Lymphoid Hyperplasia Research Articles

First report of primary tonsillar salivary gland adenocarcinoma in a dog

AbstractA 9‐year‐old, female, spayed, mixed breed dog was presented for diagnosis of adenocarcinoma of the minor salivary glands of the right tonsil by histopathology. A whole‐body computed tomography scan showed no detectable abnormalities in the major salivary glands. No pulmonary metastasis or lymphadenopathy was noted. An anaesthetised oropharyngeal examination revealed an erythematous and irregular broad‐base mass in the right tonsil, and an erythematous and slightly irregular nodular area in the contralateral tonsil. Bilateral excisional biopsies of the tonsils via tonsillectomies were performed for definitive diagnosis. Histopathology of the right tonsillar mass was consistent with an incompletely excised adenocarcinoma of the minor salivary gland, and reactive lymphoid hyperplasia of the contralateral tonsil. Based on this case report, it is important to consider salivary adenocarcinoma as a differential diagnosis for primary tonsillar tumour, as there are lobules of salivary glands in normal canine tonsils.

Pulmonary toxicity associated with high-dose favipiravir and treatment options: biochemical and histopathological evaluation.

Favipiravir is a broad-spectrum antiviral drug that is a viral RNA-dependent RNA polymerase inhibitor. Favipiravir is used in high doses to treat COVID-19 but has a side effect on humans at high doses. The side effects of favipiravir have been associated with oxidative stress in the literature. In this trial, we investigated the biochemical and histopathological effects of lacidip-ine, thiamine pyrophosphate (TTP), and adenosine triphosphate (ATP), drugs with antioxidant properties, on the lung toxicity caused by high-dose favipiravir in rats. The rats were classified into five groups: healthy (HG), favipiravir alone (Fav), lacidipine+favipiravir (LFav), TPP+favipiravir (TFav), and ATP+favipiravir (AFav). Favipiravir (800 mg/kg) was administered twice daily for seven days. Laci-dipine (4 mg/kg), TPP (20 mg/kg), and ATP (25 mg/kg) were administered once daily for seven days. Oxidant (malondialdehyde), non-enzymatic (total glutathi-one), and enzymatic (superoxide dismutase and catalase) antioxidant levels were measured in the excised lung tissues. Furthermore, the tissues were histopatho-logically examined. The systemic administration of high doses of favipiravir in-creased oxidant levels and decreased antioxidant levels in the lung tissue of rats. In parallel, the histopathological examination of the lung tissue revealed the presence of severe mononuclear cell infiltrations in interstitial areas and pronounced lymphoid hyperplasia. Lacidipine exhibited superior efficacy in mit-igating oxidative stress and preventing the decline of antioxidants induced by favipiravir compared with TPP and ATP. Histopathologically, the lacidipine admin-istration significantly reduced lung oxidative damage. TTP moderately reduced severe favipiravir-associated lung injury. However, ATP was ineffective against fa-vipiravir-associated lung injury. Lacidipine offers more therapeutic benefits than TPP in treating oxidative lung injury caused by high doses of favipiravir.

Granulomatous pneumonia due to metastrongylus species associated with <i>Mycoplasma hyopneumoniae</i> and <i>Pasteurella multocida</i> in slaughtered pigs

Pneumonia has been identified as one of the limiting factors to pig production. Some of the pneumonia-inducing agents include Mycoplasma hyopneumoniae (MHYO), the primary cause of enzootic pneumonia and Metastrongylus species. which are widely distributed lungworms commonly found in indigenous free-range pigs. This paper describes the pathological findings of 6 cases out of 204 lungs randomly collected from slaughtered pigs in Southwest Nigeria. Samples of the lungs were collected from the cases for bacterial culture, histopathology and detection of MHYO antigens using immunohistochemisty. Gross lesions were severe acute lobular bronchopneumonia (104/204, 50.98%) and greyish discrete nodules in the lungs. Microscopically, there were varying degrees of lymphoid hyperplasia of bronchial-associated lymphoid tissue (BALT) (82.2%), suppurative bronchiolitis with widespread bronchiolar epithelial cells necrosis (57.4%) and granulomatous bronchopneumonia with presence of Metastrongylus spp. and bronchiolar intraluminal cellular exudate consisting predominantly of eosinophils (2.9%). Pasteurella multocida was the most isolated bacterial pathogen (49.0%) either as a single pathogen or in combination with other pathogens from the infected lung samples. Immunohistochemical labelling showed strong MHYO antigens on the surface of bronchial epithelial cells in infected lungs (86/204). This is the first report of granulomatous bronchopneumonia due to Metastrongylus spp. associated with a co-infection of MHYO and Pasteurella multocida in Nigerian indigenous pigs. It is suggested that metastrongylosis may be more common than reported in this study. The detection of respiratory pathogens such as Mycoplasma. hyopneumoniae, Metasrongylusspp. and Pasteurella multocida suggest that they are potential contributors to bronchopneumonia observed in this study.

