Medicine
-
Leptomeningeal metastasis (LM) is a fatal complication of advanced non-small cell lung cancer (NSCLC) with a poor prognosis. Osimertinib is a promising option for NSCLC with LM harboring epidermal growth factor receptor (EGFR) mutation. However, therapeutic approaches remain a challenge for osimertinib resistant NSCLCs with LM. Although studies have reported that the first/second-generation EGFR-tyrosine kinase inhibitors were active against osimertinib-resistant NSCLC with EGFR C797S and sensitive mutation (SM), the resistance inevitably occurred due to the development of the EGFR SM/C797S/T790M triple mutations. ⋯ LM is a fatal complication of advanced NSCLC with a poor prognosis. NGS profiling of CSF circulating tumor DNA is important in NSCLC patients with LM and erotinib plus bevacizumab and chemotherapy is a promising option for patients with LM harboring EGFR C797S/SM.
-
Chimeric antigen receptor (CAR) T-cell therapy is effective in treating relapsed and refractory B-cell non-Hodgkin lymphoma. However, because of the mortality risk associated with immune effector cell-associated neurotoxicity syndrome and pseudoprogression, patients with central nervous system (CNS) involvement are less likely to receive CAR T-cell therapy. ⋯ CAR T-cell therapy following autologous stem cell transplantation is a viable option for relapsed/refractory lymphoma with CNS infiltration. Further clinical studies are warranted to verify its safety and efficacy.
-
Case Reports
Bilateral spontaneous massive renal hemorrhage in a peritoneal dialysis patient: A case report.
Non-traumatic bilateral spontaneous massive renal hemorrhage confined to the subcapsular and perirenal space, also known as Wünderlich syndrome, can occur suddenly and insidiously and cause serious consequences if not properly identified and managed. We report a case of bilateral spontaneous massive renal hemorrhage in a series of devastating episodes. ⋯ Bilateral spontaneous massive renal hemorrhage is rare and generally occurs in patients undergoing dialysis. Known studies appear primarily in case reports. Most patients can be treated successfully with TAE when diagnosed early.
-
This retrospective study was to investigate the association between clinical characteristics and computerized tomography (CT) findings in patients with coronavirus disease-2019 (COVID-19). The clinical data of COVID-19 patients were retrospectively analyzed. Spearman correlation analysis was used to identify the correlation. ⋯ The CT features of COVID-19 included pulmonary, bronchial, and pleural changes, with the significant pulmonary presentation of ground-glass opacification (93.30%), consolidation (48.80%), ground-glass opacification plus a reticular pattern (54.07%), telangiectasia (84.21%), and pulmonary fibrotic streaks (49.76%). Spearman analysis showed that the CT findings had significantly inverse associations with the platelets, lymphocyte counts, and sodium levels, but were positively related to the age, erythrocyte sedimentation rate, D-dimer, lactic dehydrogenase, α-hydroxybutyrate dehydrogenase, and C-reactive protein levels (P < .05). In conclusion, the severity of lung abnormalities on CT in COVID-19 patients is inversely associated with the platelets, lymphocyte count, and sodium levels, whereas positively with the age, erythrocyte sedimentation rate, D-dimer, lactic dehydrogenase, hydroxybutyrate dehydrogenase, and C-reactive protein levels.
-
Primary nasopharyngeal papillary adenocarcinoma is a rare nasopharyngeal neoplasm with a good prognosis and a low propensity for regional recurrence. To date, only few cases of primary nasopharyngeal papillary adenocarcinoma have been reported in the literature. ⋯ We aim at highlighting the importance of a thorough differential diagnosis of nasopharyngeal tumor. Further investigation is still needed for providing evidence to standardize the treatment protocol.