Hodgkin's disease masquerading as fibrous thyroiditis: potential role of cytokines in in vivo and in vitro studies.
Hodgkin's disease appearing as, or associated with, fibrous thyroiditis has only been described rarely. We report the observation of a patient presenting with a goitre, fibrosis of the thyroid and adjacent structures, and hypothyroidism. The histological examination was compatible with fibrosclerotic thyroiditis. This diagnosis was reviewed 6 months later when the biopsy of a supraclavicular nodule that had subsequently appeared led to the diagnosis of a nodular-sclerosis type of Hodgkin's disease. The plasmatic levels of interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-alpha) were very high compared to the levels in healthy subjects (12 and 40 IU/l vs. 0.05 and 2.0 IU/l, respectively). These cytokine levels decreased when the initial illness was treated, and their normalization was associated with the disappearance of the cervical and thyroidal fibroses. A parallel in vitro study of these cytokines and of TNF-alpha receptors and IL-13 was performed. The results suggest a possible cause-and-effect relationship between IL-6 and IL-13 produced locally by the tumoral tissue and the development of cervical fibrosis.
Bercovici
Jean Pierre
JP
Départements d'Endocrinologie, d'Hématologie, et d'Anatomie pathologique, CHU Brest, Clamart, France.
Machelon
Veronique
V
Gaudin-Nome
Françoise
F
Roudaut
Nathalie
N
Conan-Charlet
Virginie
V
Leroy
Jean Paul
JP
Sensebe
Luc
L
Kerlan
Veronique
V
D000328:Adult; D016207:Cytokines / Q000276:immunology*; D005355:Fibrosis; D006042:Goiter / Q000000981:diagnostic imaging / Q000276:immunology* / Q000473:pathology; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000276:immunology*; D006801:Humans; D007037:Hypothyroidism / Q000000981:diagnostic imaging / Q000276:immunology* / Q000473:pathology; D015850:Interleukin-6 / Q000276:immunology; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
D016207:Cytokines; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha