Immunohistochemical analysis of the distribution of RANKL: a case of disseminated carcinomatosis of bone marrow as the first presentation of relapse in curatively resected colorectal cancer.

IF 1.2 4区医学 Q3 PATHOLOGY

Medical Molecular Morphology Pub Date : 2023-06-01 DOI:10.1007/s00795-022-00342-9

Yoshitaka Shimada, Yasushi Nagaba, Hiroyuki Okawa, Kaori Ehara, Shinya Okada, Masanori Naito, Hiroaki Yokomori

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Abstract

Poorly differentiated adenocarcinoma of colorectal carcinoma (CRC) is a rare condition with poor prognosis. In this report, we describe a case of a 69-year-old man who underwent laparoscopic low anterior resection after being diagnosed with stage IIIB CRC. At 10 months post-operation, he developed fever and loss of appetite. Laboratory examination revealed > 120.0 μg/dL fibrin degradation products and > 60.0 μg/dL D-dimer. Bone marrow (BM) examination showed malignant epithelioid infiltrate with CK20 and CDX2 expression, leading to diagnosis of disseminated carcinomatosis of BM, which is rare in CRC and indicative of widespread disease throughout the body. Furthermore, immunohistochemistry revealed high expression of receptor activator of nuclear factor κB ligand (RANKL) in tumor cells, including budding cells of CRC and BM tissues. Thus, RANKL expression, which is known to indicate metastatic behavior of cancer cells, may play a critical role in promoting osteoclast formation, which has been associated with the pathogenesis of BM lesions.

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RANKL分布的免疫组织化学分析:一例以骨髓播散性癌病为首发复发的治愈性结直肠癌。

摘要结直肠癌低分化腺癌是一种罕见且预后差的疾病。在这个报告中，我们描述了一个69岁的男性在诊断为IIIB期CRC后接受腹腔镜下前低位切除术的病例。术后10个月，患者出现发热和食欲减退。实验室检查显示纤维蛋白降解产物> 120.0 μg/dL, d -二聚体> 60.0 μg/dL。骨髓(BM)检查显示CK20和CDX2表达的恶性上皮样浸润，诊断为弥散性BM癌，这在CRC中很少见，表明疾病在全身广泛传播。免疫组化结果显示，核因子κB配体受体激活因子(receptor activator of nuclear factor κB ligand, RANKL)在肿瘤细胞(包括CRC和BM组织的出芽细胞)中高表达。因此，已知表明癌细胞转移行为的RANKL表达可能在促进破骨细胞形成中起关键作用，这与BM病变的发病机制有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Molecular Morphology 医学-病理学

CiteScore

2.90

自引率

5.60%

发文量

审稿时长

>12 weeks

期刊介绍： Medical Molecular Morphology is an international forum for researchers in both basic and clinical medicine to present and discuss new research on the structural mechanisms and the processes of health and disease at the molecular level. The structures of molecules, organelles, cells, tissues, and organs determine their normal function. Disease is thus best understood in terms of structural changes in these different levels of biological organization, especially in molecules and molecular interactions as well as the cellular localization of chemical components. Medical Molecular Morphology welcomes articles on basic or clinical research in the fields of cell biology, molecular biology, and medical, veterinary, and dental sciences using techniques for structural research such as electron microscopy, confocal laser scanning microscopy, enzyme histochemistry, immunohistochemistry, radioautography, X-ray microanalysis, and in situ hybridization. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.