BackgroundAsthma–COPD overlap (ACO) is difficult to diagnose because it is characterized by persistent airflow limitation, and patients present with several manifestations that are usually associated with both asthma and COPD. In this retrospective study, we aimed to evaluate the diagnostic accuracy of fractional exhaled nitric oxide (FeNO) and blood eosinophil counts for the clinical diagnosis of ACO.Patients and methodsA total of 121 patients were divided into two study groups, COPD alone or ACO, which was based on criteria from the joint document by the Global Initiative for Asthma and the Global initiative for chronic Obstructive Lung Disease. From July 2014 to April 2017, FeNO levels and blood eosinophil counts were measured in specimens from patients naïve to inhaled corticosteroids (ICS) and those using ICS. Receiver operating characteristic curve analysis was used to determine the cutoff values of FeNO and blood eosinophil levels that provided the best differential diagnosis between ACO and COPD.ResultsAmong a total of 121 patients, 65 patients were diagnosed with COPD and 56 patients with ACO. The FeNO level was higher in patients with ACO than in patients with COPD (median 24.5 vs 16.0 ppb, respectively; P<0.01). Among patients naïve to ICS, the area under the receiver operating characteristic curve of FeNO values was 0.726, and the optimal diagnostic cutoff level of FeNO was 25.0 ppb, with 60.6% sensitivity and 87.7% specificity for differentiating ACO from COPD. FeNO (≥25.0 ppb) combined with blood eosinophil counts (≥250/μL) showed 96.1% specificity.ConclusionThese results demonstrate that the FeNO level combined with blood eosinophil count is useful for the differential diagnosis between ACO and COPD.

Background Primary human herpesvirus 8 (HHV8)‐unrelated effusion large B‐cell lymphoma is a clinical disease entity distinct from HHV8‐positive primary effusion lymphoma (PEL). However, the lack of experimental HHV8‐unrelated effusion large B‐cell lymphoma models continues to hinder the pathophysiologic and therapeutic investigations of this disorder. Methods The lymphoma cells were obtained from the pleural effusion of a patient with primary HHV8‐unrelated effusion large B‐cell lymphoma and cultured in vitro. Results We established a novel HHV8‐unrelated effusion large B‐cell lymphoma cell line, designated Pell‐1, carrying a c‐MYC rearrangement with features distinct from those of HHV8‐positive PEL. Moreover, we developed an HHV8‐unrelated effusion large B‐cell lymphoma cell line‐derived xenograft model. Pell‐1 cells induced profuse lymphomatous ascites and subsequently formed intra‐abdominal tumors after intraperitoneal implantation into irradiated nonobese diabetic/severe combined immunodeficient mice. Thus, this xenograft mouse model mimicked the clinical phenomena observed in patients and recapitulated the sequential stages of aggressive HHV8‐unrelated effusion large B‐cell lymphoma. The bromodomain and extraterminal domain (BET) inhibitors JQ1 and birabresib (MK‐8628/OTX015) reduced the proliferation of Pell‐1 cells in vitro through the induction of cell cycle arrest and apoptosis. The antitumor effect of BET inhibition was also demonstrated in vivo, as birabresib significantly reduced ascites and suppressed tumor progression without apparent adverse effects in the xenografted mice. Conclusion These preclinical findings suggest the therapeutic potential of targeting c‐MYC through BET inhibition in HHV8‐unrelated effusion large B‐cell lymphoma.

Precise control of molecule‐electrode interface is essential for molecular devices. Herein, new ruthenium acetylide molecular wires with long‐legged phosphine ligands to form a sterically controlled molecule‐electrode interface are designed. The sharpened Raman signals ascribed to acetylene stretching are observed for the self‐assembled monolayers (SAMs) of the molecular wires with the biphenyl‐ (2Au) and tert‐butylbiphenyl‐substituted long‐legged dppe‐type ligands (3Au), suggesting that steric hindrance causes formation of uniform SAMs. Scanning tunneling microscope break‐junction (STM‐BJ) study of 3Au reveals narrow conductance features compared with those of 1Au bearing the parent dppe ligands, indicating formation of a uniform molecular junction. Furthermore, the effective electronic interactions between the molecule and electrodes are unique to the long‐legged derivatives, as revealed by the surface‐enhanced Raman scattering study. Thus, the bulky long‐legged strategy turns out to provide a design concept for a well‐defined molecule‐electrode interface.

Large B-cell lymphomas that grow exclusively in body cavity effusions without identifiable tumour masses are universally associated with human herpesvirus 8 (HHV8), also called Kaposi sarcomaassociated herpesvirus, and this lymphoma entity is defined as primary effusion lymphoma (PEL) according to the 2017 World Health Organization classification. 1 PEL often appears with Epstein-Barr virus (EBV), especially in the setting of human immunodeficiency virus (HIV) infection. 1 PEL has a characteristic phenotype in that it lacks pan-B-cell markers such as CD19 and CD20 but expresses plasma cell markers such as CD138. [1][2][3] Primary HHV8-unrelated effusion lymphoma, hereinafter referred to as HHV8-unrelated effusion large B-cell lymphoma

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We report a case of mantle cell lymphoma mimicking Castleman disease. A 76-year-old man presented with generalized lymphadenopathy, splenomegaly, anemia, polyclonal gammopathy, and pulmonary infiltrations. Lymph node biopsy revealed histological features of hyaline vascular Castleman disease. Treatment with prednisolone induced lymphocytosis with immunophenotypic and genetic features of mantle cell lymphoma. A detailed immunohistochemical study of the lymph node demonstrated a mantle cell lymphoma-mantle zone growth pattern. Glucocorticoid-induced distribution lymphocytosis has not been reported in mantle cell lymphoma. Careful observation of circulating lymphocytes during steroid treatment may enable diagnosis of the underlying occult lymphoma in a subset of patients exhibiting clinical manifestations of Castleman disease.

Objective Patients with hematological malignancies and solid organ tumors reportedly tend to have a more severe COVID-19 trajectory than do those with other diseases. We studied the clinical features and outcomes of nosocomial SARS-CoV-2 infection during the seventh wave of the pandemic. Methods This study retrospectively described the characteristics of COVID-19 clusters involving patients in the hematology/respirology ward of Kochi Medical School Hospital during the seventh wave of the pandemic of SARS-CoV-2. Patients and Materials A total of 40 individuals, including 25 patients and 15 healthcare workers, were studied. The diagnosis of SARS-CoV-2 infection was based on reverse transcription polymerase chain reaction performed on nasopharyngeal samples. Results Eleven patients had hematological diseases, and 14 had respiratory diseases. Most patients presented with a fever (n = 19) and/or sore throat (n = 10). Lower respiratory tract symptoms and pneumonia were rather infrequent, occurring in two patients. All patients received antivirals. The maximal severities were mild in 21 patients and moderate in 2. Two asymptomatic patients with SARS-CoV-2 infection did not develop symptoms of COVID-19. Cycle threshold values in nasopharyngeal samples were significantly lower in patients with COVID-19 than in those who were asymptomatic at the time of the diagnosis with SARS-CoV-2 infection. All SARS-CoV-2-infected inpatients recovered or did not develop symptoms of COVID-19. Conclusion COVID-19 vaccination, early or preemptive treatment with antivirals, and intrinsic changes in SARS-CoV-2 may have contributed to the more favorable outcomes in our series than in previously reported nosocomial clusters.

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