Immune checkpoint inhibitors (ICIs) have provided an additional treatment option for various types of human cancers. However, ICIs often induce various immune‐related adverse events (irAEs). ...Enterocolitis is a major irAE with poorly understood histopathological characteristics. In this study, we retrospectively investigated the histopathology of colon tissue samples from 17 patients treated with ICIs. There were two major histological patterns of colitis: an ulcerative colitis‐like pattern and a graft vs host disease‐like pattern. Although these two patterns of colitis were mutually exclusive, both patterns often showed a characteristic that we call “subepithelial surface granulomatosis” (SSG), which has not been reported in other types of colitis. SSG was found even in colon tissue without symptoms or endoscopic findings of colitis. Given the increasing reports of sarcoid reaction or exacerbation of tuberculosis after treatment with ICIs, granuloma formation could be a histological hallmark of systemic immune activation by ICIs. Although statistical significance was not obtained, probably because of the small sample size, SSG may be a surrogate biomarker of systemic anticancer immune activation. We propose that a prospective study with larger sample size be performed.
In this study, we retrospectively investigated the histopathology of colon tissue samples from 17 patients treated with immune checkpoint inhibitors. Interestingly, we found characteristic “subepithelial surface granulomatosis” (SSG) in the colon tissue. Although statistical significance was not obtained, probably because of the small sample size, SSG may be a surrogate biomarker of systemic anti‐cancer immune activation.
Abstract
SS Cyg has long been recognized as the prototype of a group of dwarf novae that show only outbursts. However, this object has entered a quite anomalous event in 2021, which at first appeared ...to be standstill, i.e., an almost constant luminosity state observed in Z Cam-type dwarf novae. This unexpected event gives us a great opportunity to reconsider the nature of standstill in cataclysmic variables. We have observed this anomalous event and its forerunner, a gradual and simultaneous increase in the optical and X-ray flux during quiescence, through many optical telescopes and the X-ray telescopes NICER and NuSTAR. We have not found any amplification of the orbital hump during quiescence before the anomalous event, which suggests that the mass transfer rate did not significantly fluctuate on average. The estimated X-ray flux was not enough to explain the increment of the optical flux during quiescence via X-ray irradiation of the disk and the secondary star. It would be natural to consider that viscosity in the quiescent disk was enhanced before the anomalous event, which increased mass accretion rates in the disk and raised not only the optical flux but also the X-ray flux. We suggest that enhanced viscosity also triggered the standstill-like phenomenon in SS Cyg, which is considered to be a series of small outbursts. The inner part of the disk would always stay in the outburst state and only its outer part would be unstable against the thermal–viscous instability during this phenomenon, which is consistent with the observed optical color variations. This scenario is in line with our X-ray spectral analyses which imply that the X-ray-emitting inner accretion flow became hotter than usual and vertically expanded, and that it became denser and was cooled down after the onset of the standstill-like state.
A pancreatic tumor was suspected on the abdominal ultrasound of a 72-year-old man. Abdominal computed tomography showed pancreatic enlargement as well as a diffuse, poorly enhanced area in the ...pancreas; endoscopic ultrasound-guided fine needle aspiration biopsy and endoscopic retrograde cholangiopancreatography failed to provide a definitive diagnosis. Based on the trend of improvement of the pancreatic enlargement, the treatment plan involved follow-up examinations. Later, he was hospitalized with an alveolar hemorrhage and rapidly progressive glomerulonephritis; he tested positive for myeloperoxidase-anti-neutrophil cytoplasmic antibody (ANCA) and was diagnosed with ANCA-related vasculitis, specifically microscopic polyangiitis. It appears that factors such as thrombus formation caused by the vasculitis in the early stages of ANCA-related vasculitis cause abnormal distribution of the pancreatic blood flow, resulting in non-uniform pancreatitis. Pancreatic lesions in ANCA-related vasculitis are very rare. Only a few cases have been reported previously. Therefore, we report our case and a review of the literature.
We herein report a rare case of mucinous tubular and spindle cell carcinoma (MTSCC) in an 80-year-old woman. A well circumscribed tumor located on the right kidney was discovered incidentally as a ...result of screening non-contrast CT. Fluorodeoxyglucose positron emission tomography (FDG PET)/CT showed the increased tracer accumulation in the tumor. The histological diagnosis was MTSCC, which is a rare and only recently established subtype of the malignant renal cell carcinoma (RCC). The present case suggests the clinical benefit of a high uptake of FDG combined with enhanced contrast CT in the differentiation of MTSCCs and other RCCs.
