Hemophagocytic Lymphohistiocytosis Secondary to Acute Human Immunodeficiency Virus and COVID-19.

Hemophagocytic lymphohistiocytosis (HLH), characterized by acute and progressive hyperinflammation, is a rare syndrome documented in a limited number of coronavirus disease 2019 (COVID-19) and human immunodeficiency virus (HIV) cases. While severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can provoke extensive immune activation and systemic inflammation, individuals with HIV, susceptible to immune dysregulation, are at heightened risk of severe complications from SARS-CoV-2. We report a case of a 24-year-old male with no significant medical history presenting with fever, weight loss, respiratory symptoms, and acute renal failure.

Catch the Calcium: T-Cell Histiocyte-Rich B-Cell Lymphoma Presenting as Hypercalcemia.

T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is an extremely rare and aggressive subtype of diffuse large B-cell lymphoma (DLBCL) that typically presents in middle-aged patients and carries a poor prognosis. Hypercalcemia presenting as the initial manifestation of the disease is rare, with only one other case reported in the literature. We report a case of a 90-year-old male who presented with progressive lethargy and unintentional weight loss.

The Diagnostic and Treatment Challenges of Concomitant Mantle Cell Lymphoma and IgM Myeloma.

Unlabelled: It is rare for IgM multiple myeloma (MM) and mantle cell lymphoma (MCL) to coexist. Furthermore, it is challenging to demonstrate if there are two distinct types of neoplasia or if plasma cell differentiation of MCL is present. We discuss the case of a patient concomitantly diagnosed with MCL and IgM MM, and the subsequent diagnostic and management difficulties, and the positive treatment outcome.

Reliability of combined fine needle aspiration and core needle biopsies in the diagnosis of liver lesions: An 8-year institutional experience.

Objective: Fine needle aspiration (FNA), followed by core needle biopsy (CNB) when needed, was adopted as the standard care for liver lesions in our institution. This study explores the diagnostic efficacy of combined image-guided FNA and CNB in liver lesion diagnosis.

Method: We retrospectively reviewed all liver FNA cases performed in our institution between January 2010 and September 2018.

Outcome of atypia of undetermined significance/follicular lesion of undetermined significance in thyroid fine-needle aspirations: A six-year institutional experience.

Background: Atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) is one of six diagnostic categories of The Bethesda System for Reporting Thyroid Cytopathology (BSRTC). The goal of our study is to assess the outcome of cases classified as AUS/FLUS at our institution.

Methods: AUS/FLUS cases were identified by computer searching of the thyroid fine-needle aspiration (FNA) cases performed between 2010 and 2016.

Gamna-Gandy bodies in fine-needle aspiration from abdominal splenosis: A clue to underlying portal hypertension.

A 40-year-old woman presented with abdominal pain and jaundice. Past medical history was significant only for splenectomy following a motor vehicle accident. Owing to presence of multiple peritoneal nodules on computerized tomography (CT) and elevated serum CA-125, ovarian peritoneal carcinomatosis was suspected.

Dual Expression of TCF4 and CD123 Is Highly Sensitive and Specific For Blastic Plasmacytoid Dendritic Cell Neoplasm.

The diagnosis of blastic plasmacytoid dendritic cell neoplasm (BPDCN) has been based on the expression status of multiple markers, including CD123. TCF4 was discovered recently to be an obligatory master regulator of plasmacytoid dendritic cells. We postulated that a tissue-based assay designed to detect dual CD123 and TCF4 expression would provide a highly reliable and practical marker for BPDCN in biopsy material.

Early T precursor acute lymphoblastic leukaemia/lymphoma shows differential immunophenotypic characteristics including frequent CD33 expression and in vitro response to targeted CD33 therapy.

The differential immunophenotypic characteristics of early T precursor (ETP) acute lymphoblastic leukaemia/lymphoma (ALL) remain incompletely characterized. The study group (n = 142) included 106 (74·7%) men and 36 (25·3%) women with a median age of 34·9 years (range, 2-79) at diagnosis. Patients were subtyped by flow cytometry immunophenotyping as follows: 33 (23·2%) ETP; 32 (22·5%) early non-ETP; 60 (42·2%) thymic; and 17 (12·1%) mature.

