title: Generalized lymphadenopathy mimicking malignant lymph node metastases after interferon-α2b therapy for melanoma.
abstract: A patient, who complained of axillary swelling, was diagnosed with malignant melanoma of stage IIb and received adjuvant high-dose interferon-α2b (HDI) therapy for 3 months. Computed tomography demonstrated multiple, generalized lymph node enlargement with high fluorine-18-fluorodeoxyglucose uptake (6.6 of the standardized uptake value) on PET. Histological examination of the axillary lymph node revealed reactive hyperplasia, without evidence of malignant cells. Discontinuation of interferon therapy for 6 weeks resulted in near-complete resolution of the lymphadenopathies. HDI therapy was therefore resumed at a reduced dose and was continued for 25 weeks without recurrence of the lymphadenopathies. HDI therapy is the only adjuvant therapy proven to be effective in malignant melanoma. The release of various additional cytokines is stimulated by interferon, which is responsible for the more common side effects of this therapy. The cytokines are also likely to stimulate helper T cells and induce T-cell sequestration within lymph nodes. These actions are possibly associated with generalized lymph node enlargement in some patients undergoing HDI therapy. The results from the present case indicate that HDI therapy can be safely maintained after confirming the benign nature of the lymphadenopathies that occur during the treatment.
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sehyo
authors.initials: S
authors.lastname: Yune
authors.forename: Kee-Taek
authors.initials: KT
authors.lastname: Jang
authors.forename: Seung Min
authors.initials: SM
authors.lastname: Jung
authors.forename: Jung Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Jeeyun
authors.initials: J
authors.lastname: Lee
mesh_terms: D003937:Diagnosis, Differential; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects*; D008206:Lymphatic Diseases / Q000139:chemically induced / Q000175:diagnosis*; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011379:Prognosis; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins