Subject(s)
Biomarkers, Tumor/blood , Neoplasms, Muscle Tissue/diagnosis , Polyps/diagnosis , Uterine Neoplasms/diagnosis , Biomarkers, Tumor/analysis , Child , Diagnosis, Differential , Female , Humans , Immunohistochemistry , Inflammation , Lymphatic Metastasis , Neoplasms, Muscle Tissue/blood , Neoplasms, Muscle Tissue/pathology , Polyps/blood , Uterine Neoplasms/blood , Uterine Neoplasms/pathology , Watchful WaitingABSTRACT
We describe a case of inflammatory myofibroblastic tumor (IMT) that occurred in the retroperitoneum. The patient manifested systemic symptoms, such as intermittent fever, anemia, thrombocytosis, and hypergammaglobulinemia. In order to elucidate the mechanism of intermittent fever in IMT, we analyzed nuclear factor-kappa B (NF-kappaB) activation in peripheral blood mononuclear cells (PBMCs) using flow cytometry, and serum cytokine levels. NF-kappaB activation was observed in the peripheral blood T cells and monocytes/macrophages. Among the measured cytokines, only interleukin (IL)-6 levels were elevated. IL-6 levels during pyrexia in the afternoon were higher than those during apyrexia in the morning. In contrast to IL-6, NF-kappaB activation in PBMCs was lower during pyrexia than during apyrexia; this is considered to be because the activation is subject to negative feedback. The time lag between the increase of IL-6 in the serum and NF-kappaB activation in the PBMCs at the onset of intermittent fever in IMT may provide further insight into the role of cytokines and NF-kappaB activation in febrile inflammatory diseases.
Subject(s)
Fever , Interleukin-6 , NF-kappa B , Neoplasms, Muscle Tissue/immunology , Retroperitoneal Neoplasms/immunology , Child, Preschool , Cytokines/blood , Cytokines/immunology , Female , Fever/blood , Fever/immunology , Humans , Interleukin-6/blood , Interleukin-6/immunology , NF-kappa B/blood , NF-kappa B/immunology , Neoplasms, Muscle Tissue/blood , Neoplasms, Muscle Tissue/pathology , Retroperitoneal Neoplasms/blood , Retroperitoneal Neoplasms/pathology , Time FactorsABSTRACT
BACKGROUND: The aim of the current study was to evaluate the expression of Ki-67 in uterine smooth muscle tumors, comparing leiomyomas, uterine smooth muscle tumors of uncertain malignant potential (STUMP) and uterine leiomyosarcomas (LMS) and to prove the accuracy of a Ki-67 expression as a useful parameter in the diagnosis of LMS. METHODS: Ki-67 was assessed using immunohistochemistry from paraffin-embedded tissue in 20 patients with uterine LMS, 22 cases of STUMP and 25 cases of leiomyomas. RESULTS: Ki-67 was present in 10/20 (50%) LMS, in 0/22 (0%) STUMP and in 2/25 (8%) leiomyomas. Significant differences regarding the frequency of Ki-67 expression were observed between LMS and STUMP (p = 0.0001) as well as between LMS and leiomyomas (p = 0.002), but not between STUMP and leiomyomas (p = 0.491). Likewise, the staining intensity differed significantly between LMS and leiomyomas (p = 0.018) as well as between LMS and STUMP (p = 0.002), but not between STUMP and leiomyomas (p = 0.368). CONCLUSIONS: Our results demonstrate that the significantly elevated Ki-67 antigen expression in LMS, which correlates well with the rapid growth of these malignant tumors, may be a useful immunohistochemical parameter to distinguish between cases of malignant smooth muscle tumors and those of uncertain or borderline histology.
