Monomorphic epitheliotropic intestinal T-cell lymphoma with bone marrow involved: A case report

BACKGROUND Monomorphic epithelial intestinal T-cell lymphoma(MEITL)is a rare type of peripheral T-cell lymphoma.The clinical manifestations are diarrhea,abdominal pain,perforation and an abdominal mass.CASE SUMMARY We present a 52-year-old female patient who was diagnosed with MEITL.Further disease progression was observed after multiline chemotherapy.Eventually,the patient died of a severe infection.CONCLUSION MEITL is a rare intestinal primary T-cell lymphoma with aggressive behavior,a high risk of severe life-threatening complications,and a poor prognosis.

Monomorphic epitheliotropic intestinal T-cell lymphoma presenting as melena with long-term survival: A case report and review of literature

BACKGROUND Monomorphic epitheliotropic intestinal T-cell lymphoma(MEITL)is a rare primary intestinal T-cell lymphoma,previously known as enteropathy-associated T-cell lymphoma type II.MEITL is an aggressive T-cell lymphoma with a poor prognosis and high mortality rate.The known major complications of MEITL are intestinal perforation and obstruction.Here,we present a case of MEITL that was diagnosed following upper gastrointestinal bleeding from an ulcerative duodenal lesion,with recurrence-free survival for 5 years.CASE SUMMARY A 68-year-old female was admitted to our hospital with melena and mild anemia.An urgent esophagogastroduodenoscopy(EGD)revealed bleeding from an ulcerative lesion in the transverse part of the duodenum,for which hemostatic treatment was performed.MEITL was diagnosed following repeated biopsies of the lesion,and cyclophosphamide,doxorubicin,vincristine,and prednisone(CHOP)chemotherapy was administered.She achieved complete remission after eight full cycles of CHOP therapy.At the last follow-up examination,EGD revealed a scarred ulcer and 18Fluorodeoxyglucose(18FDG)positron emission tomography/computed tomography showed no abnormal FDG accumulation.The patient has been in complete remission for 68 mo after initial diagnosis.CONCLUSION To rule out MEITL,it is important to carefully perform histological examination when bleeding from a duodenal ulcer is observed.

Chidamide based combination regimen for treatment of monomorphic epitheliotropic intestinal T cell lymphoma following radical operation:Two case reports

BACKGROUND Monomorphic epitheliotropic intestinal T cell lymphoma(MEITL)is a rare extranodal T-cell lymphoma that has uniformly aggressive features with a poor prognosis.No standardized treatment protocols have been established.Previous experience has demonstrated favorable outcomes with combination chemotherapy followed by autologous hematopoietic stem cell transplant.However,many patients are unable to tolerate the toxicities.Chidamide is a new histone deacetylase inhibitor that has shown preferential efficacy in mature T-cell lymphoma.CASE SUMMARY We herein present two cases of MEITL who were both intermediate risk according to enteropathy-associated T cell lymphoma prognostic index.Case one was a 61-year-old man.He complained of upper abdominal pain and intermittent black stool for 2 mo.Imaging examination revealed that the intestinal wall was thickened.He received a partial excision of the small intestine.A chidamidebased combination regimen was given postoperatively.Eleven months later,he presented with recurrence in the bilateral lungs.He passed away 15 mo after his diagnosis.Case two was a 35-year-old woman who complained of abdominal distention for 1 mo.Positron emission tomography/computed tomography demonstrated wall thickening of the small intestine and upper sigmoid colon.Colon perforation and septic shock occurred on the fourth day of her admission.She was treated by sigmoid colostomy.Chidamide-based combination therapy was then provided.She was recurrence-free for 6 mo until lesions were found in the bilateral brain and lived for 17 mo since her diagnosis.Compared to historical data,chidamide seems to improve the prognosis of MEITL slightly.CONCLUSION MEITL is a type of aggressive lymphoma.Chidamide is a new promising approach for the treatment of MEITL.

Surgical management of monomorphic epitheliotropic intestinal Tcell lymphoma followed by chemotherapy and stem-cell transplant:A case report and review of the literature

