SS-A52 antigen expression in thymic carcinoma accompanied with Sjögren syndrome
Autor: | Tomomi Isono, Hiroyuki Shiono, Keiji Shimada, Tomoko Wakasa, Takafumi Ogawa, Hidenori Kusumoto |
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Rok vydání: | 2021 |
Předmět: |
Male
Pathology medicine.medical_specialty Mediastinal tumor 03 medical and health sciences 0302 clinical medicine Antigen thymic tumor medicine Carcinoma Humans Clinical Case Report 030212 general & internal medicine Thymic carcinoma Thymic Squamous Cell Carcinoma Aged business.industry Autoantibody FOXP3 Germinal center Thymus Neoplasms General Medicine medicine.disease Sjögren syndrome thoracic surgery stomatognathic diseases Sjogren's Syndrome Ribonucleoproteins 030220 oncology & carcinogenesis Carcinoma Squamous Cell business Research Article |
Zdroj: | Medicine |
ISSN: | 1536-5964 0025-7974 |
DOI: | 10.1097/md.0000000000024491 |
Popis: | Rationale: The relationship between thymic tumors and Sjögren syndrome (SjS) is unknown, and surgical resection has not been optimized. Especially, thymic carcinoma with autoimmune disease is rare. Analysis of SS-A52, germinal centers, plasma cells, and Foxp3+ Treg in thymic carcinoma has never been reported, and their pathological roles in causing SjS have not been studied. Patient concerns: A 78-year-old man presented with sputum production and xerostomia while asleep. Chest computed tomography showed a homogeneous and hypodense mass in the anterosuperior mediastinum. Serum levels of the antinuclear antibody, antibody to SS-A, and antibody to SS-B were positive. Diagnoses: Thymic carcinoma (squamous cell carcinoma) and SjS. Interventions: Video-assisted thoracoscopic resection of the mediastinal tumor and postoperative radiation therapy was performed. Outcomes: The histological diagnosis was thymic squamous cell carcinoma. Histologically, the squamous carcinomatous cells were arranged in nests and cords in the fibrohyaline stroma with capsular invasion. In the stroma, dense lymphoid tissues containing large reactive germinal centers and many plasma cells were also noted. In the involuted thymus, CD20-positive mature lymphocytes infiltrated, and germinal centers were noted. Double immunohistochemical staining revealed that SS-A52 antigen was positive in both the carcinoma component and CD20-positive mature B cells. Postoperatively, the xerostomia persisted, and serum SS-A and SS-B remained positive. No evidence of carcinoma recurrence with chest computed tomography scan was observed at 18-months follow-up. Lessons: In the surgical treatment of thymic tumors with SjS, extended thymectomy might be worth considering to stop the progressive destruction of the targets of SjS-specific autoantibodies. However, the postoperative symptoms may not dramatically improve because the target organs might have changed irreversibly, and memory B cells might persist. This is the first report that demonstrated the SS-A52 antigen presentation in a thymic tumor to the best of our knowledge. |
Databáze: | OpenAIRE |
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