Cheng-long Huang

Systemic artery-to-pulmonary artery shunt after using an omental pedicle flap

A 66-year-old man was hospitalized because of hemoptysis. Four years earlier, he had undergone an operation involving the use of an omental pedicle flap that was supplied by the right gastroepiploic artery for the treatment of empyema. Arteriography revealed that the right gastroepiploic artery communicated with the periphery of the right pulmonary artery. The right gastroepiploic artery was divided surgically.

Coexistence of Epstein–Barr virus-associated lymphoproliferative disorder and marginal zone B-cell lymphoma of the thymus in a patient with rheumatoid arthritis treated with methotrexate

that DLBCLs arising in these sites show decreased or absent expression of MHC-II, allowing tumour cells to escape from immune attack. By extrapolation, it is distinctly possible that lack of MHC-II on the EATL type II in this case allowed it to home-in on immuneprivileged sites, probably explaining the clinical presentation of vitreous involvement and imaging-confirmed brain involvement. Once in these sites, the lymphoma could expand unchecked, probably explaining the rapid neurological deterioration of the patient. Finally, very little is known of MHC-II down-regulation in T-cell lymphomas of all subtypes in general. In the light of the observations made in this case report, a lack of MHC-II on T-cell lymphomas may be relevant in the prediction of likely tumour behaviour, and alert the clinician to keep a close watch on immune-privileged sites (i.e. brain, eye, and testis) for post-treatment recurrences.