subsequent GC formation in both infected tissue-draining and non-draining LNs. From the footpad, ZIKV initially disseminated through two LN chains, infecting LN macrophages and leading to GC formation. Despite rapid ZIKV viremia, non-draining LNs were not infected for several days. Non-draining LN infection correlated with virus-induced vascular leakage and neutralization of permeability reduced LN macrophage attrition. Depletion of non-draining LN macrophages significantly decreased GC B cells in these nodes. Thus, although LNs inefficiently captured viral Ag directly from the blood, GC formation in non-draining LNs proceeded similarly to draining LNs through LN sinus CD169+ macrophages. Together, our findings reveal a conserved pathway allowing LN macrophages to activate antiviral B cells in LNs distal from infected tissue after blood-borne viral infection.

270 Radiologic diagnosis of Extranodal Extension (ENE) in patients with HPV-positive oropharyngeal cancer: consensus diagnosis and influence on prognosis

Tumor often progresses through the weakest part of any surrounding tissues. The extent of tumor invasion depends on: a. Aggressiveness of the tumor cells (e.g. number and invasive character of stem cells), b. robustness of the surrounding tissues and their composition (e.g. vessels), and c. time to allow the tumor to proliferate. The lymph node (LN) capsule comprises dense connective tissue stroma and collagenous fibers, and is a natural barrier that generally prevents further tumor progression. Permeation of tumor through the nodal capsule into surrounding tissues is termed “extranodal extension”. The idiosyncratic and inconsistent mechanism of ENE is imprecisely understood, but it is thought to be due to either tumor cell proliferation that outpaces the capacity of nodal capsular expansion (“ruptures” the LN capsule), or factors within the tumor or tumor microenvironment that facilitate the “breach” of the capsule. The latter might explain ENE in small LNs, or a “neglected” tumor (lengthy intranodal tumor growth with eventual “rupture” through an expanded nodal capsule). Several biomarkers (e.g. podoplanin) that are often associated with tumor aggressiveness have been reported to have a high expression in ENE+ LN. ENE represents a spectrum of tumor nodal invasion. The early sign of ENE can only be visible under the microscope (pathologic ENE); when ENE progresses further, the radiographic signal changes become apparent, making it visible on imaging (iENE). Most advanced ENE causes emergence of clinical surrogates (e.g. peau d'orange, or a “fixed” nodal mass), rendering it detectable by regular clinical examination (ENEc). iENE has been reported to be one of the strongest anatomic prognostic factors for overall survival (mainly due to increased risk of distant metastasis) in HPV-positive oropharyngeal carcinoma (HPV+ OPC), and is able to identify a subgroup of stage I disease with poor prognosis. Several deintensification trials (NRG-HN002, ORATOR, ORATOR2, E3311) have excluded HPV+ OPC with some form of iENE from trial enrolment. Several authors have proposed that iENE be included in future clinical N classification for HPV+ OPC. However, adoption of iENE in clinical care remains challenging because it is not a well-defined radiologic feature among the radiology community. Various definitions / descriptions of iENE have been used in literature. There is also insufficient awareness of the prognostic importance of this parameter in head and neck oncology community. The international iENE Expert Panel was convened under the HNCIG comprised expert internationally renowned neuroradiologists and clinicians. Several rounds of Delphi process were conducted to consolidate iENE definition. The consensus recommendations on the terminology and diagnostic criteria for iENE were generated. The experts in the consensus process recognized the following as criteria for the diagnosis of iENE: clear evidence of irregular or indistinct nodal margin/border; extension into perinodal fat; extension into adjacent structures, and conglomerate/matted/coalescent nodes. These recommendations have been endorsed by 19 national organisations, representing 34 countries. With increased awareness and consolidated definition as well as training, iENE could become an important baseline factor for risk stratification and staging in HPV+ OPC.

IL-12-Overexpressed Nanoparticles Suppress the Proliferation of Melanoma Through Inducing ICD and Activating DC, CD8+ T, and CD4+ T Cells.

The drug resistance and low response rates of immunotherapy limit its application. This study aimed to construct a new nanoparticle (CaCO3-polydopamine-polyethylenimine, CPP) to effectively deliver interleukin-12 (IL-12) and suppress cancer progress through immunotherapy. The size distribution of CPP and its zeta potential were measured using a Malvern Zetasizer Nano-ZS90. The morphology and electrophoresis tentative delay of CPP were analyzed using a JEM-1400 transmission electron microscope and an ultraviolet spectrophotometer, respectively. Cell proliferation was analyzed by MTT assay. Proteins were analyzed by Western blot. IL-12 and HMGB1 levels were estimated by ELISA kits. Live/dead staining assay was performed using a Calcein-AM/PI kit. ATP production was detected using an ATP assay kit. The xenografts in vivo were estimated in C57BL/6 mice. The levels of CD80+/CD86+, CD3+/CD4+ and CD3+/CD8+ were analyzed by flow cytometry. CPP could effectively express EGFP or IL-12 and increase ROS levels. Laser treatment promoted CPP-IL-12 induced the number of dead or apoptotic cell. CPP-IL-12 and laser could further enhance CALR levels and extracellular HMGB1 levels and decrease intracellular HMGB1 and ATP levels, indicating that it may induce immunogenic cell death (ICD). The tumors and weights of xenografts in CPP-IL-12 or laser-treated mice were significantly reduced than in controls. The IL-12 expression, the CD80+/CD86+ expression of DC from lymph glands, and the number of CD3+/CD8+T or CD3+/CD4+T cells from the spleen increased in CPP-IL-12-treated or laser-treated xenografts compared with controls. The levels of granzyme B, IFN-γ, and TNF-α in the serum of CPP-IL-12-treated mice increased. Interestingly, CPP-IL-12 treatment in local xenografts in the back of mice could effectively inhibit the growth of the distant untreated tumor. The novel CPP-IL-12 could overexpress IL-12 in melanoma cells and achieve immunotherapy to melanoma through inducing ICD, activating CD4+ T cell, and enhancing the function of tumor-reactive CD8+ T cells.