Pathogenic significance of interleukin-6 in angioimmunoblastic lymphadenopathy-type T-cell lymphoma.

Abstract

Patients with angioimmunoblastic lymphadenopathy (AILD)-type T-cell lymphoma may develop hypergammaglobulinemia. Among four cases of AILD-type T-cell lymphoma that we have studied, we detected a correlation between the number of plasma cells in tissue and the extent of interleukin-6 (IL-6) expression in lymphoma cells. We did not detect IL-6 in three patients who had no hypergammaglobulinemia and whose tissues showed only minimal plasma cell infiltration. In the fourth patient we observed an abundant IL-6 production by lymphoma cells, which accounted for a B-cell plasmacytic tissue response and for hypergammaglobulinemia. The pathogenic significance of IL-6 was substantiated by a concomitant decrease in the serum IL-6 level, measurable tumor mass, and immunoglobulin levels, as well as by a decline in the proportion of plasmacytoid cells in peripheral blood promptly on administration of chemotherapy. Plasmacytoid B cells could be maintained in culture in the presence of IL-6, but viability was lost on co-incubation with anti-IL-6. Interleukin-1 and tumor necrosis factor were not produced by T lymphoma cells and were incapable of sustaining plasmacytoid B-cell viability in vitro. Small amounts of IL-4 were noted in T lymphoma cells. Thus, in this case of AILD-type T-cell lymphoma, tumor cells with a T-cell phenotype produced IL-6 in large quantities, explaining the accompanying B-cell and plasmacytic histologic changes and humoral disease manifestations, including marked hypergammaglobulinemia. Although not all cases of AILD-type T-cell lymphoma have an accompanying plasma cell proliferation and hypergammaglobulinemia, and although the cytokine network in these patients may be more complex than has been recognized, this case with IL-6 expression serves to illustrate the utility of cytokine assays in the analysis of the histopathologic and clinical heterogeneities of peripheral T-cell lymphomas.

• Authors: S M Hsu, J A Waldron Jr, L Fink, C King, S S Xie, A Mansouri, B Barlogie
• Journal: Human pathology (Hum Pathol) Vol. 24 Issue 2 Pg. 126-31 (Feb 1993) ISSN: 0046-8177 [Print] United States
• PMID: 8432509 (Publication Type: Case Reports, Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Immunoglobulins
• Interleukin-6
• C-Reactive Protein

Topics

• Aged
• Bone Marrow (pathology)
• C-Reactive Protein (analysis)
• Enzyme-Linked Immunosorbent Assay
• Humans
• Immunoblastic Lymphadenopathy (complications, metabolism, pathology)
• Immunoglobulins (analysis)
• Immunohistochemistry
• Interleukin-6 (metabolism)
• Lymphoma, T-Cell (complications, metabolism, pathology)
• Male
• Middle Aged
• Plasma Cells (pathology)
• Tumor Cells, Cultured (metabolism, pathology)