Abstract
We report on time-resolved photometry of the 2015 February–March superoutburst of QZ Virginis. The superoutburst consisted of a separated precursor, main superoutburst, and rebrightening. We ...detected superhumps with a period of 0.061181(42) d between the precursor and main superoutburst. Based on analyses of period changes and amplitudes of superhumps, the observed superhumps were identified as growing superhumps (stage A superhumps). The duration of the stage A superhumps was about 5 d, unusually long for SU UMa-type dwarf novae. Using the obtained stage A superhump period, we estimated the mass ratio of QZ Vir to be 0.108(3). This value suggests that QZ Vir is an SU UMa-type dwarf nova evolving toward the period minimum. Based on the present and previous observations regarding long-lasting stage A superhumps, the time scale for stage A superhumps is likely to be determined by the mass ratio of the system and the temperature of the accretion disk.
We observed the first-ever recorded outburst of PM J03338+3320, the cataclysmic variable selected by proper-motion survey. The outburst was composed of a precursor and the main superoutburst. The ...precursor outburst occurred at least 5 d before the maximum of the main superoutburst. Despite this separation, long-period superhumps were continuously seen between the precursor and main superoutburst. The period of these superhumps is longer than its orbital period by 6.0(1)% and can be interpreted to reflect the dynamical precession rate at the 3 : 1 resonance for a mass ratio of 0.172(4). These superhumps smoothly evolved into those in the main superoutburst. These observations provide the clearest evidence that the 3 : 1 resonance is triggered by the precursor outburst, even if it is well separated, and the resonance eventually causes the main superoutburst as predicted by the thermaltidal instability model. The presence of superhumps well before the superoutburst cannot be explained by alternative models (the enhanced mass-transfer model and the pure thermal instability one) and the present observations clearly support the thermaltidal instability model.
A 66-year-old patient was diagnosed with primary gastric B-cell lymphoma. The pathological findings were consistent with diffuse large B-cell lymphoma (DLBCL); however, a small area showed features ...of mucosa-associated lymphoid tissue (MALT) lymphoma. Biopsy specimens were referred to two other pathologists, both of whom diagnosed the case as pure DLBCL, denying the area of MALT lymphoma. As the lymphoma was limited to the submucosal layer and the patient's general condition was excellent, eradication of Helicobacter pylori was selected as the initial treatment. The lymphoma completely disappeared three months after the eradication treatment, and complete remission has been maintained for nearly two years.
We report on a discovery of “negative” superhumps during the 2011 January superoutburst of ER UMa. During the superoutburst, which started on 2011 January 16, we detected negative superhumps having a ...period of 0.062242(9) d, shorter than its orbital period by 2.2%. No evidence of a positive superhump was detected during this observation. This finding indicates that the disk exhibited retrograde precession during this superoutburst, contrary to all other known cases of superoutbursts. The duration of this superoutburst was shorter than those of ordinary superoutbursts, and the interval of its normal outbursts was longer than those of ordinary normal outbursts of ER UMa. We suggest the possibility that such unusual outburst properties are likely to be a result of a disk tilt, which is supposed to be a cause of negative superhumps; the tilted disk could prevent the disk from being filled with materials in the outmost region, which is supposed to be responsible for long-duration superoutbursts in ER UMa-type dwarf novae. This discovery signifies the importance of the classical prograde precession in sustaining long-duration superoutbursts. Furthermore, the presence of pronounced negative superhumps in this system with a high mass-transfer rate supports the hypothesis that hydrodynamical lift is the cause of the disk tilt.
Trastuzumab has recently been introduced as a treatment for HER2-positive metastatic and/or unresectable gastric cancer (MUGC); however, compared with breast cancer, some issues concerning HER2 and ...trastuzumab therapy for gastric cancer remain unclear. A 74-year-old woman received trastuzumab-containing chemotherapy for HER2-positive MUGC. She had a marked response to 8 months of chemotherapy, and gastrectomy and hepatic metastasectomy with curative intent were performed. The resected specimen showed complete loss of HER2 positivity in the residual tumor. For MUGC, a change in HER2 status during the course of the disease with or without chemotherapy has rarely been reported. However, in breast cancer, a significant frequency of change in HER2 status during the course of disease has been reported, and reevaluation of HER2 positivity in metastatic/recurrent sites is recommended. The choice of trastuzumab for MUGC is currently based on the HER2 status of the primary tumor at the time of initial diagnosis, without reassessment of HER2 status during the course of disease and/or in metastatic/recurrent sites, on the assumption that HER2 status is stable. However, our case casts doubt on the stability of HER2 in gastric cancer.
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