CD123 expression patterns and selective targeting with a CD123-targeted antibody-drug conjugate (IMGN632) in acute lymphoblastic leukemia.

The potential of CD123-targeted therapies in acute lymphoblastic leukemia/lymphoma remains largely unexplored. We examined CD123 expression levels in a large cohort of patients with acute lymphoblastic leukemia/lymphoma and assessed the impact of IMGN632, a conjugate of CD123-binding antibody with a novel DNA-alkylating payload. CD123 expression on leukemic blasts was surveyed using multicolor/multiparameter flow cytometry.

IgM plasma cell myeloma in the era of novel therapy: a clinicopathological study of 17 cases.

IgM plasma cell myeloma (PCM) is a rare subtype of myeloma, and its response to novel therapies has not been fully characterized. We describe clinicopathological features and outcome of 17 patients with IgM PCM (11 men and 6 women) with a median age of 63 years. Patients presented with serum hyperviscosity (77%), bone lesions (71%), anemia (65%), renal dysfunction (53%), and hypercalcemia (35%).

Clinicopathologic and molecular features in hairy cell leukemia-variant: single institutional experience.

Hairy cell leukemia-variant is rare. Only a small number of cases have been reported in the literature with little cytogenetic or molecular data available. In this study, we describe the clinicopathologic and genetic features of 23 patients with hairy cell leukemia-variant (16 men and 7 women) with a median age of 70 years.

EPIDEMIOLOGICAL REGISTRY OF NEUROENDOCRINE TUMORS IN BULGARIA--A PILOT SURVEY.

The National registry of patients with neuroendocrine tumors (NET) in Bulgaria was established in 2013 as a joint initiative of the Bulgarian Surgical Society and the Institute for Rare Diseases. The register aims to explore the epidemiology of NET in Bulgaria, as well as the different diagnostic and treatment approaches for the disease throughout the country. This the first of its kind retrospective study of NET in the country is covering the period January 2012 - January 2013.

Serum levels of siCAM-1, sVCAM-1, sE-selectin, sP-selectin in healthy Bulgarian people.

Background: Endothelial dysfunction is increasingly recognized as an important early feature of vascular disease. As the damage to endothelium is a key underlying factor in the development and progression of atherosclerotic processes, markers of endothelial abnormalities have been sought. Increased expression of cell adhesion molecules (CAMs) on the vascular endothelium has been postulated to play a significant role in atherogenesis.

Plasma asymmetric dimethylarginine levels in healthy people.

Unlabelled: Asymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of the endothelial nitric oxide synthase (eNOs). ADMA is believed to be implicated in angiogenesis because it regulates the nitric oxide biosynthesis; any pathological abnormalities in ADMA play a crucial role in the pathogenesis and progression of atherosclerosis. The AIM of the present study was to determine the reference range for plasma concentration of ADMA in a sample of Bulgarian population.

DNA identification of biological traces and interpretation in a sexual assault case.

The approaches in research and practical work in the forensic laboratories of DNA profiling in a sexual assault case can be assessed by the individual valuation of the quality and quantity of available DNA and the choice of combination of the STRs loci that have been examined. The applied procedures are classic or modificated extraction, amplification, and electrophoretical procedures, which have been selected for every individual case. We set up to present a criminal case of sexual assault over a woman, where the suspect used a condom which--after being examined--gave a negative sperm cytologic result.

[A case of 11 operation because of genitourilal abnormalites and cervical carcinoma].

A case of young woman with 11 operation because of genitourinal abnormalities and cancer of the uterine cervix. The patient was with bladder exstrophy and 2nd stage cervical cancer, treated operatively and with chemotherapy. Because local recurrence she was operated 3 times.

Role of some biomarkers of atherogenic risk in the screening for molecular defects in the low density lipoprotein receptor in severe hypercholesterolemia.

