Volume 106 ·  Issue 21 ·  2026

To analyze the clinical and genetic characteristics of patients with mucosa-associated lymphoid tissue (MALT) lymphoma transformed into diffuse large B-cell lymphoma (DLBCL). A retrospective analysis was performed on patients diagnosed with MALT lymphoma at Henan Provincial People′s Hospital from January 2016 to December 2025. According to whether DLBCL transformation occurred, the patients were divided into the transformed group (MALT lymphoma patients who developed DLBCL transformation) and the non-transformed group. The patients were followed up until December 30, 2025, and the clinical and genetic characteristics were compared between the two groups. A total of 175 patients were included, including 13 patients in the transformation group, 4 males and 9 females, aged (58±18) years; and 162 pattients in the non-transformed group, 73 males and 89 females, aged (57±12) years.The incidence of B symptoms in the transformed group [46.2% (6/13) vs 16.7% (27/162), P=0.018], the proportion with a MALT-international prognostic index (IPI) score≥2 point [69.2% (9/13) vs 17.3% (28/162), P<0.001], and lactate dehydrogenase (LDH) levels [227 (194, 262) vs 173 (146, 196) U/L, P<0.001] were all higher than those in the non-transformed group. The mutation rate of gene in the transformed group [84.6% (11/13) vs 45.7% (74/162), P=0.007] and the mutation rate of ≥2 genes [69.2% (9/13) vs 17.3% (28/162), P<0.001] were both higher than those in the non-transformed group. The mutation rates of the NOTCH1 gene [23.1% (3/13) vs 3.7% (6/162), P=0.021], the SOCS1 gene [15.4% (2/13) vs 0, P=0.005], and the KRAS gene [15.4% (2/13) vs 0, P=0.005] were all higher in the transformed group than those in the non-transformed group. Patients with MALT lymphoma who transformed to DLBCL are often accompanied by B symptoms, a higher MALT-IPI score, elevated LDH and multiple gene mutations, and the mutation frequencies of NOTCH1, SOCS1, and KRAS are higher.

To analyze the efficacy of ustekinumab (UST) in the patients with isolated perianal Crohn disease (ipCD). ipCD patients who received UST therapy in the Second Affiliated Hospital of Wenzhou Medical University between January 2021 and September 2025 were retrospectively recruited. Each patient received the first dose of UST (6 mg/kg) for intravenous induction, followed by the same dose of intravenous UST every 8 weeks for maintenance treatment. At week 16, the fistula clinical response was evaluated based on perianal disease activity index (PDAI) (a decline of more than 50% in PDAI compared with week 0). Follow-up was conducted until week 40, at week 40, the fistula clinical remission was assessed based on PDAI (PDAI score≤4 scores). The radiologic outcome events of perianal fistula were evaluated based on pelvic MRI data and Van Assche index, and the fistula radiologic response consisted of healing and partial response. A total of 16 ipCD patients were included, all of whom were male, with a diagnosed age of (31±6) years. At week 16 of UST therapy, the PDAI of 16 ipCD patients was decreased compared with week 0 [(7.3±2.5) vs (13.1±2.2) scores, P<0.001], and 10 patients obtained the fistula clinical response. At week 40, the average PDAI [(4.4±2.3) vs (13.1±2.2) scores, P<0.001], and the median Van Assche index [9 (8, 12) vs 16 (12, 16) scores, P=0.002] of 16 patients were lower compared with week 0; Eleven patients achieved the fistula clinical remission, and 10 patients obtained the fistula radiologic response. During 40-week follow-up, no adverse event related to UST treatment occurred in the ipCD patients. The UST therapy may demonstrate favorable clinical efficacy and safety in patients with ipCD.

A patient with high-risk chronic lymphocytic leukemia (CLL) complicated with disseminated cryptococcosis was reported. A 57-year-old male was seen in Jiangsu Provincial People's Hospital in January 2021 due to "recurrent fever, headache, and jet vomiting for 2 months". He was positive for cryptococcal antigen in blood and cerebrospinal fluid, and Cryptococcus neoformans was detected by second-generation sequencing (NGS). The patient had a 15-year history of CLL/small lymphocytic leukemia (SLL) and had received chemotherapy and ibrutinib (later discontinued due to intolerance). After admission, positron emission tomography/X-ray computed tomography (PET/CT) showed massive retroperitoneal lymph nodes (66 mm ×76 mm). CLL/SLL was confirmed by puncture pathology with cryptococcal infection. It was confirmed that he was disseminated cryptococcosis (involving blood, central nervous system, lung, lymph nodes) and CLL [Rai stage IV, high risk of chronic lymphocytic leukemia International Prognostic Index (CLL-IPI) 7 points]. Zebutinib was initiated after antifungal treatment with fluconazole. Due to the detection of Bruton's tyrosine kinase (BTK) C481S mutation (0.29%) in combination with venecra, the dose was adjusted by therapeutic drug monitoring (TDM) during treatment. Complete remission was achieved after 1 year of combination therapy. By April 2025, Veneclax had been discontinued, cryptococcosis was stable, and persistent minimal residual lesions (MRD) were negative. This case suggests that in high-risk CLL combined with active cryptococcosis, targeted therapy should be initiated after infection control, drug interactions should be managed through TDM, BTK mutations should be dynamically monitored and B-cell lymphoma factor 2 (Bcl-2) inhibitors should be combined in advance, and a limited course of MRD-directed therapy can promote immune reconstitution.

