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We report a rare case of metastasis to the nasolacrimal sac from colorectal carcinoma in a 69-year old man. Despite tumor removal and endoscopic dacryocystorhinostomy with stenting, the tumor recurred 3 months later, which was treated with chemotherapy and radiotherapy. Five months later, the patient eventually died from respiratory failure secondary to malignant pleural effusion.

Introduction: IPF is characterised by irreversible lung function decline. This study assessed lung function in a repetitive bleomycin challenge model to better diagnose fibrosis in conscious rats. Respiratory parameters were determined using Intra-Pleural Pressure/Head-out Plethysmography and Whole Body Plethysmography. Method: Male telemetered rats were administered bleomycin on 5 occasions and treated with nintendanib (60 mg/kg, BID) or vehicle. Respiratory assessments were performed during Week 1 and 4. Lungs were scored for fibrosis. Results: Bleomycin-challenged animals developed fibrosis; fibrosis was reduced in nintedanib-treated animals. In the acute phase, bleomycin significantly changed respiratory rate, tidal volume, apnoea time and compliance; these parameters were improved with nintedanib treatment (Table). There were no significant differences in respiratory parameters in the established fibrosis phase. Acute phase respiratory rates and apnoea times were positively correlated with the extent of lung fibrosis on Day 29 (P Conclusion: Lung function assessment in concious rats detected early damage but did not diagnose the extent of fibrosis once established. These data will now be analysed using Attractor Reconstruction to determine whether fibrosis is better identified by novel parameters generated from the complete waveform.

Background: Cardiac transplantation is an excellent treatment for end-stage heart disease. However, rejection of the donor graft, in particular, by chronic rejection leading to cardiac allograft vasculopathy, remains a major cause of graft loss. The lymphatic system plays a crucial role in the alloimmune response, facilitating trafficking of antigen-presenting cells to draining lymph nodes. The encounter of antigen-presenting cells with T lymphocytes in secondary lymphoid organs is essential for the initiation of alloimmunity. Donor lymphatic vessels are not anastomosed to that of the recipient during transplantation. The pathophysiology of lymphatic disruption is unknown, and whether this disruption enhances or hinders the alloimmune responses is unclear. Although histological analysis of lymphatic vessels in donor grafts can yield information on the structure of the lymphatics, the function following cardiac transplantation is poorly understood. Methods: Using single-photon emission computed tomography/computed tomography lymphoscintigraphy, we quantified the lymphatic flow index following heterotrophic cardiac transplantation in a murine model of chronic rejection. Results: Ten weeks following transplantation of a minor antigen (HY) sex-mismatched heart graft, the lymphatic flow index was significantly increased in comparison with sex-matched controls. Furthermore, the enhanced lymphatic flow index correlated with an increase in donor cells in the mediastinal draining lymph nodes; increased lymphatic vessel area; and graft infiltration of CD4 + , CD8 + T cells, and CD68 + macrophages. Conclusions: Chronic rejection results in increased lymphatic flow from the donor graft to draining lymph nodes, which may be a factor in promoting cellular trafficking, alloimmunity, and cardiac allograft vasculopathy.