Retroperitoneal Castleman’s disease in a young Nepalese girl: A rare cause of childhood abdominal mass

Introduction: Castleman’s disease (CD), or benign angio-follicular lymph node hyperplasia, is an uncommon condition in childhood. When a child presents with a huge retroperitoneal mass and inconclusive findings on clinico-radiological evaluation or tissue sampling, management becomes exceedingly difficult. CD herein becomes an uncommon presentation of an uncommon diagnosis. Case presentation: A six-year-old girl with no past medical problems presented to the office with a slowly progressive, painless mass over the right lumbar region for a year. Abdominal ultrasound showed a well-defined oval mass in the right periumbilical region, further evaluation of which with a computed tomography scan suggested lymphoma. A preoperative core-cut biopsy could not confirm the findings and suggested a neoplastic lesion, probably an inflammatory myofibroblastic tumour or small round cell tumour. She underwent an exploratory laparotomy with in-toto excision of the mass. Intraoperatively, a solid retroperitoneal tumour measuring 8×8×6 cm was found. Histopathology and immunohistochemistry confirmed a unicentric CD of the hyaline-vascular type. At two years of follow-up, she remained asymptomatic and disease-free. Conclusion: While CD in children is rare, retroperitoneal localization of the same can further add to the diagnostic conundrum. However, if carefully considered, an en-bloc surgical resection offers complete treatment.

Localised reactive lymphoid hyperplasia (LLH) of the spleen: a rare benign condition simulating lymphoma

Localised reactive lymphoid hyperplasia (LLH) of the spleen: a rare benign condition simulating lymphoma

A rare case of unilateral lymphoid papillary hyperplasia of tonsil in a nine-year-old girl

We report a rare case of lymphoid papillary hyperplasia of palatine tonsil in a 9-year-old girl. It is a rare benign pathology characterised by papillomatous appearance of palatine tonsil with reactive lymphoid hyperplasia. Early recognition of this lesion is important because in spite of clinical feature being suggestive of malignant tumour, it is a benign tumour-like proliferation, that can easily be cured by tonsillectomy.

P939 Ozanimod-Exposed Patients with Ulcerative Colitis Undergoing Total Colectomy Exhibit Unique Histologic Changes in Lymph Nodes

