title: Hodgkin's disease masquerading as fibrous thyroiditis: potential role of cytokines in in vivo and in vitro studies.
abstract: 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.
authors.affiliation: Départements d'Endocrinologie, d'Hématologie, et d'Anatomie pathologique, CHU Brest, Clamart, France.
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Bercovici
authors.forename: Veronique
authors.initials: V
authors.lastname: Machelon
authors.forename: Françoise
authors.initials: F
authors.lastname: Gaudin-Nome
authors.forename: Nathalie
authors.initials: N
authors.lastname: Roudaut
authors.forename: Virginie
authors.initials: V
authors.lastname: Conan-Charlet
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Leroy
authors.forename: Luc
authors.initials: L
authors.lastname: Sensebe
authors.forename: Veronique
authors.initials: V
authors.lastname: Kerlan
mesh_terms: 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
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha