Citations 2
Meeting the Challenges of Myocarditis: New Opportunities for Prevention, Detection, and Intervention—A Report from the 2021 National Heart, Lung, and Blood Institute Workshop
Čiháková, Daniela , Adhikari, Bishow B., Bandettini, W. Patricia , Cunningham, Madeleine W. , Danthi, Narasimhan , Longacre, Lisa Schwartz, Mann, Douglas L. , Tang, W.H. Wilson , Zhou, Guofei , Cooper, Leslie T. , Mann, Douglas L , Tang, W H Wilson , Cooper, Leslie T , Shi, Yang , Friedrich, Matthias G. , Liu, Peter Xiaoping , Świrski, Filip K.
Journal of Clinical Medicine | September 28, 2022 | Volume: 11 | Issue: 19 | Pages: 5721
The National Heart, Lung, and Blood Institute (NHLBI) convened a workshop of international experts to discuss new research opportunities for the prevention, detection, and intervention of myocarditis in May 2021. These experts reviewed the current state of science and identified key gaps and opportunities in basic, diagnostic, translational, and therapeutic frontiers to guide future research in myocarditis. In addition to addressing community-acquired myocarditis, the workshop also focused on emerging causes of myocarditis including immune checkpoint inhibitors and SARS-CoV-2 related myocardial injuries and considered the use of systems biology and artificial intelligence methodologies to define workflows to identify novel mechanisms of disease and new therapeutic targets. A new priority is the investigation of the relationship between social determinants of health (SDoH), including race and economic status, and inflammatory response and outcomes in myocarditis. The result is a proposal for the reclassification of myocarditis that integrates the latest knowledge of immunological pathogenesis to refine estimates of prognosis and target pathway-specific treatments.
CD138− Plasmablastic Lymphoma: A Multi-institutional Study and Review of the Literature
Choudhuri, Jui , Pan, Zenggang , Yuan, Ji, Wu, Xiaojun , Yuan, Youzhong , Agarwal, Beamon , Liu, J M, Maxwell, Y, Wang, Yanhua , Ji, Yuan , Zheng, Gang , Yuan, Ji , Chen, Mingyi , Zheng, Gang , Chen, Zhao , Shi, Yang
Archives of Pathology & Laboratory Medicine | September 26, 2022 | Volume: 147 | Issue: 6 | Pages: 643-654
Context.— Plasmablastic lymphoma (PBL) is a rare aggressive lymphoma, usually positive for CD138 and frequently occurring in the oral cavity of human immunodeficiency virus (HIV) patients. Up to 10% of cases are negative for CD138 and diagnostically very challenging. Objective.— To investigate the appropriate approach to diagnose CD138− plasmablastic lymphoma and avoid misdiagnosis. Design.— We studied 21 cases of CD138− PBL from multiple large institutes in the United States and 21 cases from the literature. Results.— CD138− PBLs were positive for different B/plasma cell markers at various percentages: MUM1 (94.4%; 34 of 36), OCT2 (70.6%; 12 of 17), immunoglobulin light chains (68.8%; 22 of 32), CD38 (68.4%; 13 of 19), CD79a (34.2%; 13 of 38), and PAX5 (15.6%; 5 of 32), suggesting that MUM1, OCT2, immunoglobulin light chains, and CD38 are useful markers to help establish the lineage. A total of 83% of cases (30 of 36) were extraoral lesions. Extraoral lesions showed much lower Epstein-Barr virus (EBV) infection rates (16 of 30; 53.3%) and had worse prognosis. MYC was positive in 80% (8 of 10) of EBV+ cases and 40% (2 of 5) EBV− cases, indicating the importance of MYC in pathogenesis, especially in EBV+ cases. Conclusions.— Our study emphasizes that CD138− PBLs tend to be extraoral lesions, with much lower EBV infection rates, and diagnostically very challenging. Accurate diagnosis requires a thorough investigation and workup by using appropriate markers.