Background: Familial hypercholesterolemia is difficult to diagnose because of different expressions of the defective gene in low density lipoprotein (LDL) receptor mutation carriers and the presence of elevated LDL levels in noncarriers.

Aim: To study specific biomarkers of atherogenic risk in carriers and noncarriers of low density lipoprotein receptor (LDLR) defective gene and utilize them to screen in molecular biological analysis for defects in the LDL receptor (spot mutation and polymorphism) in severe hypercholesterolemia.

Patients And Methods: We investigated 120 patients after screening using the Simon-Broome criteria.

Associations between serum selenium and total plasma homocysteine during the acute phase of ischaemic stroke.

Background/aims: Risk of ischaemic stroke (IS) was associated with total homocysteine (tHCY). On the other hand, serum selenium (Se) exhibited anti-aging and cardiopreventive effects. Se and tHCY showed relationships in animals but these were contradictory or inconclusive in humans; therefore, we searched for such associations in acute IS.

Relationship of asymmetric dimethylarginine with flow-mediated dilatation in subjects with newly detected severe hypercholesterolemia.

Background: Little is know about the relationship between asymmetric dimethylarginine (ADMA) and percent flow-mediated dilatation (%FMD) in subjects with severe hypercholesterolemia (HH).

Aim: The aim of the present study was the evaluation of the relationship of ADMA to %FMD, as well as to lipid parameters and other markers of endothelial dysfunction in newly detected subjects with severe HH.

Methods: One hundred and twenty asymptomatic patients with severe, newly detected HH and 100 controls were evaluated.

Analysis of the K-ras/B-raf/Erk signal cascade, p53 and CMAP as markers for tumor progression in colorectal cancer patients.

Colorectal cancer patients may succumb to their disease because of local recurrence or formation of metastasis. To develop a prognostic tool for these fatal types of progression, 23 patients with colorectal carcinoma were included in this study for the detection at the time of surgery of the incidence of K-ras, B-raf and p53 mutations, the phosphorylation status of Erk and the expression of cystatin-like metastasis-associated protein (CMAP) in tumor, mucosa and liver samples. Polymerase chain reaction-restriction fragment length polymorphism and PCR-SSCP were used to detect the respective mutations.

Modelling of increased homocysteine in ischaemic stroke: post-hoc cross-sectional matched case-control analysis in young patients.

Background & Purpose: Hyperhomocysteinaemia has been postulated to participate in pathogenesis of ischaemic stroke (IS). However, especially in young adults, there is possibility of significantly increased IS risk due to increased normal homocysteinaemia, i.e.

Total plasma homocysteine in Bulgarian population measured by high-performance liquid chromatography with fluorescence detection--comparison with fluorescence polarization immunoassay.

Over the last decade, evidence has accumulated that elevated total homocysteine (tHcy) is an independent risk factor for vascular disease. Due to the variety of Hcy determinants (age, gender, ethnicity and lifestyle), it is now recommended that the distribution of plasma Hcy concentrations should be established for different populations. Therefore the objective of our study was to evaluate a modified HPLC with fluorescence detection procedure for reliable quantification of tHcy and to demonstrate its successful application to determine the distribution of tHcy levels in healthy Bulgarians.

A study of plasma total homocysteine levels in healthy people.

Unlabelled: Elevated plasma levels of homocysteine have been identified as an independent risk factor for atherosclerosis.

Aim: The aim of this study was to determine the reference limits of plasma total homocysteine for Bulgarian population.

Materials And Methods: We investigated 153 healthy individuals without vitamin deficiency aged from 18 to 65 years.

Expression of galanin in hypothalamic magnocellular neurones of lactating rats: co-existence with vasopressin and oxytocin.

Lactation is a physiological condition known to upregulate the expression of the hypothalamic neurohormones, oxytocin and vasopressin, in the rat supraoptic and paraventricular nuclei. Other neuropeptides such as galanin are co-localized in the same magnocellular neurones and their expression has been demonstrated to be regulated by different experimental and physiological conditions. In the present study, we investigated the possible changes in galanin expression during lactation, using in situ hybridization and immunohistochemistry separately or in combination.