Abstract Background Ozanimod regulates lymphocyte egress from the spleen and lymph nodes into the systemic circulation. The histologic changes which occur in the lymph nodes of patients on these therapies is unknown. We describe histologic changes in lymph nodes from patients with UC who were treated with ozanimod and underwent subsequent colectomy due to treatment-refractory disease. Methods This retrospective study included patients with UC undergoing total colectomy for treatment-refractory disease who were treated with ozanimod within the 2 months prior to colectomy and a cohort of patients with UC undergoing colectomy who did not have ozanimod exposure. Histology of the lymph nodes from the mesentery of colectomy specimens were reviewed blindly by a hematophatologist (JXC) and an expert GI pathologist (CRW). Histopathological parameters were scored and demographic and clinical data were recorded. Results Of forty-five patients treated with ozanimod at our center, 6 (13%) required surgery for treatment-refractory disease. Colectomy specimen data were available for 5 patients (1 patient had surgery at an outside center). Lymph node specimens from 6 control patients with UC who had colectomy were also examined. Demographic and clinical data are summarized in Table 1. The duration of ozanimod therapy prior to surgery ranged from 6 to 24 weeks. Lymph nodes from patients treated with ozanimod had significantly greater extent of sinus dilatation than control patients (1.5 vs 0.67, p=0.022), they also had significantly more sinus histiocytosis (2.67 vs 1.67, p=0.03) (Figure 1). There was a tendency towards more Castleman-like angiotrophic hyperplasia (1.5 vs 1, p=0.34), plasma cell infiltration (1.5 vs 0.67, p=0.26) and subcortical interfollicular expansion (1.5 vs 0.83, p=0.1) in ozanimod treated patients. Patients treated with ozanimod and controls showed similar amounts of monomorphic lymphoid cells (1.3 vs 1.5, p=0.7), follicular hyperplasia (1 vs 1.1, p=0.8) and vascular proliferation (1.5 vs 1.5, p=1). Conclusion This study identifies unique histologic changes in the lymph nodes of patients with UC treated with ozanimod. These changes could be in keeping with the known mechanism of action of ozanimod and suggests that other inflammatory pathways were driving their disease activity in these patients. The significance of the changes, particularly the Castleman-like features, needs to be further investigated. Table 1: Demographic and clinical data of patients treated with ozanimod and control patients Figure 1: Representative images of lymph nodes from patients with UC treated with ozanimod and control patients showing significant sinus dilatation in patients receiving ozanimod

Trans-replicase helper activity of porcine circoviruses promotes the synergistic replication of torque teno virus.

While the primary pathogenic potential of torque teno viruses (TTVs) is yet to be defined, TTVs are often co-detected with other pathogens and are suspected of exacerbating clinical disease in coinfections. Swine TTVs (TTSuVs) enhance clinical signs of porcine circovirus type 2 (PCV2) in a gnotobiotic pig model. However, the mechanisms involved are unknown. In this study, we observed that co-culture of TTSuV1 and PCV1, and specifically supplementing TTSuV1 cultures with the PCV replicase protein in trans consistently resulted in higher levels of replication of TTSuV1 when compared to TTSuV1 cultured alone. Therefore, the hypothesis that the PCV replicase (rep) protein has trans-replicase helper activity for TTSuV1 was examined. Based on EMSA and reporter gene assays, it was determined that the PCV1 rep directly interacted with the TTSuV1 UTR. The TTSuV1 rep trans-complemented a PCV rep null mutant virus, indicating that the TTSuV1 and PCV1 replicase proteins supported the replication of both viruses. In mice, the administration of plasmids encoding the PCV1 rep and a TTSuV1 infectious clone resulted in the production of higher TTSuV1 genome copies in dually exposed mice when compared to singly exposed mice. Higher sero-conversion and lymphoid hyperplasia were also observed in the dually exposed experimental mice. Thus, this study provides evidence for trans-replicase activity of PCVs and TTVs as a novel mechanism of explaining enhanced viral replication in coinfections involving both viruses.

Influence of Splenomegaly and Splenectomy on the Immune Cell Profile of Patients with Common Variable Immunodeficiency Disease.

About 25% of patients with common variable immunodeficiency disease (CVID) have splenomegaly, necessitating sometimes splenectomy whom consequences on the immunological profile of CVID patients have never been studied. We analyzed 11 CVID patients' comprehensive blood immune cell phenotypes pre- and post-splenectomy. Flow cytometry analyses of immune cell populations. Among 89 CVID cohort patients, 41 with splenomegaly, splenomegaly was strongly associated with granulomatous disease, autoimmune disorders, lymphoid hyperplasia, and/or portal hypertension. CVID patients with splenomegaly have significant peripheral lymphopenia (p = 0.001), and significantly fewer peripheral class-switched memory B cells (smBs) (p = 0.001), CD4+ T lymphocytes (p = 0.001), NK (p = 0.0001) and dendritic cells (p ≤ 0.01), and significantly more circulating CD4+ and CD8+ (p = 0.00001) T cell subset activation (p = 0.00005), than CVID patients without splenomegaly. Examination of splenectomy impact on circulating lymphocyte subset distributions demonstrated the drastically enhanced total circulating lymphocyte count post-splenectomy, predominantly B lymphocytes and CD8+ T cells. However, splenectomy did not change B cell distribution, with smBs remaining persistently low, in contrast to complete inversion of the circulating T cell composition, with reversal of the CD4+/CD8+ ratio suggesting that amplification of the CD8+ T cell compartment is a CVID characteristic in patients with splenomegaly. Our results highlight this CD8+ amplification in CVID-splenomegaly patients that might be explained by a homing effect to the spleen and/or possible chronic virus replication, which in turn could induce T cell expansions. Splenectomizing CVID patients with splenomegaly restores the absolute circulating lymphocyte count, suggesting that the decreased T cell count in the presence of splenomegaly cannot be used as an exclusive criterion for combined immunodeficiency.

