Snezana Rakic

Primary non-Hodgkin lymphoma of the uterine cervix of a follicular type - case report.

A 37 years old patient, G2 P2 presented with a 2 month history of intermenstrual and postcoital bleeding. She did not have other diseases in her history. On speculum examination, the presence of tumefaction was established affecting a larger part of the cervix. At bimanual examination, uterus and adnexa were normal. Cytological finding was NILM. Pathohistology together with immunohistology implied follicular type of NHL. There were no general (B) symptoms of systemic disease in terms of lymphadenopathy, hepatosplenomegaly, weight loss, high body temperature, etc. Blood count results were as follows: white blood cells 4.09 10l, red blood cells 4.33 10l haemoglobin 13 g/l, hematocrit 39.4%, platelets 218 10l . Lactate dehydrogenase (LDH) value was 154 U/L (normal range 125–243 U/L). Computed tomography (CT) examination results of the neck and thorax were normal, as well as magnetic resonance imaging (MRI) finding of abdomen without signs of lymphadenopathy and hepatosplenomegaly. MRI examination of pelvis implied expansive change of vaginal fornix, with the largest diameter being 57 mm originating from the anterior cervical lip, also without lymphadenopathy . It did not involve the corpus uteri and it did not expand into the parametria. Bone marrow biopsy findings were also normal. She was staged as Ann Arbor IEA (Carbone PP et al. 1971). Primary cervical NHL is defined according to a criterion implying apparent presence of extranodal localisation, even in cases where the disease is disseminated as long as extranodal localisation is apparent and dominant (Otter et al. 1989). Taking in account the overall analysis which implied localised primary cervical extranodal NHL corresponding to low-grade follicular type, and the fact that the patient had completed her family surgical treatment was recommended as a first-line therapy. Considering the reproductive age of the patient, hysterectomy with bilateral conservation of adnexa was performed. Intraoperative palpation confirmed the absence of pelvic lymphadenopathy. After surgery, it was confirmed that the cervix was the primary location of the lymphoma (Figure 1.) and that it belonged to a rare low-grade follicular lymphoma, immunohistochemically (CD20, bcl2, bcl6, Ki 67-5%) after which on the advice of the hematologist it was decided to proceed as per ‘Watch and Wait’ (W&W) protocol. At present, 12 months after primary surgical treatment, the patients is without a relapse, having further regular follow ups.

Fetus Sound Stimulation: Cilia Memristor Effect of Signal Transduction

Background. This experimental study evaluates fetal middle cerebral artery (MCA) circulation after the defined prenatal acoustical stimulation (PAS) and the role of cilia in hearing and memory and could explain signal transduction and memory according to cilia optical-acoustical properties. Methods. PAS was performed twice on 119 no-risk term pregnancies. We analyzed fetal MCA circulation before, after first and second PAS. Results. Analysis of the Pulsatility index basic (PIB) and before PAS and Pulsatility index reactive after the first PAS (PIR 1) shows high statistical difference, representing high influence on the brain circulation. Analysis of PIB and Pulsatility index reactive after the second PAS (PIR 2) shows no statistical difference. Cilia as nanoscale structure possess magnetic flux linkage that depends on the amount of charge that has passed between two-terminal variable resistors of cilia. Microtubule resistance, as a function of the current through and voltage across the structure, leads to appearance of cilia memory with the “memristor” property. Conclusion. Acoustical and optical cilia properties play crucial role in hearing and memory processes. We suggest that fetuses are getting used to sound, developing a kind of memory patterns, considering acoustical and electromagnetically waves and involving cilia and microtubules and try to explain signal transduction.