Primary renal mucosa-associated lymphoid tissue lymphoma, the result of chronic pyelonephritis?

Objective: To report 2 cases of primary renal marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue (MALT lymphoma), and observe the relations between this rare tumor of kidney and chronic pyelonephritis. Methods: 2 renal MALT lymphomas were collected from referral consultation. Detailed clinical information were reviewed, morphological analysis based on the HE section, and immunohistochemistry were performed by CD20, CD79a, CD5, CD10, CD43, CD23, BCL10 and Cyclin D1 antibodies. Results: 2 female patients with age of 48 and 55, respectively, all had a history of chronic pyelonephritis. Under the B ultrasonic and CT scanning a bump in the kidney was found. Renal carcinoma suspected and hereby the whole nephrectomy performed. In the macroscopic, tumors were laid in the renal medulla, with dark red color and ill-defined boundary. In the microscopic, there were mixed lymphoid cells infiltrate which mainly consisted of small lympho- cytes, centrocyte-like cells, lymphoplasmacytoid and plasma cells, reactive follicles and lymphoepithelial lesions also could be seen in the lesion, but follicles colonization was rare. In fact, except changes of lymphoma, basic renal disease also could be seen. Most glomeruli were atrophic, some glomeruli were hyperplastic and hypertrophic. Tubules were dilated or contacted, many dilated tubules contained pink-color glassy-appearing casts that suggest the appearance of thyroid tissue. As a result, those 2 cases showed juxtaposed changes of lymphoma and pyelonephritis. Immunohistochemistry showed that tumor cells were CD20 and CD79a positive, CD43 was weak positive, but CD5, CD10, CD23, BCL10 and Cyclin D1 were all negative. Conclusion: Primary renal MALT lymphoma was very rare disease. According to the clinical manifestation, it’s hard to differentiate from renal cell carcinoma. But the morphological features were consistent with the classic MALT lymphomas in other sites. Immunophenotypic profiles were helpful for diagnosis. Based on the truth that many MALT lymphomas in other sites were connected with chronic inflammations, we suppose that the renal MALT lymphoma may originate from chronic pyelonephritis.

Two vs three cycles of neoadjuvant sintilimab plus chemotherapy for resectable non-small-cell lung cancer:neoSCORE trial

Dear Editor,Lung cancer is the predominant cause of cancer-related deaths globally,with non-small cell lung cancer(NSCLC)accounting for 85%of all cases.1 The five-year overall survival(OS)after surgery remains poor because of the high rate of postoperative recurrence and metastasis.Recently,immune checkpoint inhibitors(ICIs)have shown promising efficacy in resectable NSCLC.

Analysis of the genomic landscape of primary central nervous system lymphoma using whole-genome sequencing in Chinese patients

Primary central nervous system lymphoma(PCNSL)is an uncommon non-Hodgkin’s lymphoma with poor prognosis.This study aimed to depict the genetic landscape of Chinese PCNSLs.Whole-genome sequencing was performed on 68 newly diagnosed Chinese PCNSL samples,whose genomic characteristics and clinicopathologic features were also analyzed.Structural variations were identified in all patients with a mean of 349,which did not significantly influence prognosis.Copy loss occurred in all samples,while gains were detected in 77.9%of the samples.The high level of copy number variations was significantly associated with poor progression-free survival(PFS)and overall survival(OS).A total of 263 genes mutated in coding regions were identified,including 6 newly discovered genes(ROBO2,KMT2C,CXCR4,MYOM2,BCLAF1,and NRXN3)detected in≥10%of the cases.CD79B mutation was significantly associated with lower PFS,TMSB4X mutation and high expression of TMSB4X protein was associated with lower OS.A prognostic risk scoring system was also established for PCNSL,which included Karnofsky performance status and six mutated genes(BRD4,EBF1,BTG1,CCND3,STAG2,and TMSB4X).Collectively,this study comprehensively reveals the genomic landscape of newly diagnosed Chinese PCNSLs,thereby enriching the present understanding of the genetic mechanisms of PCNSL.

Progression from ductal carcinoma in situ to invasive breast cancer:molecular features and clinical significance

Ductal carcinoma in situ(DCIS)represents pre-invasive breast carcinoma.In untreated cases,25-60%DCIS progress to invasive ductal carcinoma(IDC).The challenge lies in distinguishing between non-progressive and progressive DCIS,often resulting in over-or under-treatment in many cases.With increasing screen-detected DCIS in these years,the nature of DCIS has aroused worldwide attention.A deeper understanding of the biological nature of DCIS and the molecular journey of the DCIS-IDC transition is crucial for more effective clinical management.Here,we reviewed the key signaling pathways in breast cancer that may contribute to DCIS initiation and progression.We also explored the molecular features of DCIS and IDC,shedding light on the progression of DCIS through both inherent changes within tumor cells and alterations in the tumor microenvironment.In addition,valuable research tools utilized in studying DCIS including preclinical models and newer advanced technologies such as single-cell sequencing,spatial transcriptomics and artificial intelligence,have been systematically summarized.Further,we thoroughly discussed the clinical advancements in DCIS and IDC,including prognostic biomarkers and clinical managements,with the aim of facilitating more personalized treatment strategies in the future.Research on DCIS has already yielded significant insights into breast carcinogenesis and will continue to pave the way for practical clinical applications.