PD-L1 positivity was associated with worse CRR and CER, and marginally worse CMR. The effect on progression-free and overall survival needs to be validated in a study with a larger sample size.

A 59-year-old patient with multiple myeloma on maintenance chemotherapy presented with fever, weight loss, and night sweats. An F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) computed tomography (CT) showed intra-abdominal lymphadenopathy with a mesenteric mass that led to further workup and diagnosis of histoplamosis. The patient was treated with amphotericin B and subsequently switched to itraconazole. This exemplifies the usefulness of FDG PET CT in diagnosis of infectious complications.

Since 2005, we have used the Ethylene vinyl alcohol copolymers (Onyx 18 and Onyx 34) in the treatment of 29 patients with high flow arteriovenous vascular malformations. There were 20 females and 9 males with ages ranging from 1-67 years (mean 28 years). Nineteen of the malformations involved the extremities and 10 involved the chest, abdominal wall or pelvis. All patients were evaluated with MRI/MRA pre-treatment and ultrasound if necessary to document lesion visibility. Onyx 18 was delivered by subselective transarterial and /or venous microcatheter techniques with or without ultrasound and fluoroscopic guided direct injection under tourniquet control. Tissues from patients whose embolized lesions were subsequently explanted were examined histologically, employing standard Hematoxylin and Eosin staining. Results: Ethylene vinyl alcohol copolymer (Onyx) was found to be durable and effective. Its visibility allowed observation of filling of the malformation interstices. There was minimal post procedure discomfort with Onyx. Of the thirty-nine patients, two developed an area of skin ulceration, and one had worsening of a pre-existing radiation burn. There was one minor complication with migration of a small Onyx fragment to the lung, without sequelae. In patients who received multiple treatments, multiple imaging obliquities were sometimes needed to allow visualization of untreated portions of the lesion. On H & E stains, the filling of the intraluminal spaces of the malformation with associated foreign body type giant cell reaction was observed. Conclusions: Ethylene vinyl alcohol copolymer is a safe, durable agent for treatment of high flow arteriovenous malformations.

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