Primary central nervous system neuroblastoma (PCNSN) is very rare in solid tumors. It has no specific clinical symptoms and imaging findings, and is characterized by high aggressiveness and high dissemination and metastasis rate. This article reports the diagnosis and treatment of a rare patient with PCNSN. The patient is a 56-year-old female who visited West China Hospital of Sichuan University in December 2020 due to "sudden vertigo, confusion and limb weakness". The MRI of the brain showed a 2.0 cm ×1.8 cm space-occupying lesion in the pineal region, and no obvious abnormalities were found in thoracic and abdominal CT. The patient underwent resection of space-occupying lesions in the pineal region under general anesthesia in December 2020, and the postoperative pathology finally confirmed pineal neuroblastoma. After operation, the patients received whole brain and whole spinal cord radiotherapy, and the symptoms of vertigo, confusion and limb weakness were significantly relieved, which provided a reference for the treatment plan selection of adult PCNSN.

The core of the field of reverse tumor cardiology focuses on the bidirectional association between cardiovascular disease (CVD) and tumors. The two share many common risk factors and pathogenic mechanisms. Among them, CVD not only increases the risk of tumor disease, but also may induce tumor progression and metastasis. In this paper, the common risk factors of CVD and tumor are described in detail, including adjustable risk factors such as hypertension, dyslipidemia, obesity, and non-adjustable risk factors such as genetic factors, age and sex; At the same time, the effects of different types of CVD on tumorigenesis and development and their potential mechanisms were systematically discussed and summarized. In addition, this article focuses on sorting out the common pathophysiological mechanisms of CVD and tumors, covering inflammation, clonal hematopoiesis (CHIP), tumor angiogenesis and circulation related factors, and deeply discusses the role of cardiovascular related drugs and interventional therapy on tumor development. The newly proposed five classifications of tumor heart disease syndrome (COS) further clarifies the two-way relationship between them. It is of important theoretical and clinical significance to explain and grasp this bidirectional relationship in depth for promoting the disciplinary collaboration between cardiology and oncology and optimizing the prevention and treatment strategies of related diseases.

Diabetic foot ulcer (DFU) is one of the most serious and common complications of diabetes, and its refractory nature is closely related to multiple cellular dysfunctions in the high-glucose microenvironment. This paper reviews the abnormalities of signaling pathways and targeted therapeutic strategies in four key cells in DFU, namely keratinocytes, fibroblasts, vascular endothelial cells and macrophages. DFU pathogenesis includes dysregulation of the Notch1 signaling pathway in keratinocytes, leading to abnormal cell migration, proliferation, and differentiation; The TGF-β 1/SMAD pathway was abnormal in fibroblasts, which inhibited their transformation into myofibroblasts and collagen synthesis; Inhibition of Nrf2 antioxidant pathway in vascular endothelial cells aggravates oxidative stress and vascular dysfunction; Abnormal activation of the NF-κ B pathway in macrophages induces macrophage polarization to type M1, leading to chronic inflammation. In view of these mechanisms, multiple treatment strategies have shown the potential to promote DFU wound healing in preclinical studies, providing a theoretical basis and direction for the development of effective treatment options.

Primary cardiac involvement (SSc-pHI) in systemic sclerosis is one of the important factors affecting the prognosis of patients, among which myocarditis may be the early critical stage. Systemic sclerosis (SSc) -related myocardial injury is often recognized at the late stage of the disease due to the lack of specificity of early symptoms and large heterogeneity of clinical manifestations. Based on the epidemiological characteristics and pathogenesis of cardiac involvement in SSc, this paper systematically summarizes the specific research progress of multi-dimensional integrated assessment strategy integrating clinical typical manifestations, biomarkers, electrocardiogram, echocardiogram, cardiac magnetic resonance (CMR) and endocardial myocardial biopsy. Using this strategy for early screening and risk stratification may help improve disease recognition rates and optimize clinical management strategies. It should be noted that although CMR and other methods have high sensitivity in detecting subclinical myocardial inflammation and fibrosis, endocardial myocardial biopsy is still the pathological gold standard for the diagnosis of myocarditis, and more prospective studies are needed in the future to further clarify its pathogenesis and the best diagnosis and treatment pathway.