BACKGROUND Monomorphic epitheliotropic intestinal T-cell lymphoma(MEITL)is a rare and rapidly progressive intestinal T-cell non-Hodgkin lymphoma associated with a very poor prognosis and a median survival of 7 mo.Advances in the identification of MEITL over the last two decades have led to its recognition as a separate entity.MEITL patients,predominantly male,typically present with vague and nonspecific symptoms and diagnosis is predominantly confirmed at laparotomy.Currently,there are no standardized treatment protocols,and the optimal therapy remains unclear.CASE SUMMARY We report a case of MEITL that was initially considered to be gastrointestinal stromal tumor(GIST)and Imatinib was administered for one cycle.The 62-yearold man presented with abdominal pain,abdominal distension,and weight loss of 20 pounds.Within 2 wk,the size of the mass considerably increased on computed tomography scans.The patient underwent surgery followed by chemotherapy with CHOP(cyclophosphamide,doxorubicin,vincristine,and prednisone)and stem-cell transplant.A correct diagnosis of MEITL was established based on postoperative pathology.Immunophenotypically,the neoplastic cells fulfilled the diagnostic criteria for MEITL as they were CD3+,CD4+,CD8+,CD56+,and TIA-1+.CONCLUSION Given that MEITL has no predisposing factor and presents with vague symptoms with rapid progression,the concomitant presence of abdominal symptoms and B symptoms(weight loss,fever,and night sweats)with hypoalbuminemia,anemia,low lymphocytic count and endoscopic findings of diffuse infiltrating type lesions should alert physicians to this rare disease,especially when it comes to Asian patients.Immediate laparotomy should then be carried out followed by chemotherapy and stem-cell transplant.

Aryepiglottic Fold as a Rare Location for a Monomorphic Adenoma—Case Report

We report a case of Monomorphic adenoma of aryepiglottic fold. Histopathological findings are described. This is the first case, to our knowledge, of a Monomorphic adenoma presenting at aryepiglottic fold. Complete excision of the mass was done through laryngofissure approach.

Radiofrequency catheter ablation at the left coronary cusp in treatment of repetitive monomorphic tachycardia of the left ventricular outflow tract

Background The aim of this study was to clarify the electrocardiographic characteristics of repetitive monomorphic ventricular tachycardia (RMVT) originating from the left ventricular outflow tract, and to describe the results of treatment with radiofrequency catheter ablation (RFCA).Methods Routine 12-lead surface electrocardiography and electrophysiological studies were performed on 11 RMVT patients with no organic heart disease, who were subsequently treated with RFCA directed at targets identified by pace mapping.Results The surface electrocardiogram QRS characteristics of RMVT included an atypical left bundle branch block and right axis deviation, with a low amplitude 'rs' or 'rS' pattern in lead I , an 'rS' or 'RS' pattern in V1, and a precordial R wave transition zone in V2 or V3. In 1 patient, a small S wave was observed in V5. Using pace mapping techniques, we selected the left coronary cusp as the ablation target. RMVT was eliminated in all 11 patients immediately after radiofrequency energy delivered. During a follow-up of 13 ±7 months, RMVT recurred in only 1 patient.Conclusion RMVT originating from the left ventricular outflow tract has specific electrocardiographic characteristics, and can be successfully and safely cured using RFCA directed at the left coronary cusp.

Truth lies below: A case report and literature review of typical appearing polyps yet with an atypical diagnosis

BACKGROUND Enteropathy associated T-cell lymphoma(EATL) is a rare form of peripheral Tcell lymphoma and makes up less than 5% of gastrointestinal lymphomas. EATL can be divided into type 1 which is associated with celiac disease, and monomorphic epitheliotropic intestinal T-cell lymphoma(MEITL), formally type 2, which is not associated with celiac disease.CASE SUMMARY We present a 60-year-old African American female, without celiac disease, who presented with abdominal pain, diarrhea, and 30 lb. weight loss over a 3 month period. She was subsequently diagnosed with EATL throughout her entire gastrointestinal tract. She is currently undergoing chemotherapy with EOCH(Etoposide, Oncovin, Cyclophosphamide, and Hydroxydaunorubicin). EATL is most common in the Asian and Hispanic population yet the incidence in African Americans is uncertain and emphasizes the rarity of this case. A literature review was included to further emphasize similarities and differences between our case and previously reported cases of MEITL.CONCLUSION The patient was diagnosed with EATL, immunochemical testing was not conclusive for MEITL however was suggestive of the disease.

Gender identification using acoustic analysis in birds without external sexual dimorphism

Zoo and wildlife management faces a problem with bird sexing,as many bird taxa have indiscernible gender differences in size and coloration.Problematic groups are geese,cranes,rails,raptors,owls,parrots,doves,auks,shearwaters and some passerines.Commonly accepted invasive sexing techniques based on genetics,laparoscopy,morphometric and on cloacal inspection,are all needed in bird capturing and handling.Capturing and subsequent manipulations may be inapplicable for free-ranging birds,whereas distant voice-based sexing is relevant for many species.This review evaluates the potential for noninvasive sexing by separate calls or duet calls,for adult birds of 69 species from 16 orders and for chicks of 11 species from 7 orders.For adult birds of 25 species,a single call per individual was sufficient for 100 % reliable sexing by ear or using spectrographic analysis.For chicks,the potential for voice-based sexing seems to be very limited.For birds calling rarely or unpredictably,we propose a simple way of provoking vocalization using playbacks of species-specific calls that are available from sound libraries.We conclude that sexing by voice may represent a feasible alternative to the classical sexing techniques,both in the wild and in captivity.

