BackgroundLymph node tuberculosis (LNTB) is the most frequent extrapulmonary form of tuberculosis (TB). Studies of human tuberculosis at sites of disease are limited. LNTB provides a unique opportunity to compare local in situ and peripheral blood immune response in active Mycobacterium tuberculosis (Mtb) disease. The present study analysed T regulatory cells (Treg) frequency and activation along with CD4+ T cell function in lymph nodes from LNTB patients.ResultsLymph node mononuclear cells (LNMC) were compared to autologous peripheral blood mononuclear cells (PBMC). LNMC were enriched for CD4+ T cells with a late differentiated effector memory phenotype. No differences were noted in the frequency and mutifunctional profile of memory CD4+ T cells specific for Mtb. The proportion of activated CD4+ and Tregs in LNMC was increased compared to PBMC. The correlation between Tregs and activated CD4+ T cells was stronger in LNMC than PBMC. Tregs in LNMC showed a strong positive correlation with Th1 cytokine production (IL2, IFNγ and TNFα) as well as MIP-1α after Mtb antigen stimulation. A subset of Tregs in LNMC co-expressed HLA-DR and CD38, markers of activation.ConclusionFurther research will determine the functional relationship between Treg and activated CD4+ T cells at lymph node sites of Mtb infection.Electronic supplementary materialThe online version of this article (10.1186/s12865-018-0266-8) contains supplementary material, which is available to authorized users.
Disease-specific quality of life (QOL) measures have enhanced the capacity of outcome measures to evaluate subtle changes and differences between groups. As many of the QOL measures have been developed in English, they require translation to ensure their usefulness in a multi-cultural and/or international society. Published guidelines provide formal methods to achieve cross-culturally comparable versions of a QOL tool. The aim of this study was to adapt the head and neck specific module of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-H&N 35 questionnaire) into Moroccan Arabic and to determine its psychometric properties. After translation, back translation and pretesting of the pre-final version, the translated version was submitted to a committee of professionals composed by otolaryngologists and epidemiologists. The psychometric properties were tested in patients with ENT cancer. Internal consistency was tested using Cronbach's alpha and the test-retest reliability using interclass correlation coefficients. Construct validity was assessed by examining item convergent and divergent validity. It was also tested using Spearman's correlation between QLQ-H&N 35 scales and EQ-5D. The study was conducted in 120 patients. The Moroccan version was internally reliable, Cronbach's α ranged from 0.71 for "trouble with social contact" to 0.94 for "senses impairment", indicating good internal consistency. Test-retest reliability was assessed using the intra-class correlation coefficient, which ranged from 0.64 for "speech trouble" to 0.89 for "physical activities". The instrument demonstrated a good construct and concomitant validity. We have developed a semantically equivalent translation with cultural adaptation of EORTC QLQ-H&N 35 questionnaire. The assessment of its measurement properties showed that it is quite reliable and a valid measure of the effect of cancer on the quality of life in Moroccan patients.
Solitary extramedullary plasmacytoma of the thyroid gland is an uncommon condition. Up to date, its clinical pathological features are not fully understood. We present a case of an extramedullary nonmucosal plasmacytoma of the thyroid gland which is the first case with regional metastatic lymph nodes. This condition requires a scrupulous survey to rule out a metastatic multiple myeloma. Although localized forms management is still controversial, authors require combined approach for regional metastatic forms. The prognosis is favorable compared to solitary bone plasmacytomas or multiple myeloma.
Chondrosarcoma is a malignant tumor relatively rare on the larynx, and raises diagnostic and therapeutic difficulties. Its diagnosis often requires the recourse to a radiological, endoscopic and anatomopathologic confrontation. Its treatment is exclusively surgical. It is based on broad excision sometimes mutilating and requires in this kind of localization a multidisciplinary collaboration between ORL, vascular surgeon and radiotherapy. In the light of a new very conclusive observation and data of the literature, we wanted to give a progress report on the clinical and therapeutic positions of the various authors.
Schwannomas of the descending loop of the hypoglossal nerve are very rare. Existing literature of the schwannoma of the descending loop of the hypoglossal nerve is limited to two previously reported case. They are slow-growing tumors that may masquerade a carotid body tumor. We herein described a rare case of schwannoma of the descending loop of the hypoglossal nerve in the s right latero-cervical region with diagnostic imaging and histopathological findings. A 37-years-old woman has had a palpable firm, mobile mass in the right latero-cervical region, of imaging, MR images showed homogeneous hypointensity on T1-weighted imaging (T1-WI), heterogeneous hyperintensity on T2-WI, and heterogeneous enhancement on contrast-enhanced T1-WI. Diagnostic imaging using computed tomography (CT) and magnetic resonance imaging (MRI) was suspected of Chemodectoma or neurogenic tumor. At operation, a 4 cm mass arising from the descending loop of the hypoglossal nerve of was resected en bloc with the loop itself; Final diagnosis was confirmed on the basis of histopathological finding and intraoperative findings. Postoperative course was uneventful and the patient is free from disease recurrence at tree-year follow-up. En bloc resection remains the real curative treatment of Schwannomas, ensuring unlimited freedom from disease, although causing functional impairment which may be significant. Nonetheless recurrence should be prevented as, besides requiring reintervention, it may harbor a malignant evolution towards sarcoma. Schwannomas of the descending loop of the hypoglossal nerve may masquerade a chemodectoma of the carotid bifurcation and can be curatively resected without any functional impairment. This case confirmed the differential diagnosis on the basis of the intraoperative finding that the tumor was continuous with the hypoglossal nerve.
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