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Modolin MLA, Camargo CP, Milcheski DA, Cintra W, Rocha RI, Clivatti GM, Nascimento B, Gemperli R. Castleman disease. Interaction with dermatopathy: Case report. Int J Surg Case Rep 2020; 73:332-337. [PMID: 32739521 PMCID: PMC7393987 DOI: 10.1016/j.ijscr.2020.07.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/13/2020] [Accepted: 07/15/2020] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Castleman disease (CD) is a lymphoproliferative disorder with lymph node hypertrophy. In the unicentric form (UCD), it affects one lymph node or chain of lymph nodes. In the multicentric form (DCM), there is hypertrophy of several lymph node chains with the formation of tumor masses, causing compressive symptoms. This case report showed a case of CD in a different location(inguinal region) associated to a multiple skin lesions. PRESENTATION OF THE CASE We reported a UCD in a 43-year-old female patient with no previous comorbidities. Since January 2016, this patient developed erysipelas lesions of the left leg (LL) from the thigh root to the foot. Concomitantly, a tumor mass appeared in the inguinal region. In 2019 we performed a biopsy that revealed changes characteristic of CD. Due to extremely poor trophic conditions, the skin area with erysipelas was resected, and the raw surface was grafted. DISCUSSION As an inference, the erysipelas may have been responsible for the subsequent lymphangitis, lymphedema and lymph node hypertrophy. CONCLUSION Resection of the diseased skin and lymph node excision constitute the treatment of UCD and result in improvement of the clinical picture. Nevertheless, further study of the inflammatory reaction and of markers such as interleukin-6 and the presence of skin disorders in DC is needed.
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Affiliation(s)
- M L A Modolin
- Universidade de São Paulo - Hospital das Clínicas, School of Medicine Universidade de São Paulo, Brazil
| | - C P Camargo
- Laboratório de investigação médica - LIM-4- School of Medicine, Universidade de São Paulo, Brazil.
| | - D A Milcheski
- Universidade de São Paulo - Hospital das Clínicas, School of Medicine Universidade de São Paulo, Brazil
| | - W Cintra
- Universidade de São Paulo - Hospital das Clínicas, School of Medicine Universidade de São Paulo, Brazil
| | - R I Rocha
- Universidade de São Paulo - Hospital das Clínicas, School of Medicine Universidade de São Paulo, Brazil
| | - G M Clivatti
- Universidade de São Paulo - Hospital das Clínicas, School of Medicine Universidade de São Paulo, Brazil
| | - B Nascimento
- Universidade de São Paulo - Hospital das Clínicas, School of Medicine Universidade de São Paulo, Brazil
| | - R Gemperli
- School of Medicine Universidade de São Paulo, Brazil
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González-García A, Patier de la Peña JL, García-Cosio M, Sarhane Y, Sánchez Díaz C, Barbolla Díaz I, López Rodríguez M, Moreno MÁ, Villarubia J, Manzano L. Clinical and pathological characteristics of Castleman disease: an observational study in a Spanish tertiary hospital. Leuk Lymphoma 2019; 60:3442-3448. [PMID: 31305183 DOI: 10.1080/10428194.2019.1639168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Castleman disease (CD) represents a heterogeneous group of lymphoproliferative disorders that share well-defined histopathological features. An observational study of patients with CD was conducted. A total of 53 patients had CD: 20 had the unicentric form (UCD) and 33 the multicentric (MCD) variant; 10 of the latter cases were infected with human herpesvirus-8 (HHV-8) and 23 were idiopathic (iMCD). Median age differed between UCD and iMCD (30 vs. 49 years, p = .004). Males were completely predominant in HHV-8-associated MCD (100%), and females were more frequent in UCD (75 vs. 48%, p = .06). Relapses were more frequent in iMCD (57 vs. 10% UCD, p = .002), and mortality was significantly higher in iMCD and the HHV-8-associated form with respect to UCD. We conclude that UCD is a benign disorder of younger ages and female predominance, while iMCD represents a different entity with more disease relapses and higher mortality.
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Affiliation(s)
- Andrés González-García
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain.,Unidad de Enfermedades Sistémicas Autoinmunes y Minoritarias. Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. IRYCIS. Madrid, Spain
| | - José Luis Patier de la Peña
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain.,Unidad de Enfermedades Sistémicas Autoinmunes y Minoritarias. Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. IRYCIS. Madrid, Spain
| | - Mónica García-Cosio
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Yasmina Sarhane
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain
| | - Cristina Sánchez Díaz
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain
| | - Ignacio Barbolla Díaz
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain
| | - Mónica López Rodríguez
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain.,Unidad de Enfermedades Sistémicas Autoinmunes y Minoritarias. Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. IRYCIS. Madrid, Spain
| | - María Ángeles Moreno
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain
| | - Jesús Villarubia
- Servicio de Hematología. Hospital Universitario Ramón y Cajal. IRYCIS. Madrid, Spain
| | - Luis Manzano
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain
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Abdul Rahim SN, Ho GY, Coward JIG. The role of interleukin-6 in malignant mesothelioma. Transl Lung Cancer Res 2015; 4:55-66. [PMID: 25806346 DOI: 10.3978/j.issn.2218-6751.2014.07.01] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 06/12/2014] [Indexed: 12/29/2022]
Abstract
Malignant mesothelioma (MM) still remains a dismal disease with a median overall survival between 9-12 months. During the past decade since the introduction of the multi-folate antagonist, pemetrexed, there have been no significant advances in its systemic treatment, particularly with novel therapeutics that have exhibited varying degrees of success in other solid tumours. In recent years, the pleiotropic proinflammatory cytokine, interleukin-6 (IL-6) has emerged as a mediator of pivotal processes such as cell proliferation and chemoresistance within the mesothelioma tumour microenvironment in addition to clinical symptoms commonly witnessed in this disease. This manuscript provides a brief summary on the pathophysiology and clinical management of MM, followed by the role of IL-6 in its tumourigenesis and the rationale for utilising anti-IL-6 therapeutics alongside standard chemotherapy and targeted agents in an attempt to prolong survival.
