Asunto(s)
Síndromes de Inmunodeficiencia/patología , Infecciones Neumocócicas/tratamiento farmacológico , Vacunas Neumococicas/efectos adversos , Adulto , Quimioterapia Combinada , Humanos , Masculino , Infecciones Neumocócicas/diagnóstico , Infecciones Neumocócicas/patología , Vacunas Neumococicas/inmunología , Enfermedades de Inmunodeficiencia Primaria , Prevención Secundaria , Bazo/anomalías , Bazo/patología , Resultado del TratamientoRESUMEN
This report describes the case of 74-year-old man who had a gastric yolk sac tumor complicated with beta human chorionic gonadotropin (beta hCG) producing metastases. He was a heavy drinker. He was admitted to the hospital for abdominal pain and fullness. Based on computed tomography and gastric endoscopy he was diagnosed to have gastric cancer that had metastasized to the liver, lung and lymph nodes. The level of serum alpha fetoprotein (AFP) was high at 523 ng/mL. He died of multiorgan failure six days after admission. The autopsy revealed the stomach tumor to be an AFP-positive yolk sac tumor. Lymph node metastases showed the same characteristics as the stomach tumor. However, the lesions on the liver and lung were negative for AFP and positive for hCG. The yolk sac tumor seemed to have retrodifferentiated to form an hCG-producing tumor in the metastatic lesions. A gastric yolk sac tumor is extremely rare and only eight cases of gastric yolk sac tumors have been previously reported in the literature. To avoid a misdiagnosis, careful attention should be paid to the above-mentioned morphological features and immunohistochemical findings, in addition to the clinical findings.
Asunto(s)
Gonadotropina Coriónica Humana de Subunidad beta/biosíntesis , Tumor del Seno Endodérmico/diagnóstico , Ganglios Linfáticos/patología , Neoplasias Gástricas/diagnóstico , Anciano , Biomarcadores de Tumor/biosíntesis , Tumor del Seno Endodérmico/metabolismo , Resultado Fatal , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/secundario , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/secundario , Ganglios Linfáticos/metabolismo , Metástasis Linfática/diagnóstico , Masculino , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/secundario , alfa-Fetoproteínas/biosíntesisRESUMEN
A 66-year-old woman developed systemic sclerosis (SSc) after receiving interferon alphacon-1 (IFNalphacon-1; consensus interferon) therapy for chronic hepatitis C. She suffered from Raynauds phenomenon about 1 year after a course of IFNalphacon-1 therapy. The combination of proximal scleroderma, Raynauds phenomenon, and ANA positivity led to a diagnosis of systemic sclerosis (SSc). IFN has multiple effects on the immune system and is known to trigger the development of autoantibodies, as well as the onset or exacerbation of autoimmune disease. We suspect that the immunomodulatory effects of IFNalphacon-1 triggered the clinical manifestations of SSc in this patient. To our knowledge this is only the third case of SSc after IFNalpha therapy, and it is the first case associated with IFNalphacon-1 therapy.