Possible relationship between fibrosis of IgG4-related thymitis and the profibrotic cytokines, transforming growth factor beta 1, interleukin 1 beta and interferon gamma: a case report
Abstract Background IgG4-related disease often forms a mass and the affected lesion is clinically removed because the mass cannot be differentiated from a neoplasm. Affected lesions commonly occur in the pancreas, hepatobiliary tract, kidney, and retroperitoneum. However, the lesion rarely occurs in...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | Diagnostic Pathology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13000-018-0684-1 |
| _version_ | 1828357316894785536 |
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| author | Atsuko Masunaga Fumihiro Ishibashi Eitetsu Koh Takashi Oide Yasuo Sekine Kenzo Hiroshima |
| author_facet | Atsuko Masunaga Fumihiro Ishibashi Eitetsu Koh Takashi Oide Yasuo Sekine Kenzo Hiroshima |
| author_sort | Atsuko Masunaga |
| collection | DOAJ |
| description | Abstract Background IgG4-related disease often forms a mass and the affected lesion is clinically removed because the mass cannot be differentiated from a neoplasm. Affected lesions commonly occur in the pancreas, hepatobiliary tract, kidney, and retroperitoneum. However, the lesion rarely occurs in the thymus. A histological worldwide consensus of IgG4-related disease proposed that pathological diagnosis of IgG4-related disease should meet more than two of three major features: 1) dense lymphoplasmacytic infiltration with greater than 40% IgG4+/IgG+ plasma cells, 2) storiform fibrosis; and 3) obliterative phlebitis. Currently, fibrosis of IgG4-related disease is thought to be induced by profibrotic cytokines such as transforming growth factor beta 1 (TGFB1), interleukin 1 beta (IL1B) and interferon gamma (IFNG), which are secreted by regulatory T cells (Tregs) and CD4-positive cytotoxic T cells. However, it is unclear whether profibrotic cytokines are associated with the fibrosis seen in IgG4-related thymitis. Here we examined whether cytokines in the mass were increased compared with those in the surrounding thymus, and whether Tregs were present in the mass, using reverse transcription absolute quantitative polymerase chain reaction (RT-ab-qPCR) and immunohistochemistry. Case presentation A 70-year-old Japanese man contracted IgG4-letated thymitis. Histological and immunohistochemical analyses demonstrated his mass had massive fibrosis with a focally storiform pattern and lymphoplasmacytic infiltration with 40% IgG4+/IgG+ plasma cells, but not obliterative phlebitis. The mass was surrounded by atrophic thymus. We diagnosed the mass as IgG4-related thymitis. Immunohistochemically, Tregs were scattered throughout the mass. RT-ab-qPCR showed that messenger RNA expressions of TGFB1, IL1B and IFNG in the mass were 270-, 158- and 5.5- fold higher than in the surrounding thymus. His serum IgG4 level after surgery was within the normal range (83.4 mg/dl soon after surgery, 89.3 mg/dl 2 weeks after surgery). Conclusions Our results suggested the profibrotic cytokines TGFB1, IL1B and IFNG induce fibrosis and that Tregs might produce some of these cytokines in IgG4-related thymitis as well as in the other affected lesions of IgG4-related disease. |
| first_indexed | 2024-04-14T03:13:34Z |
| format | Article |
| id | doaj.art-33c82a1793484c1f900ac397ab0b3b8c |
| institution | Directory Open Access Journal |
| issn | 1746-1596 |
| language | English |
| last_indexed | 2024-04-14T03:13:34Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Diagnostic Pathology |
| spelling | doaj.art-33c82a1793484c1f900ac397ab0b3b8c2022-12-22T02:15:33ZengBMCDiagnostic Pathology1746-15962018-01-011311610.1186/s13000-018-0684-1Possible relationship between fibrosis of IgG4-related thymitis and the profibrotic cytokines, transforming growth factor beta 1, interleukin 1 beta and interferon gamma: a case reportAtsuko Masunaga0Fumihiro Ishibashi1Eitetsu Koh2Takashi Oide3Yasuo Sekine4Kenzo Hiroshima5Department of Pathology, Tokyo Women’s Medical University Yachiyo Medical CenterDivision of Thoracic Surgery, Department of Surgery, Tokyo Women’s Medical University Yachiyo Medical CenterDivision of Thoracic Surgery, Department of Surgery, Tokyo Women’s Medical University Yachiyo Medical CenterDepartment of Pathology, Tokyo Women’s Medical University Yachiyo Medical CenterDivision of Thoracic Surgery, Department of Surgery, Tokyo Women’s Medical University Yachiyo Medical CenterDepartment of Pathology, Tokyo Women’s Medical University Yachiyo Medical CenterAbstract Background IgG4-related disease often forms a mass and the affected lesion is clinically removed because the mass cannot be differentiated from a neoplasm. Affected lesions commonly occur in the pancreas, hepatobiliary tract, kidney, and retroperitoneum. However, the lesion rarely occurs in the thymus. A histological worldwide consensus of IgG4-related disease proposed that pathological diagnosis of IgG4-related disease should meet more than two of three major features: 1) dense lymphoplasmacytic infiltration with greater than 40% IgG4+/IgG+ plasma cells, 2) storiform fibrosis; and 3) obliterative phlebitis. Currently, fibrosis of IgG4-related disease is thought to be induced by profibrotic cytokines such as transforming growth factor beta 1 (TGFB1), interleukin 1 beta (IL1B) and interferon gamma (IFNG), which are secreted by regulatory T cells (Tregs) and CD4-positive cytotoxic T cells. However, it is unclear whether profibrotic cytokines are associated with the fibrosis seen in IgG4-related thymitis. Here we examined whether cytokines in the mass were increased compared with those in the surrounding thymus, and whether Tregs were present in the mass, using reverse transcription absolute quantitative polymerase chain reaction (RT-ab-qPCR) and immunohistochemistry. Case presentation A 70-year-old Japanese man contracted IgG4-letated thymitis. Histological and immunohistochemical analyses demonstrated his mass had massive fibrosis with a focally storiform pattern and lymphoplasmacytic infiltration with 40% IgG4+/IgG+ plasma cells, but not obliterative phlebitis. The mass was surrounded by atrophic thymus. We diagnosed the mass as IgG4-related thymitis. Immunohistochemically, Tregs were scattered throughout the mass. RT-ab-qPCR showed that messenger RNA expressions of TGFB1, IL1B and IFNG in the mass were 270-, 158- and 5.5- fold higher than in the surrounding thymus. His serum IgG4 level after surgery was within the normal range (83.4 mg/dl soon after surgery, 89.3 mg/dl 2 weeks after surgery). Conclusions Our results suggested the profibrotic cytokines TGFB1, IL1B and IFNG induce fibrosis and that Tregs might produce some of these cytokines in IgG4-related thymitis as well as in the other affected lesions of IgG4-related disease.http://link.springer.com/article/10.1186/s13000-018-0684-1IgG4-related diseaseSclerosing mediastinitisThymitisTransforming growth factor beta 1Interleukin 1 betaInterferon gamma |
| spellingShingle | Atsuko Masunaga Fumihiro Ishibashi Eitetsu Koh Takashi Oide Yasuo Sekine Kenzo Hiroshima Possible relationship between fibrosis of IgG4-related thymitis and the profibrotic cytokines, transforming growth factor beta 1, interleukin 1 beta and interferon gamma: a case report Diagnostic Pathology IgG4-related disease Sclerosing mediastinitis Thymitis Transforming growth factor beta 1 Interleukin 1 beta Interferon gamma |
| title | Possible relationship between fibrosis of IgG4-related thymitis and the profibrotic cytokines, transforming growth factor beta 1, interleukin 1 beta and interferon gamma: a case report |
| title_full | Possible relationship between fibrosis of IgG4-related thymitis and the profibrotic cytokines, transforming growth factor beta 1, interleukin 1 beta and interferon gamma: a case report |
| title_fullStr | Possible relationship between fibrosis of IgG4-related thymitis and the profibrotic cytokines, transforming growth factor beta 1, interleukin 1 beta and interferon gamma: a case report |
| title_full_unstemmed | Possible relationship between fibrosis of IgG4-related thymitis and the profibrotic cytokines, transforming growth factor beta 1, interleukin 1 beta and interferon gamma: a case report |
| title_short | Possible relationship between fibrosis of IgG4-related thymitis and the profibrotic cytokines, transforming growth factor beta 1, interleukin 1 beta and interferon gamma: a case report |
| title_sort | possible relationship between fibrosis of igg4 related thymitis and the profibrotic cytokines transforming growth factor beta 1 interleukin 1 beta and interferon gamma a case report |
| topic | IgG4-related disease Sclerosing mediastinitis Thymitis Transforming growth factor beta 1 Interleukin 1 beta Interferon gamma |
| url | http://link.springer.com/article/10.1186/s13000-018-0684-1 |
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