Hodgkin's disease masquerading as fibrous thyroiditis: potential role of cytokines in in vivo and in vitro studies

Clin Endocrinol (Oxf). 2002 Nov;57(5):691-7. doi: 10.1046/j.1365-2265.2002.01648.x.

Abstract

Hodgkin's disease appearing as, or associated with, fibrous thyroiditis has only been described rarely. We report the observation of a patient presenting with a goitre, fibrosis of the thyroid and adjacent structures, and hypothyroidism. The histological examination was compatible with fibrosclerotic thyroiditis. This diagnosis was reviewed 6 months later when the biopsy of a supraclavicular nodule that had subsequently appeared led to the diagnosis of a nodular-sclerosis type of Hodgkin's disease. The plasmatic levels of interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-alpha) were very high compared to the levels in healthy subjects (12 and 40 IU/l vs. 0.05 and 2.0 IU/l, respectively). These cytokine levels decreased when the initial illness was treated, and their normalization was associated with the disappearance of the cervical and thyroidal fibroses. A parallel in vitro study of these cytokines and of TNF-alpha receptors and IL-13 was performed. The results suggest a possible cause-and-effect relationship between IL-6 and IL-13 produced locally by the tumoral tissue and the development of cervical fibrosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cytokines / immunology*
  • Fibrosis
  • Goiter / diagnostic imaging
  • Goiter / immunology*
  • Goiter / pathology
  • Hodgkin Disease / diagnosis*
  • Hodgkin Disease / immunology*
  • Humans
  • Hypothyroidism / diagnostic imaging
  • Hypothyroidism / immunology*
  • Hypothyroidism / pathology
  • Interleukin-6 / immunology
  • Thyroid Gland / diagnostic imaging
  • Thyroid Gland / pathology
  • Tomography, X-Ray Computed
  • Tumor Necrosis Factor-alpha / immunology

Substances

  • Cytokines
  • Interleukin-6
  • Tumor Necrosis Factor-alpha