Immunohistochemical Examination of TNF-α and SAA Expressions in Goats Infected with Mycobacterium avium subspecies paratuberculosis

Paratuberculosis (Johne Disease), caused by Mycobacterium avium subspecies paratuberculosis (MAP) and commonly seen in ruminants, is a contagious disease that causes chronic diarrhea and serious economic losses. In this study, the presence of pro-inflammatory cytokine and acute phase protein expressions in lesional tissues of naturally infected goats with MAP was investigated. For this purpose, paratuberculosis suspected goats complaining of chronic diarrhea and excessive weight loss were examined by ELISA method for Mycobacterium avium subspecies paratuberculosis infection. After sacrificing 20 animals found to be infected with MAP, tissue samples taken from the intestines and lymph nodes were stained with Hematoxylin-Eosin (HE) for histopathological examination and Ziehl-Nelsen (ZN) to show acid-fast mycobacterium. Immunohistochemical staining was performed to examine the expressions of TNF-α as a pro-inflammatory cytokine and SAA as an acute phase protein. Macroscopic examination revealed in serous fat atrophy, mesenteric lymphadenitis, and granulomatous enteritis in the intestines. Histopathological examination revealed atrophy in villi, degeneration of enterocytes, inflammatory cell infiltration consisting mostly of mononuclear leukocytes in the mucosa, and epithelioid macrophage aggregation. Lymphoid hyperplasia and epithelioid histocyst aggregates were found in the mesenterial lymph nodes. In staining with ZN revealed the presence of bright red acid-fast agents in the intestine and mesenteric lymph nodes. In immunohistochemical examination, TNF-α and SAA expressions were observed in all samples. With this study, for the first time, the expressions of TNF-α, a proinflammatory cytokine, and SAA, an acute phase protein, were shown in the lesional tissues of MAP-infected animals, contributing to the immunopathogenesis of the disease.

Frequent CDKN2B/P15 and DAPK1 methylation in duodenal follicular lymphoma is related to duodenal reactive lymphoid hyperplasia.

Duodenal type follicular lymphoma (DFL), a rare entity of follicular lymphoma (FL), is clinically indolent and is characterized by a low histological grade compared with nodal follicular lymphoma (NFL). Our previous reports revealed that DFL shares characteristics of both NFL and mucosa-associated lymphoid tissue (MALT) lymphoma in terms of clinical and biological aspects, suggesting its pathogenesis may involve antigenic stimulation. In contrast to NFL, the genomic methylation status of DFL is still challenging. Here, we determined the methylation profiles of DNAs from patients with DFL (n = 12), NFL (n = 10), duodenal reactive lymphoid hyperplasia (D-RLH) (n = 7), nodal reactive lymphoid hyperplasia (N-RLH) (n = 5), and duodenal samples from normal subjects (NDU) (n = 5) using methylation specific PCR of targets previously identified in MALT lymphoma (CDKN2B/P15, CDKN2A/P16, CDKN2C/P18, MGMT, hMLH-1, TP73, DAPK, HCAD). DAPK1 was frequently methylated in DFL (9/12; 75%), NFL (9/10; 90%), and D-RLH (5/7; 71%). CDKN2B/P15 sequences were methylated in six DFL samples and in only one NFL sample. Immunohistochemical analysis showed that p15 expression inversely correlated with methylation status. Genes encoding other cyclin-dependent kinase inhibitors (CDKN2A/P16, CDKN2C/P18) were not methylated in DFL samples. Methylation of the genes of interest was not detected in DNAs from D-RLH, except for DAPK1, and the difference in the extent of methylation between NDU and D-RLH was statistically significant (P = 0.013). Our results suggest that D-RLH serves as a reservoir for the development of DFL and that methylation of CDKN2B/P15 plays an important role in this process.

