Subject(s)
Aortic Aneurysm/complications , Aortic Aneurysm/diagnostic imaging , Aortic Dissection/complications , Hoarseness/etiology , Vocal Cord Paralysis/etiology , Aged , Aortic Dissection/diagnostic imaging , Aortic Aneurysm/diagnosis , Aortic Aneurysm/pathology , Humans , Laryngoscopy , Male , Tomography, X-Ray ComputedABSTRACT
When a 63-year-old man was hospitalized with nephrotic syndrome due to focal segmental glomerulosclerosis, a mediastinal mass was discovered. A biopsy specimen obtained by mediastinoscopy showed findings compatible with the plasma cell type of Castleman's disease. Fever, anemia, and anti-nuclear antibody were present. Serum concentrations of gamma globulin, acute phase proteins, and, most strikingly, interleukin-6 (IL-6) were elevated. Methylprednisolone pulse therapy resulted in no clinical improvement. Pathologic examination of the resected thymic tumor showed a squamous cell carcinoma immunoreactive for IL-6. To our knowledge, this case represents the first reported IL-6-producing thymic squamous cell carcinoma associated with Castleman's disease and nephrotic syndrome.
Subject(s)
Carcinoma, Squamous Cell/blood , Castleman Disease/blood , Interleukin-6/blood , Nephrotic Syndrome/blood , Thymus Neoplasms/blood , Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/diagnosis , Castleman Disease/complications , Castleman Disease/diagnosis , Humans , Male , Mediastinum/diagnostic imaging , Mediastinum/pathology , Middle Aged , Nephrotic Syndrome/complications , Nephrotic Syndrome/diagnosis , Plasma Cells/physiology , Radiography, Thoracic , Thymus Neoplasms/complications , Thymus Neoplasms/diagnosis , Tomography, X-Ray ComputedABSTRACT
A 53-year-old man with aortic regurgitation was admitted to our hospital because of fever. A diagnosis of ruptured mitral valve aneurysm was made by Doppler echocardiography. Aortic regurgitant flow along the anterior mitral leaflet may have predisposed to mitral valve endocarditis, aneurysm formation, and its rupture.