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Affiliation(s)
- Siti N Abdul Rahim
- 1 Inflammation & Cancer Therapeutics Group, Mater Research, University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane, QLD, 4102, Australia ; 2 School of Chemistry & Molecular Bioscience, 3 School of Medicine, University of Queensland, Brisbane, QLD 4072, Australia ; 4 Mater Health Services, Raymond Terrace, South Brisbane, QLD 4101, Australia
| | - Gwo Y Ho
- 1 Inflammation & Cancer Therapeutics Group, Mater Research, University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane, QLD, 4102, Australia ; 2 School of Chemistry & Molecular Bioscience, 3 School of Medicine, University of Queensland, Brisbane, QLD 4072, Australia ; 4 Mater Health Services, Raymond Terrace, South Brisbane, QLD 4101, Australia
| | - Jermaine I G Coward
- 1 Inflammation & Cancer Therapeutics Group, Mater Research, University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane, QLD, 4102, Australia ; 2 School of Chemistry & Molecular Bioscience, 3 School of Medicine, University of Queensland, Brisbane, QLD 4072, Australia ; 4 Mater Health Services, Raymond Terrace, South Brisbane, QLD 4101, Australia
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Burger R, Wendler J, Antoni K, Helm G, Kalden JR, Gramatzki M. Interleukin-6 production in B-cell neoplasias and Castleman's disease: evidence for an additional paracrine loop. Ann Hematol 1994; 69:25-31. [PMID: 8061104 DOI: 10.1007/bf01757344] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Functioning as a B-cell growth and differentiation factor, interleukin-6 (IL-6) may play an important role in the pathophysiology of B-cell tumors. The capacity for IL-6 secretion was evaluated in 58 patients with various B-cell leukemias/lymphomas and in four patients with Castleman's disease (CMD). Cell populations from various sites including peripheral blood, bone marrow, lymph nodes, and osteolytic bone lesions were cultured and tested for spontaneous or IL-1 beta/TNF alpha-induced IL-6 production in a sensitive bioassay. No significant IL-6 levels were released by the tumor cells in any of the B-cell leukemias or lymphomas tested, including hairy cell leukemia (HCL) and B-cell chronic lymphocytic leukemia (B-CLL). In contrast, purified malignant plasma cells were found to secrete IL-6, strengthening the idea that an autocrine pathway for growth regulation in multiple myeloma (MM) exists. For the first time, in several patients with CMD, peripheral blood cells were shown to produce extremely high levels of IL-6, the pathogenetic significance of which remains to be elucidated. However, similar observations were very occasionally made in MM patients. Therapy with corticosteroids strongly inhibited this IL-6 production. These data provide evidence for autocrine and possibly an additional paracrine regulatory loop in plasma cell neoplasias and CMD.
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Affiliation(s)
- R Burger
- Department of Medicine III, University of Erlangen, Germany
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Agematsu K, Komiyama A. Ki-1 positive large cell anaplastic lymphoma: multiple bone lytic lesions and interleukin-6. Leuk Lymphoma 1992; 7:309-15. [PMID: 1337292 DOI: 10.3109/10428199209049783] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Ki-1-positive large cell anaplastic lymphoma (Ki-1 LCAL) is recognized as a clinicopathologic syndrome with fever, peripheral lymphadenopathy and cutaneous nodules; the neoplastic cells express Hodgkin's disease-associated antigen, Ki-1 (CD30). We review here a recent case of Ki-1 LCAL with multiple bone lesions with destruction and present additional information. Although bone absorption is reported in some cases of Ki-1 LCAL, the genesis of bone absorption is unclear. Interleukin-6 (IL-6) is an important regulator of osteoclast formation and activation and can induce bone absorption. In our case, the surgically removed tumor tissue was studied for IL-6 mRNA expression and IL-6 secretion without any stimulation. Northern blot analysis showed strong IL-6 mRNA expression in the tumor tissue and ELISA assay showed a large amount of IL-6 in culture supernatants of the tumor tissue. Based on these results, coupled with the reported evidence, we discuss the close relationship between the presence of osteolytic lesions and IL-6 production in Ki-1 LCAL.
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MESH Headings
- Antigens, CD/analysis
- Antigens, Neoplasm/analysis
- Antigens, Surface/analysis
- Bone and Bones/pathology
- Child
- Genotype
- Humans
- Interleukin-6/analysis
- Interleukin-6/biosynthesis
- Interleukin-6/genetics
- Ki-1 Antigen
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Osteoblasts/physiology
- Osteolysis/pathology
- RNA, Messenger/analysis
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Affiliation(s)
- K Agematsu
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
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Roncella S, Di Celle PF, D'amore ESG, Casoli C, Cutrona G, Muzzulini C, Quaini F, Nicolo G, Foa R, Pistoia V. Cellular and Molecular Characterization of Two Cases of Castleman's Disease, Plasma Cell Variant. Leuk Lymphoma 1991; 5:391-6. [DOI: 10.3109/10428199109067634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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