Lymphoma and Other Lymph Node Pathologies Among Adult Patients with Lymphadenopathy in Abakaliki, Nigeria.

Lymphadenopathy is usually due to benign or malignant conditions. It can also be local or systemic in distribution and can involve peripheral or deep-seated lymph nodes. This study aimed to determine the prevalence of lymphoma and the distribution pattern of lymph node pathologies among adult patients who presented with lymphadenopathy and its relationship with age and sex. A retrospective study was conducted, and a record of all cases of lymphadenopathy with histological diagnosis over 5-year period (January 2017 to December 2021) was extracted from Departments of Anatomical Pathology of Alex Ekwueme Federal University Teaching Hospital, Abakaliki. The data generated were analyzed using Statistical Package for Social Sciences (SPSS) software, version 26. One hundred and ninety results were extracted with an age range of 18 to 94 years and a mean age of 41 ± 16 years. They were made up of 75 (39.5%) males and 115 (60.5%) females, with a male-to-female ratio of 1:1.5. The prevalence of lymphoma was 50.0% (95/190). Thirty-five (18.4%) were Hodgkin's lymphoma (HL), while 60 (31.6%) were non-Hodgkin's lymphoma (NHL). Other pathologies manifested by cases of lymphadenopathy include metastatic tumor deposits (38 (20%)), reactive lymphoid hyperplasia (29 (15.3%)), and tuberculous lymphadenitis (18 (9.5%)). Others include sinus histiocytosis (4 (2.1%)), dermatopathic lymphadenitis (5 (2.6%)), and Castleman's disease (1 (0.5%)). About half of all patients who presented with lymphadenopathy were lymphoma with a high prevalence of 50%, and the majority were NHL. Other major causes of lymphadenopathy were metastatic tumor deposits, reactive lymphoid hyperplasia, and tuberculous lymphadenitis. Any case of lymphadenopathy should be properly investigated early for effective management.

Alterações patológicas em tonsilas palatinas de bubalinos (Bubalus bubalis)

ABSTRACT: This study evaluated palatine tonsils from 327 water buffaloes collected in a slaughterhouse located in the city of Belém, Pará State, Brazil, over four months (nine sample collecting visits). The overwhelming majority (84.71%) of these buffaloes came from Marajó Island, Pará State, Brazil. The main pathological findings were crypt dilatations/keratin cysts (96.0%, 314 cases), mild to moderate follicular lymphoid hyperplasia (93.0%, 304 cases), crypt abscesses (79.8%, 261 cases), tonsillar corpuscles (31.2%, 102 cases) and tuberculoid granulomas (1.53%, 5 cases). Acid-fast bacilli (AFB) were observed in 20% (1 out of 5 cases) of these granulomas. The study indicates that pathological evaluation of tonsils in buffaloes can provide details of structural features of the organ in the species and information on subclinical or asymptomatic tonsillitis.

Localized Lymphoid Hyperplasia of the Colon Mimicking Lymphoma in a Patient with Ulcerative Colitis

Localized Lymphoid Hyperplasia of the Colon Mimicking Lymphoma in a Patient with Ulcerative Colitis

Non-neoplastic B-cell predominant lymphoid proliferations at the organs exposed to external environment mimicking lymphoma: A potential diagnostic pitfall.

