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Case Reports
. 2014 Aug 13:14:588.
doi: 10.1186/1471-2407-14-588.

A pleomorphic carcinoma of the lung producing multiple cytokines and forming a rapidly progressive mass-like opacity

Masataka Matsumoto  1 , Takashi Nakayama, Daiki Inoue, Kazufumi Takamatsu, Ryo Itotani, Manabu Ishitoko, Shinko Suzuki, Minoru Sakuramoto, Yoshiaki Yuba, Osamu Yoshie, Masaya Takemura, Motonari Fukui
Affiliations
Case Reports

A pleomorphic carcinoma of the lung producing multiple cytokines and forming a rapidly progressive mass-like opacity

Masataka Matsumoto et al. BMC Cancer. .

Abstract

Background: Lung cancer cells have been reported to produce cytokines, resulting in systemic reactions. There have been few reports showing that these cytokines induced the formation of an inflammatory mass around lung cancers.

Case presentation: We encountered a patient with a pleomorphic carcinoma of the lung. This tumor produced interleukin (IL)-8, granulocyte colony-stimulating factor and IL-6, which in turn recruited inflammatory cells, such as CD8 positive lymphocytes, around the tumor, resulting in a rapidly growing tumor shadow.

Conclusion: 18 F-fluoro-deoxy-glucose positron emission tomography, in addition to a conventional radiological approach such as computed tomography, may detect immunological responses around a tumor.

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Figures

Figure 1
Figure 1
Chest X ray on admission. Arrow: tumor.
Figure 2
Figure 2
Chest CT scan on admission. Arrow: tumor.
Figure 3
Figure 3
Clinical course. Before the operation, the mass-like opacity rapidly grew. After the operation, the patient’s neutrophilia and elevated CRP level rapidly subsided.
Figure 4
Figure 4
FDG-PET/CT in September 2005. FDG-PET/CT showed the localized uptake of FDG to the center of the mass-like lesion, in addition to diffuse uptake by the bone marrow and an enlarged liver and spleen.
Figure 5
Figure 5
Resected tumor. Black arrow: main tumor including necrosis. White arrow: non-cancerous areas.
Figure 6
Figure 6
Tumor tissue. Black arrow: Giant cell, White arrows: Large cell carcinoma, Yellow arrows: Neutrophils.
Figure 7
Figure 7
RT-PCR analysis of chemokine receptors and their ligands. RT-PCR showed that CXCR1 mRNA was strongly expressed in the surrounding area of the cancer and that mRNA encoding IL-8, the ligand of CXCR1, expressed in the cancer. In addition, CXCR3 mRNA was expressed in the cells surrounding area of the cancer, and that Mig and IP-10, the ligand of CXCR3, was expressed in the cancer itself. CCR3 was also expressed in the cancer.
Figure 8
Figure 8
Immunohistological staining of the cancer lesion (×400). The cancerous lesion in our patient was infiltrated by many CD8 positive lymphocytes and neutrophils and by a small number of CD4 positive lymphocytes. These lymphocytes were positively stained with anti-IL-8 antibody. The tumor cells were positive for G-CSF, partly positive for IL-8 and weakly positive for IL-6, but negative for IL-8R/CXCR1.
Figure 9
Figure 9
Immunohistological staining of the tissue surrounding the cancer lesion (×400). The area surrounding the tumor in our patient contained many CD8 positive lymphocytes, but few neutrophils. The neutrophils were negative for IL-8, whereas the infiltrating lymphocytes were weakly positive for IL-8R/CXCR1.
Figure 10
Figure 10
Receptors and ligands in the cancer lesion and in the surrounding area. Our findings suggest that the tumor cells produced IL-8, G-CSF and IL-6, IL-8 recruited CD8-positive lymphocytes and neutrophils from the bloodstream, resulting in the rapid organization of an inflammatory zone around the tumor.
See this image and copyright information in PMC

References

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Pre-publication history
    1. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/14/588/prepub

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