Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan.
Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Japan.
Intern Med. 2020 Oct 15;59(20):2553-2558. doi: 10.2169/internalmedicine.4702-20. Epub 2020 Jun 23.
Anti-transcriptional intermediary factor 1γ (anti-TIF1γ) antibody-positive dermatomyositis (DM) is strongly associated with cancer, although the mechanism of action is still unclear. We herein describe the first known case of an 80-year-old woman diagnosed with TIF1γ-positive primary pulmonary lymphoepithelioma-like carcinoma (LELC) coexisting with anti-TIF1γ antibody-positive DM. The diagnosis of LELC can only be made by a surgical lung biopsy, and not by a computed tomography-guided biopsy, because of heavy lymphocytic infiltration. This instructive case reaffirmed the importance of active screening for malignancy in patients with anti-TIF1γ antibody-positive DM. Interestingly, the results also suggested that the strong relationship which exists between anti-TIF1γ antibody-positive DM and cancer is potentially caused by tumor-derived TIF1γ.
抗转录中介因子 1γ(anti-TIF1γ)抗体阳性皮肌炎(DM)与癌症密切相关,尽管其作用机制尚不清楚。本文描述了首例 80 岁女性 TIF1γ 阳性原发性肺淋巴上皮瘤样癌(LELC)伴抗 TIF1γ 抗体阳性 DM 的病例。由于淋巴细胞浸润严重,仅通过手术肺活检才能诊断 LELC,而不能通过 CT 引导下活检。这一有启发性的病例再次证实了对 TIF1γ 抗体阳性 DM 患者进行恶性肿瘤主动筛查的重要性。有趣的是,结果还表明,抗 TIF1γ 抗体阳性 DM 与癌症之间的密切关系可能是由肿瘤源性 TIF1γ 引起的。