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Wstęp: Choroba Castlemana jest rzadką, łagodną chorobą limfoproliferacyjną o nieznanej etiologii. Schorzenie występuje w dwóch postaciach klinicznych o różnym rokowaniu, sposobie leczenia i objawach: postaci zlokalizowanej (UCD) oraz wieloogniskowej, charakteryzującej się powiększeniem węzłów chłonnych oraz objawami ogólnymi. Celem pracy był przegląd piśmiennictwa, a także analiza dowodów na skuteczność resekcji chirurgicznej w zlokalizowanej postaci choroby. Materiał i metody: Przeprowadzono przegląd systematyczny piśmiennictwa angielskojęzycznego oraz baz danych (Medline, Pubmed, Cochrane i źródeł dodatkowych) w poszukiwaniu artykułów dotyczących leczenia zlokalizowanej postaci choroby Castlemana. Każdy artykuł oceniony był przez dwóch autorów przy użyciu ustrukturyzowanego narzędzia oceny, a następnie skategoryzowany zgodnie z siłą dowodu. Wyniki: Zgodnie z kryteriami włączenia, do badania zakwalifikowano 14 badań. Nie znaleziono prospektywnych, randomizowanych badań z grupą kontrolną. W jednej metaanalizie, obejmującej 278 chorych na UCD, stwierdzono, że resekcja chirurgiczna jest bezpieczna i powinna być traktowana jako „złoty standard” w leczeniu. Wnioski zawarte w siedmiu badaniach retrospektywnych potwierdzały ten punkt widzenia. Radioterapia (RT) była stosowana w sześciu badaniach, z różnym efektem. Wnioski: W leczeniu choroby Castlemana zlokalizowanej w klatce piersiowej resekcja chirurgiczna wydaje się metodą o najwyższej skuteczności. Ponadto, pozytywną odpowiedź kliniczną można w niektórych przypadkach osiągnąć przy zastosowaniu radioterapii.

Introduction: Castleman’s disease is a rare benign lymphoproliferative disorder of unknown etiology. The disease occurs in two clinical forms with different prognoses, treatments and symptoms: a unicentric form (UCD), which is solitary, localized, and a multicentric form characterized by generalized lymphadenopathy and systemic symptoms. This article aims to review the current literature to consolidate the evidence surrounding the curative potential of surgical treatment to the unicentric type. Material and methods: A systematic review of English-language literature was performed and databases (Medline, Pubmed, the Cochrane Database and grey literature) were searched to identify articles pertaining to the treatment of unicentric form of Castleman’s disease. Each article was critiqued by two authors using a structured appraisal tool, and stratified according to the level of evidence. Results: After application of inclusion criteria, 14 studies were included. There were no prospective randomized control studies identified. One meta-analysis including 278 patients with UCD reported that resective surgery is safe and should be considered the gold standard for treatment. Seven retrospective studies enhance this standpoint. Radiotherapy (RT) has been used in six studies with controversial results. Conclusions: We conclude that surgical resection appears to be the most effective treatment for Unicentric Castleman’s Disease of the thoracic cavity. Radiotherapy can also achieve clinical response and cure in selected patients.

Highlights • The tumour microenvironment promotes induction of mesenchymal stromal cells through the production of soluble factors. • Data from animal models indicates that mesenchymal stromal cells could accelerate pulmonary metastases, promote proliferation of sarcoma cells and increase chemoresistance. • Pre-activated and use of transduced mesenchymal stromal cells have a positive effect on bone sarcoma. • There is preliminary clinical evidence for mesenchymal stromal cell in promoting bone regeneration within large bone defects after surgical excision., Over the past few decades, there has been growing interest in understanding the molecular mechanisms of cancer pathogenesis and progression, as it is still associated with high morbidity and mortality. Current management of large bone sarcomas typically includes the complex therapeutic approach of limb salvage or sacrifice combined with pre- and postoperative multidrug chemotherapy and/or radiotherapy, and is still associated with high recurrence rates. The development of cellular strategies against specific characteristics of tumour cells appears to be promising, as they can target cancer cells selectively. Recently, Mesenchymal Stromal Cells (MSCs) have been the subject of significant research in orthopaedic clinical practice through their use in regenerative medicine. Further research has been directed at the use of MSCs for more personalized bone sarcoma treatments, taking advantage of their wide range of potential biological functions, which can be augmented by using tissue engineering approaches to promote healing of large defects. In this review, we explore the use of MSCs in bone sarcoma treatment, by analyzing MSCs and tumour cell interactions, transduction of MSCs to target sarcoma, and their clinical applications on humans concerning bone regeneration after bone sarcoma extraction.

