Pneumomediastinum is a rare, potentially life-threatening complication of PCP that occurs in HIV-positive and HIV-negative patients. We are presenting a rare case pneumomediastinum caused by pneumocystis Jirovecii pneumonia in a HIV-negative patient with history of diffuse B-cell lymphoma on R CHOP chemotherapy. What is unique about our case is that the patient developed pneumomediastinum while in the hospital, on atovaquone that improved when switched to clindamycin and primaquine with improvement in her respiratory status. Another interesting point is that diagnosis was entertained due to the characteristic CT scan finding of ground glass opacities with cystic lung lesions and pneumomediastinum in an immunocompromised patient who was started on empirical treatment for PCP. The diagnosis was eventually confirmed with PCP PCR.

Solitary fibrous tumors of the pleura (SFTPs) are rare neoplasms of mesenchymal origin most commonly arising in the pleura and have a benign biological behavior in the majority of cases. Most patients with SFTPs are asymptomatic; however, symptoms are mostly related to the mass effect within the thoracic cavity. Chest computed tomography (CT) scanning is the radiographic test of choice, but findings lack specificity. Surgical resection is the treatment of choice for most patients. Long-term survival after resection of benign SFTPs is excellent. In this case series, we present two females, one presented with shortness of breath (SOB) and nonproductive cough and the other one was referred because of abnormal x-ray findings. The histological as well as the immunohistochemical examination revealed the mass to be a solitary fibrous tumor of the pleura.

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RATIONALE: This study found Cystatin SN (CST1), a type 2 cystatin subfamily member, to be highly expressed in nasal polyps from patients with intractable chronic rhinosinusitis with nasal polyps (CRSwNP), using a whole transcript analysis with next-generation sequencing. Eosinophilic chronic rhinosinusitis (ECRS) involves nasal polyps that are refractory and recurrent immediately after endoscopic sinus surgery. We hypothesized that CST1 may contribute to the pathogenesis of ECRS. METHODS: The expression of CST1 in nasal polyps from patients with ECRS was examined by mRNA expression levels, using real-time PCR and immunohistochemistry. We examined the function of CST1 using nasal epithelial cells and nasal fibroblasts. RESULTS: CST1 was significantly expressed in the epithelial cells of the nasal polyps from patients with ECRS, compared with patients who did not have ECRS (non-ECRS). Particularly, CST1 showed very strong expression in patients with severe ECRS. The expression of CST1 may be correlated with the recurring and refractory nature of ECRS. Stimulation by a combination of IL-4 plus dsRNA plus CST1 significantly elevated mRNA expression levels and protein levels of TSLP in nasal epithelial cells. Stimulation by TSLP or IL-33 significantly elevated mRNA expression levels of CST1 in nasal epithelial cells. Stimulation of CST1 significantly elevated mRNA expression levels of CCL11 and POSTN in nasal fibroblasts. CONCLUSIONS: CST1 could amplify eosinophilic infiltration and Th2 inflammation by interacting with epithelial-derived cytokines and fibroblasts on nasal polyps. CST1 may be involved in the pathogenesis of ECRS, and may contribute to the severity and recurrence of CRSwNP after ESS.

Introduction: The ABO antigens are expressed on the surface of red blood cells, epithelial cells, and endothelial cells. The association between different ABO blood group and several conditions such as VTE, CAD, and several neoplasms is well documented in the literature. The aim of this study is to examine the impact of ABO blood group on the biochemical failure after radical prostatectomy. Methods: After Institutional research board approval; we retrospectively reviewed the radical prostatectomy database (1998-2012) to examine the association between the ABO blood group and biochemical recurrence. Hazard ratio (HRs) and their 95% confidence intervals were calculated using Univariable and multivariable Cox regression models. Results: 385 patients underwent open radical retropubic prostatectomy between 1998 and 2012. Follow-up more than 2 months was available for 229 patients. Seventy-Five patients developed biochemical failure, defined as PSA > 0.2 ng/dl. The 10-year Biochemical recurrence-free survival were 53.6% (95% CI, 39.8%-65.7%) for blood group O, 58.0% for blood group A (95% CI, 43.1%-70.3%) and 61.8% (95% CI, 33.1%-81.1%) for blood group B. The log-rank test showed no significant associations between blood group and PSA failure at the univariate level and Multivariate. On the other hand, pre-op PSA, Gleason score, surgical margin and extra-prostatic extension were significantly associated with biochemical recurrence-free survival.