Background: Typically, lymphatic tissue proliferative lesions include either benign lesions or lymphoma. However, not all lymphatic lesions can currently be accurately classified into one category, particularly in mucosal areas that are in contact with the external environment.Aims: To explore the morphology, immunophenotype, and molecular changes of Non-neoplastic B-cell predominant lymphoid proliferations (NBPLP) in pathological areas that are exposed to external surroundings which mimicked lymphoma.Methods and Results: 18 cases of Atypical lymphoid hyperplasia (AtLP) were retrieved in this study. The biopsy samples were mucosal samples obtained from areas exposed to external surroundings, including intestines, urethra, cervix, tonsils, and tongue. Microscopically, there is a different level of B cell hyperplasia accompanied by morphological atypia. We categorized the morphology into 4 groups: type A (7/18), type B (3/18), type C (3/18), type D (5/18). Part of the AtLP was found positive for BCR gene rearrangement (6/15), and TCR gene rearrangement (1/4). The follow-up period ranged from 14.2 to 70 months. No evidence of lymphoma was found. Therefore, we diagnosed all of the presented cases as NBPLP. We illustrated the key differential points and provided valuable diagnostic experience on each subtype.Conclusions: Areas exposed to the external environment are commonly exposed to antigen and easily present with AtLP of NBPLP, accompanying with positive IGH rearrangement. Therefore, a comprehensive evaluation of macroscopic, morphology, immunophenotype, and molecular diagnostics is required to prevent the overdiagnosis of lymphoma.

APPENDICITIS INFLAMMATORY RESPONSE SCORE FOR DIAGNOSIS OF ACUTE APPENDICITIS AS COMPARED TO ALVARADO SCORE

Background: Acute appendicitis was first described by Reginald. H. Fitz in 1886. It is the most frequent cause of acute abdominal pain requiring surgical intervention. Annually appendectomy is the most common abdominal operation performed on emergency basis. Lifetime risk for developing acute appendicitis is 8.6% in men and 6.7% in women. Acute Appendicitis inciting event in most instances is obstruction of the appendix lumen. Acute Appendicitis is classified as catarrhal phlegmonus, gangrenous and perforated. This classification describes the evolutionary stage of disease. Acute appendicitis is more of a clinical diagnosis present as pain abdomen with classical migration from peri-umbilical region to right iliac fossa in 75% of patient nausea and anorexia. Clinical signs are mostly pyrexia, localized tenderness in the right iliac fossa, muscle guarding and rebound tenderness. Laboratory and radiological investigation are also important tool for the diagnosis. Scoring system have been designed to aid in the clinical assessment of patient with acute appendicitis. The most used scoring is the Alvarado score is best performing in validation studies. Alvarado score doesnt incorporate C reactive protein as a variable, many studies shows the importance of C reactive protein in assessment of patient with appendicitis. Objective: Appendicitis Inflammatory Response score as a diagnostic tool for acute appendicitis in our hospital setting. Study design: A Prospective Study. Study period: October 2016 – September 2018. Study setting: Department of General Surgery, Justice K. S. Hegde charitable hospital. Study population: Patients admitted with signs and symptoms of acute appendicitis at Justice K.S. Hegde charitable Hospital, Mangalore. Sample size: 123 patients using epiinfo software for diagnostic test with PPV 64% with article reference (12) confidence interval of 95% and power of study at 80%. Study group: Patients clinically diagnosed with acute appendicitis and giving consent for the study. Methodology: The present study was conducted in the Department of General surgery, Justice K.S. Hegde charitable Hospital Mangalore, in 123 patients, of any age, who were admitted with complaint of acute appendicitis. Patients included in the study were finally correlate with the histopathological report. Result: The maximum patients were in the age group of 11-20 year compromising around 30.9%. Most of the patients were female around 56.1%. Histopathological report showed around 82.1% as Acute appendicitis, 6.5% acute on chronic, recurrent appendicitis 8.9%, chronic appendicitis, granulomatous appendicitis & lymphoid hyperplasia of appendix were .8% each. AIR classified around 46.3% in low probability, 48% indeterminate and 5.7% in high probability group. Alvarado classified around 3.3% in unlikely, 51.2% in possible diagnosis, 37.4% acute and 8.1% in definite group. On spearman correlation coefficient there was found to be a strong positive correlation between both the scoring system and statistically significant p value of 0.0001. AIR score showed a sensitivity of 56.44% and specificity of 59.09% at score >4. Alvarado had a sensitivity of 98.02 % and specificity of 9.09% at score >4. Alvarado and AIR showed 9.90% and 6.93% at score >8 respectively. The specificity of Alvarado and AIR was 100% respectively. The AIR at a low and higher score had a high PPV and NPV, that may help in correctly diagnosing the patient with acute appendicitis and ruling out from non- appendicitis patient. Conclusion: 1. Alvarado score is better diagnostic tool for acute appendicitis as compared to the AIR score. 2. Alvarado score has higher sensitivity in score of >4 as compared to AIR. 3. AIR score with low sensitivity has low discriminatory power in ruling out patient with acute appendicitis.

