Increased extrinsic apoptotic pathway activity in patients with hepatocellular carcinoma following transarterial embolization

AIM:To determine the apoptosis pathway in residualviable hepatocellular carcinoma(HCC) tissues following transarterial embolization(TAE) .METHODS:Ten patients with HCC who received sur-gical resection after TAE were enrolled in the study group,and 24 patients with HCC who received surgical resection only served as the control group. In thestudy group,we measured the changes in tumor sizeand α fetoprotein(AFP) levels after TAE. All tissuesamples were taken from the residual tumors. The ex-pression of various apoptotic proteins was evaluatedvia immunoblotting procedures. The results were ana-lyzed using a Student's t test.RESULTS:Tumor size and the AFP level decreased by46.2% and 55.3% after TAE,respectively. There wasno significant difference detected for the Bcl-2/Bax ratio or the cleaved caspase-9 expression levels in eithergroup. However,extrinsic apoptopic pathway-relate dexpression of Fas and cleaved caspase-8 expression were significantly higher in the study group than inthe control group(P < 0.05) . In addition,cleaved caspase-3 expression in the study group was higher(1.62-fold) than in control group(P < 0.05) .CONCLUSION:TAE is an effective palliative the rapy that decreases tumor size and AFP levels via an increase in extrinsic apoptosis path way in patients with unresectable HCC.

Plasmacytosis mimicking multiple myeloma in angioimmunoblastic T-cell lymphoma:A case report and review of literature

BACKGROUND Angioimmunoblastic T-cell lymphoma(AITL)is a common subtype of peripheral T-cell lymphoma.Approximately half of patients with AITL may concurrently present with hypergammaglobulinemia.Increased numbers of plasma cells in the bone marrow are commonly observed at diagnosis.These tumors mimic plasma cell myelomas,hindering a conundrum of clinical diagnoses and potentially delaying appropriate treatment.CASE SUMMARY A 78-year-old woman experienced poor appetite,weight loss of 5 kg,fatigue 2 months before presentation,and shortness of breath 2 d before presentation,but no fever or night sweats.Physical examination revealed splenomegaly and many palpable masses over the bilateral axillary regions,approximately>2 cm in size,with rubbery consistency and no tenderness.Blood tests revealed anemia and thrombocytopenia,lactate dehydrogenase level of 153 U/L,total protein level of 10.9 g/dL,albumin to globulin ratio of 0.2,and immunoglobulin G level more than the upper limit of 3000 mg/dL.The free kappa and lambda light chain concentrations were 451 and 614 mg/L,respectively.A pathological examination confirmed the diagnosis of AITL.The initial treatment was the cyclophosphamide,epirubicin,vincristine,and prednisolone regimen.Following this treatment,pleural effusion was controlled,and the patient was discharged in a stable condition and followed up in our outpatient department.CONCLUSION This report highlights the importance of differentiating reactive plasmacytosis from plasma cell myeloma in patients with hypergammaglobulinemia.A precise diagnosis of AITL requires a comprehensive evaluation,involving clinical,immunophenotypic,and histological findings conducted by a multidisciplinary team to ensure appropriate treatment.