Interleukin-6-producing Thymic Squamous Cell Carcinoma Associated with Castleman's Disease and Nephrotic Syndrome

• Published in: Internal Medicine Vol. 41; no. 10; pp. 871 - 874
• Main Authors: MATSUMURA, Norihiko, SHIIKI, Hideo, SAITO, Naotoshi, URAMOTO, Hiroki, HANATANI, Masakazu, NONAKA, Hideo, NAKAMURA, Shinobu
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 01-10-2002; Japanese Society of Internal Medicine
• Subjects: Biological and medical sciences; Carcinoma, Squamous Cell - blood; Carcinoma, Squamous Cell - complications; Carcinoma, Squamous Cell - diagnosis; Castleman Disease - blood; Castleman Disease - complications; Castleman Disease - diagnosis; focal segmental glomerulosclerosis; Glomerulonephritis; Humans; Interleukin-6 - blood; Male; mediastinal tumor; Mediastinum - diagnostic imaging; Mediastinum - pathology; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Nephrotic Syndrome - blood; Nephrotic Syndrome - complications; Nephrotic Syndrome - diagnosis; Plasma Cells - physiology; Pneumology; Radiography, Thoracic; Thymus Neoplasms - blood; Thymus Neoplasms - complications; Thymus Neoplasms - diagnosis; Tomography, X-Ray Computed; Tumors of the respiratory system and mediastinum; Human; Kidney disease; Glomerulonephritis; Benign lymphadenopathy; Corticosteroid; Squamous cell carcinoma; Urinary system disease; Thymus gland; Mediastinum disease; Treatment efficiency; Etiopathogenesis; Male; Hemopathy; Malignant tumor; mediastinal tumor; focal segmental glomerulosclerosis; Case study; Interleukin 6; Concomitant disease; Lymphoproliferative syndrome; Castleman disease; Adult; Diagnosis
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.41.871

When a 63-year-old man was hospitalized with nephrotic syndrome due to focal segmental glomerulosclerosis, a mediastinal mass was discovered. A biopsy specimen obtained by mediastinoscopy showed findings compatible with the plasma cell type of Castleman's disease. Fever, anemia, and anti-nuclear antibody were present. Serum concentrations of gamma globulin, acute phase proteins, and, most strikingly, interleukin-6 (IL-6) were elevated. Methylprednisolone pulse therapy resulted in no clinical improvement. Pathologic examination of the resected thymic tumor showed a squamous cell carcinoma immunoreactive for IL6. To our knowledge, this case represents the first reported IL-6-producing thymic squamous cell carcinoma associated with Castleman's disease and nephrotic syndrome. (Internal Medicine 41: 871-874, 2002)