Characterization of Different Inflammatory Skin Conditions in a Mouse Model of DNCB-Induced Atopic Dermatitis

The mouse model of 2,4-dinitrochlorbenzene (DNCB)-induced human-like atopic dermatitis (hlAD) has been widely used to test novel treatment strategies and compounds. However, the study designs and methods are highly diverse, presenting different hlAD disease patterns that occur after sensitization and repeated challenge with DNCB on dorsal skin. In addition, there is a lack of information about the progression of the disease during the experiment and the achieved pheno- and endotypes, especially at the timepoint when therapeutic treatment is initiated. We here examine hlAD in a DNCB-induced BALB/cJRj model at different timepoints: (i) before starting treatment with dexamethasone, representing a standard drug control (day 12) and (ii) at the end of the experiment (day 22). Both timepoints display typical AD-associated characteristics: skin thickening, spongiosis, hyper- and parakeratosis, altered cytokine and gene expression, increased lipid mediator formation, barrier protein and antimicrobial peptide abnormalities, as well as lymphoid organ hypertrophy. Increased mast cell infiltration into the skin and elevated immunoglobulin E plasma concentrations indicate a type I allergy response. The DNCB-treated skin showed an extrinsic moderate sub-acute hlAD lesion at day 12 and an extrinsic mild sub-acute to chronic pheno- and endotype at day 22 with a dominating Th2 response. A dependency of the filaggrin formation and expression in correlation to the disease severity in the DNCB-treated skin was found. In conclusion, our study reveals a detailed classification of a hlAD at two timepoints with different inflammatory skin conditions and pheno- and endotypes, thereby providing a better understanding of the DNCB-induced hlAD model in BALB/cJRj mice.

Castleman disease of plasma cell type accompanied with bronchiolitis obliterans: a case report and review of the literature

BackgroundCastleman disease, also known as giant lymph node hyperplasia or angiofollicular lymph node hyperplasia, is a highly heterogeneous clinicopathological entity that belongs to the family lymphoproliferative disorders. Castleman disease accompanied by bronchiolitis obliterans is uncommon and often poses a great diagnostic challenge, which is easily confused with respiratory diseases and impeding the correct diagnosis and treatment. The main aim in presenting such rare case studies is to raise awareness and expand the diagnostic horizon of clinicians for appropriate management.Case presentationHere, we present a 69-year-old Chinese male who was admitted to our hospital due to right chest pain for 6 months, accompanied by cough, expectoration, and fever. Laboratory examinations revealed elevated immunoglobulin G and C-reactive protein, and normal serum levels of tumor markers and interleukin-6. Computed tomography scan detected diffuse bronchial wall thickening and patchy area of air trapping consistent with small airway disease. Pulmonary function test showed mild small airway obstructive ventilation dysfunction and moderate decrease in diffusion capacity. The pathological result of the right axillary lymph node was consistent with the plasma cell type Castleman disease. According to the above examinations, the patient was finally diagnosed with the plasma cell type Castleman disease accompanied with bronchiolitis obliterans. He received immunosuppressive medication after surgery and has been followed up for 11 months. Now the patient is currently in stable condition without recurrence.ConclusionCastleman disease is a rare lymphoproliferative disorder with a variety of symptoms. At present, the treatment of Castleman disease accompanied with bronchiolitis obliterans is mostly based on experiences or previous case reports, and there is no standard treatment. Here, we report an uncommon case of Castleman disease accompanied with bronchiolitis obliterans in which the patient received immunosuppressive medication after surgery and has been followed up for 11 months without experiencing a recurrence, which may deepen and extend our understanding of this disease.

