Higashikuni Yasutomi, Mori Masaya, Kino Hiroyoshi
Division of Internal Medicine, Center for Respiratory Diseases, Mitsui Memorial Hospital, Tokyo, Japan.
Intern Med. 2007;46(10):669-73. doi: 10.2169/internalmedicine.46.6003. Epub 2007 May 24.
We encountered a 59-year-old man with advanced lung cancer with multiple swollen lymph nodes. At autopsy the lung cancer was revealed as giant cell carcinoma. Microscopic examination showed no cancer cells, but there was polyclonal proliferation of plasma cells in the lymph nodes and in the bone marrow. In the kidneys, proliferation of mesangial matrices and mesangial cells was found. This presentation resembled multicentric Castleman's disease (MCD), in which interleukin-6 (IL-6) has a great role. Immunohistochemical staining was positive for IL-6 in cancer cells. This is the first reported case of an IL-6-producing giant cell carcinoma of the lung with MCD-like presentation.
我们遇到一名59岁患有晚期肺癌且伴有多个肿大淋巴结的男性。尸检显示肺癌为巨细胞癌。显微镜检查未发现癌细胞,但在淋巴结和骨髓中有浆细胞的多克隆增殖。在肾脏中,发现了系膜基质和系膜细胞的增殖。这种表现类似于多中心Castleman病(MCD),其中白细胞介素-6(IL-6)起重要作用。癌细胞中IL-6免疫组化染色呈阳性。这是首例报道的具有MCD样表现的产生IL-6的肺巨细胞癌病例。