Yamakawa Y, Fujimura M, Hidaka T, Yasoshima K, Saito S
Department of Obstetrics and Gynecology, Toyama Medical and Pharmaceutical University, 2630 Sugitani, Toyama-shi, 930-0194, Japan.
Gynecol Oncol. 1999 Dec;75(3):484-9. doi: 10.1006/gyno.1999.5589.
Inflammatory malignant fibrous histiocytoma (IMFH) is composed of fibroblastic and histiocytic elements with a marked inflammatory cell infiltrate. The authors examined the case of a 43-year-old woman with IMFH of the ovary.
The serum interleukin-6 (IL-6) levels were examined and immunohistochemical analysis of the tumor was performed using monoclonal antibodies against lysozyme, alpha 1-antitripsin, vimentin, and IL-6.
The patient had marked general inflammatory reactions of fever (38.0 degrees C), leukocytosis with 78.3% neutrophils, elevated CRP (23.5 mg/dl), and accelerated ESR (166 mm/h). The serum IL-6 concentration was 499 pg/ml. The right ovary was occupied by the solid tumor, composed of both fibrous and histiocytic elements with a marked inflammatory cell infiltrate. These inflammatory reactions disappeared after surgical resection and recurred when the tumor reappeared. The immunohistochemical staining of lysozyme, alpha 1-antitrypsin, vimentin, and IL-6 was localized to the malignant cells, suggesting their histiocytic origin.
This is the first case of IMFH of the ovary producing IL-6. Expression of IL-6 in the IMFH may account for both the local and the systemic inflammatory effects of tumors with these morphological features.
炎症性恶性纤维组织细胞瘤（IMFH）由成纤维细胞和组织细胞成分构成，并伴有明显的炎性细胞浸润。作者对一名患有卵巢IMFH的43岁女性病例进行了研究。
检测血清白细胞介素-6（IL-6）水平，并使用抗溶菌酶、α1-抗胰蛋白酶、波形蛋白和IL-6的单克隆抗体对肿瘤进行免疫组化分析。
患者出现明显的全身炎症反应，发热（38.0℃）、白细胞增多，中性粒细胞占78.3%，CRP升高（23.5mg/dl），血沉加快（166mm/h）。血清IL-6浓度为499pg/ml。右侧卵巢被实性肿瘤占据，肿瘤由纤维和组织细胞成分构成，并伴有明显的炎性细胞浸润。手术切除后这些炎症反应消失，肿瘤复发时炎症反应再次出现。溶菌酶、α1-抗胰蛋白酶、波形蛋白和IL-6的免疫组化染色定位于恶性细胞，提示其组织细胞起源。
这是首例卵巢IMFH产生IL-6的病例。IL-6在IMFH中的表达可能解释了具有这些形态学特征的肿瘤的局部和全身炎症效应。