S-SUPERFLUOUS AND S-ESSENTIAL HOMOMORPHISMS

Let R be a ring and S a class of R-modules. S-superfluous epimorphisms and S-essential monomorphisms are introduced and studied in this article. As applications, some new characterizations of von Neumann regular rings and perfect rings are given. Finally, these notions are also used to study minimal homomorphisms.

VAGUE MAPPINGS

In this paper, the concepts of (α,β) vague mappings, surjective (α,β) vague mappings, injective (α,β) vague mappings, bijective (α,β) vague mappings,(α,β) adjoin vague mappings, (α,β) vague monomorphism,(α,β) vague epimorphism,(α,β) vague isomorphism,(α,β) Vague par-tition are introduced through the so-called "(α,β) hierarchical divide vague relations ". We extend the results on fuzzy mappings, and obtain some of their properties.

The stable Auslander-Reiten components of certain monomorphism categories

Let Λ be an Artin algebra and let Gprj-Λ denote the class of all the finitely generated Gorenstein projective Λ-modules. In this paper, we study the components of the stable Auslander-Reiten quiver of a certain subcategory of the monomorphism category S(Gprj-Λ) containing boundary vertices. We describe the shape of such components. It is shown that certain components are linked to the orbits of an auto-equivalence on the stable category Gprj. In particular, for the finite components, we show that under certain mild conditions,their cardinalities are divisible by 3. We see that this three-periodicity phenomenon reoccurs several times in the paper.

Nestling sex ratio is unaffected by individual and population traits in the griffon vulture

Variation in offspring sex ratios is a central topic in animal demography and population dynamics.Most studies have focused on bird species with marked sexual dimorphism and multiple-nestling broods,where the offspring sex ratio is often biased due to different individual or environmental variables.However,biases in offspring sex ratios have been far less investigated in monomorphic and single-egg laying species,and few studies have evaluated long-term and large-scale variations in the sex ratio of nestling vultures.Here,we explore individual and environmental factors potentially affecting the secondary sex ratio of the monomorphic griffon vulture Gyps fulvus.We used information collected at three breeding nuclei from central Spain over a 30-year period(1990–2020)to analyse the effects of nestling age,parental age,breeding phenology,conspecific density,population reproductive parameters,and spatial and temporal variability on nestling sex.Sex ratio did not differ from parity either at the population or the nuclei level.No significant between-year differences were detected,even under highly changing conditions of food availability associated with the mad-cow crisis.We found that tree nesting breeders tend to have more sons than daughters,but as this nesting behavior is rare and we consequently have a small sample size,this issue would require additional examination.Whereas further research is needed to assess the potential effect of breeder identity on nestling sex ratio,this study contributes to understanding the basic ecology and population dynamics of Griffon Vultures,a long-lived species with deferred maturity and low fecundity,whose minor deviations in the offspring sex ratio might imply major changes at the population level.

Silting Objects over the Stable Monomorphism Category of Higher Differential Objects

Higher differential objects are investigated and used for addressing three gen-eral problems.Torsionless differential modules over path algebras are characterized.The adjoint triples between triangulated categories,involving derived categories and singularity categories,are allowed to be constructed from those between the abelian categories C and C[ε]^(n).The partial silting properties between an abelian category C and C[ε]^(n)are trans-ferred,and if moreover,C is Frobenius,the partial silting objects of the stable monomor-phism categories of C[ε]^(n)are constructed from those of C.

Localization of homotopy epimorphisms and homotopy monomorphisms

Recall that f: X→Y is a homotopy epimorphism (monomorphism), if given u, v: Y→W (u, v: W→X), uofvof implies uv (foufov implies uv). In this note, we shall consider the localization of homotopy epimorphisms andmonomorphism, 1.e. the following is considered. Problem. If f:X→Y is a homotopy epimorphism (monomorphism), then is any

Injective objects of monomorphism categories

For an acyelic quiver Q and a finite-dimensional algebra A, we give a unified form of the indecomposable injective objects in the monomorphism category Mon（Q, A） and prove that Mon（Q, A） has enough injective objects.

On homotopy regular monomorphisms

A concept of homotopy regular monomorphism is introduced which is strictly between homotopy monomorphism and homotopy equivalence. And it characterizes homotopy equivalence in some sense.