Membranous glomerulonephritis is one of the most common causes of nephrotic syndrome in adults. Pulmonary alveolar proteinosis (PAP) is a rare lung disease in which abnormal accumulation of surfactant occurs within the alveoli. We describe a 61-year-old man with concurrent membranous glomerulonephritis and PAP, which is very rare; both are pathophysiologically related to an abnormal immune response. A patient came to hospital with leg edema but no respiratory symptoms. Chest X-ray and CT showed classical PAP findings, which are ground-glass opacities with interlobular septal thickening, in both lung fields. A bubbly whitish secretion retrieved via broncho-alveolar lavage showed neutrophils and lymphocytes as well as Periodic acid-Schiff-positive proteinaceous materials. A kidney biopsy revealed findings of membranous glomerulonephritis with irregular subepithelial deposits by electron microscopy. At 1 year after diagnosis, the membranous glomerulonephritis was well under control with steroids and mycophenolate mofetil but PAP became aggravated gradually and whole-lung lavage was needed.
Adult ; Biopsy ; Diagnosis ; Edema ; Glomerulonephritis, Membranous* ; Humans ; Kidney ; Leg ; Lung ; Lung Diseases ; Lymphocytes ; Microscopy, Electron ; Middle Aged ; Nephrotic Syndrome ; Neutrophils ; Pulmonary Alveolar Proteinosis* ; Steroids ; Therapeutic Irrigation ; Thorax

Immunoreactive dynamics of tumor-infiltrating lymphocytes (TILs) within the tumor microenvironment in breast cancer are not well understood. This study aimed to investigate the spatiotemporal cellular dynamics of TILs in breast cancer models. Breast cancer cells were implanted into the dorsal skinfold chamber of BALB/c nude mice, and T lymphocytes were adoptively transferred. Longitudinal intravital imaging was performed, and the spatiotemporal dynamics of TILs were assessed. In the 4T1 model, TILs progressively exhibited increased motility, and their motility inside the tumor was significantly higher than that outside the tumor. In the MDA-MB-231 model, the motility of TILs progressively decreased after an initial increase. TIL motility in the MDA-MB-231 and MCF-7 models differed significantly, suggesting an association between programmed death-ligand 1 expression levels and TIL motility, which warrants further investigation. Furthermore, intravital imaging of TILs can be a useful method for addressing dynamic interactions between TILs and breast cancer cells.