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Imaging findings of granulocyte colony-stimulating factor-producing tumors: a case series and review of the literature. Jpn J Radiol 2021; 39:857-867. [PMID: 34021462 PMCID: PMC8413199 DOI: 10.1007/s11604-021-01130-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/28/2021] [Indexed: 11/21/2022]
Abstract
Granulocyte colony-stimulating factor (G-CSF)-producing tumors have an aggressive clinical course. Here, we report five cases of G-CSF-producing tumors and review the literature, focusing on imaging findings related to tumor-produced G-CSF. In addition to our cases, we identified 30 previous reports of G-CSF-producing tumors on which 18F-fluorodeoxyglucose positron emission tomography (FDG-PET)/CT, bone scintigraphy, or evaluation of bone marrow MR findings was performed. White blood cell count, serum C-reactive protein, and serum interleukin-6 were elevated in all cases for which these parameters were measured. G-CSF-producing tumors presented large necrotic masses (mean diameter 83.2 mm, range 17–195 mm) with marked FDG uptake (mean maximum standardized uptake value: 20.09). Diffuse FDG uptake into the bone marrow was shown in 28 of the 31 cases in which FDG-PET/CT was performed. The signal intensity of bone marrow suggested marrow reconversion in all seven MRI-assessable cases. Bone scintigraphy demonstrated no significant uptake, except in two cases with bone metastases. Splenic FDG uptake was increased in 8 of 10 cases in which it was evaluated. These imaging findings may reflect the effects of tumor-produced G-CSF. The presence of G-CSF-producing tumors should be considered in patients with cancer who show these imaging findings and marked inflammatory features of unknown origin.
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Silveira CRF, Cipelli M, Manzine C, Rabelo-Santos SH, Zeferino LC, Rodríguez Rodríguez G, de Assis JB, Hebster S, Bernadinelli I, Laginha F, Boccardo E, Villa LL, Termini L, Lepique AP. Swainsonine, an alpha-mannosidase inhibitor, may worsen cervical cancer progression through the increase in myeloid derived suppressor cells population. PLoS One 2019; 14:e0213184. [PMID: 30840689 PMCID: PMC6402676 DOI: 10.1371/journal.pone.0213184] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 02/17/2019] [Indexed: 12/24/2022] Open
Abstract
Cervical cancer, caused by high oncogenic risk Human Papillomavirus (HPV) infection, continues to be a public health problem, mainly in developing countries. Using peptide phage display as a tool to identify potential molecular targets in HPV associated tumors, we identified α-mannosidase, among other enriched sequences. This enzyme is expressed in both tumor and inflammatory compartment of the tumor microenvironment. Several studies in experimental models have shown that its inhibition by swainsonine (SW) led to inhibition of tumor growth and metastasis directly and indirectly, through activation of macrophages and NK cells, promoting anti-tumor activity. Therefore, the aim of this work was to test if swainsonine treatment could modulate anti-tumor immune responses and therefore interfere in HPV associated tumor growth. Validation of our biopanning results showed that cervical tumors, both tumor cells and leukocytes, expressed α-mannosidase. Ex vivo experiments with tumor associated macrophages showed that SW could partially modulate macrophage phenotype, decreasing CCL2 secretion and impairing IL-10 and IL-6 upregulation, which prompted us to proceed to in vivo tests. However, in vivo, SW treatment increased tumor growth. Investigation of the mechanisms leading to this result showed that SW treatment significantly induced the accumulation of myeloid derived suppressor cells in the spleen of tumor bearing mice, which inhibited T cell activation. Our results suggested that SW contributes to cervical cancer progression by favoring proliferation and accumulation of myeloid cells in the spleen, thus exacerbating these tumors systemic effects on the immune system, therefore facilitating tumor growth.
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Affiliation(s)
- Caio Raony Farina Silveira
- Instituto de Ciências Biomédicas, Universidade de São Paulo, Departamento de Imunologia, São Paulo, Brazil
| | - Marcella Cipelli
- Instituto de Ciências Biomédicas, Universidade de São Paulo, Departamento de Imunologia, São Paulo, Brazil
| | - Carolina Manzine
- Instituto de Ciências Biomédicas, Universidade de São Paulo, Departamento de Imunologia, São Paulo, Brazil
| | - Silvia Helena Rabelo-Santos
- Faculdade de Farmácia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiás, Brazil
| | - Luiz Carlos Zeferino
- Universidade Estadual de Campinas, Departamento de Ginecologia e Obstetrícia, Campinas, Brazil
| | - Gretel Rodríguez Rodríguez
- Instituto de Ciências Biomédicas, Universidade de São Paulo, Departamento de Imunologia, São Paulo, Brazil
| | - Josiane Betim de Assis
- Instituto de Ciências Biomédicas, Universidade de São Paulo, Departamento de Imunologia, São Paulo, Brazil
| | - Suellen Hebster
- Instituto de Ciências Biomédicas, Universidade de São Paulo, Departamento de Microbiologia, São Paulo, Brazil
| | | | | | - Enrique Boccardo
- Instituto de Ciências Biomédicas, Universidade de São Paulo, Departamento de Microbiologia, São Paulo, Brazil
| | - Luisa Lina Villa
- Departamento de Radiologia e Oncologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | - Lara Termini
- Departamento de Radiologia e Oncologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ana Paula Lepique
- Instituto de Ciências Biomédicas, Universidade de São Paulo, Departamento de Imunologia, São Paulo, Brazil
- * E-mail:
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