Pulmonary alveolar microlithiasis (PAM) is an uncommon genetic disorder associated with alveolar cell injury. This injury is caused in most cases by inactivating mutations in SLC34A2 gene, which is responsible for the production of a sodium-dependent phosphate co-transporter. The dysfunction or deficiency of this transporter leads to the aggregation of local phosphate intra-alveolarly and formation of microliths. Most of the patients are asymptomatic at the time of the diagnosis but as the disease progress it leads to fatal respiratory or cardiac failure. We describe a case of a 63-year-old man referred to our department for a surgical lung biopsy. He has been symptomatic for one year with progressive shortness of breath and deteriorating exercise tolerance. The imaging was suggestive of extensive interstitial bilateral lung disease. Histological findings after the lung biopsy by video-assisted thoracic surgery (VATS) established the diagnosis of pulmonary alveolar microlithiasis. His sister suffered from the same disease and passed away at the age of 54. It is remarkably rare for PAM to have such a late onset with a previous normal X-ray and only a few cases have been reported worldwide.

HRA is an alternative type of hip arthroplasty that is mainly used to young, active, male patients with end-stage joint arthritis with sufficient bone quality and minimal mechanical deformity. The head of the femur is partially removed and reconstructed to accept a new metal head that fits a metal acetabular component [1]. There have been different types of the prosthesis (cemented, uncemented, and hybrid), various types of the surface-bearing materials (MoP, CoP, MoM, and CoC), and different generations of HRAs (first generation, MoP; modern hip resurfacing systems, MoM) used. The first-generation MoP HRA failed mainly due to wear and wear-induced complications. During the mid-1990s, the introduction of the third-generation MoM HRA was promising as to decrease complications [2]. The third generation of HRA implants has a cementless, porous-coated, press-fit monoblock acetabular and a cemented femoral component and a metal-on-metal bearing articulation [3, 4]. Following an initial popular period during the past decade with promising results [5–7], the indications of use are rather decreasing following concerns with regard to the long-term consequences of the presence of metal ions in the blood and the plethora of questions for the reported series of adverse local tissue reactions (ALTRs) [8]. The excellent however published results from high-volume centres at 10–15 years in selected patient populations [9–13], the unfavourable results of the majority of registries [14], the heterogeneity of the studies, and the inconsistent outcome definitions dispute our ability to compare arthroplasty outcome studies and have a clear point of view [1].

IgG4-related disease (IgG4-RD) is a fibroinflammatory condition that can affect practically every organ. Although it was first identified in pancreas and salivary glands, major organs like liver, biliary tree, kidney, thyroid glands and lungs are commonly involved, sometimes resulting in organ failure. We describe a case of an 41-year-old man presented with back pain after a rotator cuff injury. A Computed Tomography (CT) revealed incidentally a right lower lobe paravertebral lesion extending across the T5 and T6 vertebral levels and invading into the adjacent pleural surface. The laboratory findings and the CT guided biopsy were inconclusive. Morphological and immunohistochemical findings after a lung biopsy by video-assisted thoracic surgery (VATS) were suggestive to IgG4-related lung disease (IgG4-RLD), which was confirmed with high serum levels of IgG4. This represents the first case of a IgG4-RLD lesion located in the mediastinum and extending to the adjacent pleural surface and vertebrae and should be included in the differential diagnosis of posterior mediastinal masses.