Justification of the conservative treatment of intestinal intussusception in children without age and disease duration considerations

Introduction. Since the middle of the last century, the conservative treatment of ileocecal intussusception (ICI) has dominated in children. However, questions on choosing a technique for conservative treatment and indications for surgical treatment remain open.
 Purpose. To assess the effectiveness of hydroechocolonoscopy (HEC) for ICI in children regardless of their age and disease duration.
 Material and methods. 160 children with confirmed ICI were enrolled in the study. All children, who had developed uncomplicated ICI for the first time, had HEC regardless of their age and disease duration. Failed hydrostatic disinvagination and disease relapse after HEC were indications for surgical management (laparoscopy, colonoscopy, laparotomy). To evaluate the effectiveness of conservative treatment at different age groups and at different terms of disease duration, two comparable trials were performed: 1 – stratification of patients by age: main group (n=130) - children older than one year, comparison group (n=30) – children younger than one year; 2 – stratification of patients by disease duration: main group (n=107) – more than 12 hours, comparison group (n=53) – up to 12 hours. To assess outcomes, the following parameters were analyzed: HEC effectiveness and complications, incidence of early relapses after HEC, causes of HEC failure and relapses after HEC, frequency and surgical techniques applied for treating ICI.
 Results. In the groups stratified by age, HEC effectiveness was 95.4% in the main group and 93.3% in the comparison group, p=0.216. Early relapses occurred in 10.3% in the main group and in 3.3% in the comparison group, p=0.128. In the groups stratified by the disease duration, HEC effectiveness was 93.5% in the main group and 98.1% in the comparison group, p=0.204. Early relapses occurred in 10.3% (11) in the main group and in 11.3% (6) of cases in the comparison group, p=0.841. There were no any complications during HEC procedure. Basic reasons for the conservative treatment failure were anatomical ones; for relapses – lymphoid hyperplasia of the abdominal cavity and anatomical reasons. Thus, HEC was effective in 95% of cases; relapses after HEC amounted up to 10.6%. Surgical interventions ( in 15.6%) were started with laparoscopy; laparoscopic disinvagination was effective in 68% of cases. Colonoscopy after successful laparoscopic disinvagination was performed in 5.6%, conversion to laparotomy was in 5% of the total number of observations.
 Conclusion. HEC is a highly effective and safe option for HEC conservative management in children regardless of child’s age and disease duration. Indications for surgical treatment for uncomplicated ICI are hydrostatic disinvagination failure and disease relapse.

Effect of Usnea longissima ethyl acetate extract on acute oxidative and inflammatory lung damage from Staphylococcus aureus infection in rats.

The role of oxidants and proinflammatory cytokines in the pathogenesis of pneumonia caused by Staphylococcus aureus (S. aureus) has been demonstrated. The present study aims to investigate the protective effect of ethyl acetate extract (EtOAc) obtained from Usnea longissima (UL) against acute oxidative and inflammatory lung damage due to S. aureus infection in rats. Albino Wistar-type male rats were divided into three groups: Healthy (HG), S. aureus inoculated (SaG), and S. aureus inoculated + ULEtOAc administered (SUL). SaG (n = 6) and SUL (n = 6) group rats' left nostrils (excluding HG) were inoculated with 0.1 ml bacterial mixture. After 24 hours, ULEtOAc (50 mg/kg) was administered orally to the SUL group, and the same volume of normal saline was administered orally to the HG (n = 6) and SaG groups. This procedure was performed once a day for seven days. Levels of oxidant and antioxidant parameters such as malondialdehyde (MDA) and total glutathione (tGSH), as well as pro-inflammatory cytokine levels such as nuclear factor-kappa B (NF-κB), tumor necrosis factor-alpha (TNF-α), interleukin-one beta (IL-1β), were measured in removed lung tissues. Tissues were also examined histopathologically. Biochemical results showed that ULEtOAc significantly suppressed the increase of MDA, NF-κB, TNF-α, and IL-1β levels and the decrease of tGSH caused by S. aureus in lung tissue. S. aureus inoculation caused severe mononuclear cell infiltration in interstitial areas, severe lymphoid hyperplasia in bronchial-associated lymphoid tissue and severe alveolar edema, histopathologically. Treatment with ULEtOAc had an attenuating effect on these histopathological findings. Experimental results from this study suggest that ULEtOAc may be beneficial in treating S. aureus-induced oxidative and inflammatory lung damage.