Laterocervical lymph node metastases from suspected thyroidal primary site that turned out to be metastases of lung cancer: A case report

Incidental sonographic discovery of thyroid nodules is an increasingly common event in clinical practice. Less frequently, patients with cytological benign thyroid nodules have suspicious cervical lymph nodes detected by ultrasound examination or by cytological exam. Here, we discuss an intriguing case of cervical lymph node metastasis with a probable thyroid origin in a 65-year-old asymptomatic male smoker. He underwent thyroidectomy and unilateral cervical lymphadenectomy. Despite a negative chest X-ray, the postoperative histological examination revealed that the lymph node metastasis was actually from a lung carcinoma. Metastatic lesions in cervical lymph nodes from non-thyroidal origins must be excluded when evaluating lesions in the region, especially when thyroid nodules subjected to fine needle aspiration biopsy yield negative results, or lymph node cytological evaluations are inconsistent with thyroid cytological findings and sonographic features. Thyroid and lung adenocarcinomas share some epithelial and mesenchymal markers. Thyroglobulin helps differentiate primary thyroid tumors from lung ones, but in cases of poor differentiation, distinguishing metastatic lesions in the thyroid gland can be challenging. Lung cancer (LC) is the leading cause of cancer mortality worldwide, and survival rates have only marginally improved over the last several decades. The ongoing clinical challenge is detecting LC at earlier stages of the disease.

The Size of a Thyroid Nodule with ACR TI-RADS Does Not Provide a Better Prediction of the Nature of the Nodule: A Single-Center Retrospective Real-Life Observational Study

We investigated if thyroid nodule size has a predictive value of malignancy on a par with composition, echogenicity, shape, margin, and echogenic foci, and what would be the consequence of observing the rule of the American College of Radiology (ACR) to perform a fine-needle aspiration biopsy (FNAB). We conducted a retrospective real-life observational study on 86 patients who underwent surgery after a standardized diagnostic protocol. We divided the TR3, TR4, and TR5 classes into sub-classes according to the size threshold indicating FNAB (a: up to the threshold for no FNAB; b: over the threshold for FNAB suggested). We computed sensitivity, specificity, and positive (PPV) and negative predictive value (NPV) for the different sub-classes and Youden's index (Y) for the different possible cutoffs. Each sub-class showed the following PPV (0.67, 0.68, 0.70, 0.78, 0.72), NPV (0.56, 0.54, 0.51, 0.52, 0.59), and Y (0.20, 0.20, 0.22, 0.31, 0.30). In this real-life series, we did not find a significant difference in prediction of malignancy between the sub-categories according to the size threshold. All nodules have a pre-evaluation likelihood of being malignant, and the impact and utility of size thresholds may be less clear than suggested by the ACR TIRADS guidelines in patients undergoing standardized thyroid work up.

Decisive role of structure in food microbial colonization and implications for predictive microbiology

Predictive models must consider the significant effect of the physical structure of the food on the magnitude and type of microbial growth. Before such models are developed, a thorough characterization of the food structure is mandatory because this information will determine the modeling approach. In this work, several physical structures common in poultry products were classified and described. Chicken breast skin and flesh and minced breasts were examined by scanning electron microscopy and compared with a meat-based model food. Such systems were surface or internally inoculated with Listeria innocua and incubated at 25 degrees C for 24 h. Different structures, including several substructures, found in the studied systems affected microbial distribution and growth. Based on these experimental findings, the most suitable type of model for each physical structure was determined. This information provides further clarification for predictive microbiology models.

Mixed cultures ofSerratia marcescensandKluyveromyces fragilisfor simultaneous protease production and COD removal of whey

AIMS

The aim of this study was to investigate the behaviour of a Serratia marcescens-Kluyveromyces fragilis mixed culture in whey, with the objective of proteases production and organic waste reduction.

METHODS AND RESULTS

Discontinuous aerobic fermentations in whey were carried out using individual pure cultures and mixed cultures of S. marcescens and K. fragilis. Cell growth, protease production, lactose and proteins consumption and COD/TOC reduction were monitored. Lactose and protein content of the fermenting medium was almost depleted in the mixed cultures, achieving a reduction in the organic content much higher than in both pure cultures. Interestingly, proteolytic activity in the mixed cultures was similar to that obtained for S. marcescens in pure culture. In addition, protease stability was increased in the mixed cultures. Kinetic models were developed fitting well with the experimental results.

CONCLUSIONS

Mixed cultures were found to maintain the achievements of each individual fermentation, yielding a high and stable production of proteases and a significant reduction of COD/TOC.

SIGNIFICANCE AND IMPACT OF THE STUDY

Mixed cultures tested in this work have shown a synergistic effect with possible industrial applications. These results lead to a gain in the chain value for enzyme production with an environmentally friendly operation.

Analysis and description of the evolution of alginate immobilised cells systems

Different immobilised cells models, including very simple ones, can be useful in the fitting of experimental results. However, goodness or the ability to extrapolate results needs to be in accordance with basic observations and these will also suggest models to be proposed. In this paper, observations of calcium alginate/bacteria systems are used to show the ability of basic models to fit classic observations, as well as how new observations, in this case from electronic microscopy, oblige us to think about more complex mechanisms and mathematical treatments. Nevertheless it is not only important to discuss the model type, but also the type of kinetics assumed in the interior of the beads, as well as the internal structure, the boundary conditions related to bead shredding and cell escape and finally, geometrical effects.