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Nodular Pulmonary Amyloidosis with Interstitial Lung Disease—Case Report and Literature Review

Open Journal of Thoracic Surgery 2024年第2期14卷 40-45页

作者： Efosa Imuetinyan irshad soomro Muhammad Hawari Adnan Raza Department of Thoracic Surgery Nottingham University Hospital Nottingham UK Department of Pathology Nottingham University Hospital Nottingham UK

Amyloidosis is a rare spectrum of disease which involves deposition of misfolded extracellular proteins (amyloids) in various body organs leading to progressive organ dysfunction. Clinical presentation can be variable depending on the organ involved and type of protein. Amyloidosis can be classified based on quantity, type, and location of these proteins. Amyloid light-chain amyloidosis develops in the bone marrow, producing abnormal forms of light-chain proteins, which cannot be broken down. These proteins transform into amyloid fibrils and form amyloid deposits in different organs. Pulmonary amyloidosis is uncommonly diagnosed since it is rarely symptomatic. Diagnosis of pulmonary amyloidosis is usually made in the setting of systemic amyloidosis;however, it may present as localised pulmonary disease. Localized pulmonary Amyloidosis can present as nodular, cystic, or tracheobronchial amyloidosis. Depending on the degree of the interstitial involvement, it may affect alveolar gas exchange and cause respiratory symptoms. This is a case of a 47-year-old female with background history of interstitial lung disease presenting with progressive shortness of breath. Computed tomography scan revealed bilateral pulmonary nodules. The patient was referred to our thoracic surgery team with the suspicion of bronchogenic malignancy with metastasis. Diagnostic video assisted wedge resection was performed for this patient, and histology confirmed pulmonary amyloidosis of nodular type. Amyloid deposition simulates both inflammatory and neoplastic conditions. Definitive diagnosis requires biopsy confirmation therefore early detection and commencing the patient on appropriate treatment pathway may help in symptomatic relief and better outcome.

关键词： Nodular Amyloidosis Interstitial Lung Disease Immunomodulatory Drugs

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Caspase-cleaved cytokeratin-18 and tumour regression in gastro-oesophageal adenocarcinomas treated with neoadjuvant chemotherapy

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World Journal of Gastroenterology 2012年第16期18卷 1915-1920页

作者： Khaleel R Fareed irshad N soomro Khalid Hameed Arvind Arora Dileep N Lobo Simon L Parsons Srinivasan Madhusudan Laboratory of Molecular Oncology Academic Unit of OncologySchool of Molecular Medical SciencesFaculty of Medicine and Health SciencesUniversity of Nottingham Nottingham University Hospitals Nottingham NG5 1PBUnited Kingdom Department of Pathology Nottingham University HospitalsNottingham NG5 1PBUnited Kingdom Division of Gastrointestinal Surgery Nottingham Digestive Diseases CentreNIHR Biomedical Research UnitNottingham University HospitalsNottingham NG7 2UHUnited Kingdom Department of Surgery Nottingham University HospitalsNottingham NG5 1PBUnited Kingdom

AIM:To examine cytokeratin-18(CK-18) and caspasecleaved CK-18 expression in tumours and correlate with clinicopathological outcomes including tumour regression grade(TRG) ***:Formalin-fixed human gastro-oesophageal cancers were constructed into tissue *** first set consisted of 122 gastric/gastro-oesophageal cancer cases not exposed to neoadjuvant chemotherapy and the second set consisted of 97 gastric/gastrooesophageal cancer cases exposed to pre-operative platinum-based *** of CK-18 and caspase-cleaved CK-18 was investigated using ***:CK18 was commonly expressed in gastrooesophageal tumours(92.6%).Fifty-six point seven percent of tumours previously exposed to neoadjuvant chemotherapy were positive for caspase-cleaved CK-18 expression compared to only 24.6% of tumours not previously exposed to neoadjuvant chemotherapy(P = 0.009).In patients who received neoadjuvant chemotherapy,caspase-cleaved cytokeratin-18 expression correlated with favourable TRG response(TRG 1,2 or 3,P = 0.043).CONCLUSION:This is the largest study to date of CK-18 and caspase-cleaved CK-18 expression in gastrooesophageal *** provide the first evidence that caspase-cleaved CK-18 predicts tumour regression with neoadjuvant chemotherapy.

关键词： Tumour regression grade Gastro-oesophageal cancers Chemotherapy Full length cytokeratin-18 Caspase-cleaved cytokeratin-18

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