The superfamily of glutathione S-transferases has been the subject of extensive study but Actinobacteria produce mycothiol (MSH) in place of glutathione and no mycothiol S-transferase (MST) has been identified. Using mycothiol and monochlorobimane as substrates a MST activity was detected in extracts of Mycobacterium smegmatis and purified sufficiently to allow identification of MSMEG_0887, a member the DUF664 family of the DinB superfamily, as the MST. The identity of the M. smegmatis and homologous Mycobacterium tuberculosis (Rv0443) enzymes was confirmed by cloning and the expressed proteins were found to be active with MSH but not bacillithiol (BSH) or glutathione (GSH). Bacillus subtilis YfiT is another member of the DinB superfamily but this bacterium produces BSH. The YfiT protein was shown to have S-transferase activity with monochlorobimane when assayed with BSH but not with MSH or GSH. Enterococcus faecalis EF_3021 shares some homology with MSMEG_0887 but this organism produces GSH but not MSH or BSH. Cloned and expressed EF_0321 was active with monochlorobimane and GSH but not with MSH or BSH. MDMPI_2 is another member of the DinB superfamily and has been previously shown to have mycothiol-dependent maleylpyruvate isomerase activity. Three of the eight families of the DinB superfamily include proteins shown to catalyze thiol-dependent metabolic or detoxification activities. Since more than two-thirds of the sequences assigned to the DinB superfamily are members of these families it seems likely that such activity is dominant in the DinB superfamily.

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Background: Primary renal lymphoma (PRL) is an exceptionally rare disease with under 50 reported cases in the literature. PRL is an aggressive condition that can present with nonspecific symptoms and local invasion mimicking renal cell carcinoma (RCC). We present an unusual case involving a collision tumor between PRL and RCC.Case Presentation: The patient is a 62-year-old immunosuppressed man with an incidental left renal mass on cross-sectional imaging. Renal mass biopsy confirmed clear cell type RCC. He underwent robot-assisted, laparoscopic left radical nephrectomy for presumed RCC without evidence for extrarenal disease or discernable lymphadenopathy. Final pathology revealed a collision tumor, including PRL and RCC.Conclusion: To our knowledge, this is the first reported case within the literature describing a collision tumor between PRL and RCC. Although rare, it is important to consider PRL in the differential diagnosis of a solid renal mass, especially in patients with a prior history of transplantation and/or chronic immunosuppression.

¼ 263,991; 58% of total volume) compared to inpatient (N ¼ 183,386; 40%). Radiologists performed the majority of these procedures (N ¼ 164,580; 36% of the total volume), followed by cardiologists (N ¼ 138,949; 31%) and vascular surgeons (N ¼ 75,431; 17%). However, radiologists saw the greatest decline in procedure volumes (25,907 to 13,108; -49%), compared with cardiologists (20,514 to 12,629; -35%) and vascular surgeons (9684 to 7921; -18%). Conclusions: The volume of percutaneous extremity venography procedures performed in the Medicare population declined from 2010 to 2018, most likely related to more stringent patient selection. Radiologists performed the majority of procedures but were closely followed by cardiologists.

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