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Ahrendsen JT, Anderson KR, Anderson MP. Lymphocytic ganglionitis leading to megacolon in lymphocyte-rich glioblastoma. J Neuroimmunol 2019; 337:577075. [PMID: 31655421 DOI: 10.1016/j.jneuroim.2019.577075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/23/2019] [Accepted: 09/24/2019] [Indexed: 12/17/2022]
Abstract
T-cell immune attack of cancer cells underlies the efficacy of immune checkpoint inhibitors in many cancer subtypes, but is not yet well established in the primary brain cancer glioblastoma. Immune checkpoint inhibitor treatments that disinhibit the immune system to enhance immune clearance of cancer have in rare cases resulted in T-cell attack of peripheral ganglia causing lymphocytic ganglionitis. In glioblastoma, lymphocytic ganglionitis has not been reported and checkpoint inhibitors are not routinely used. Here we report a case of glioblastoma not treated with checkpoint inhibitors in which the primary tumor and peripheral ganglia of the celiac and sympathetic chains, as well as myenteric plexus, are infiltrated by CD8+ cytotoxic T-cells. In addition to the marked lymphocytic infiltrates, this case is also notable for an unusually long survival (8 years) after diagnosis with glioblastoma, but an ultimately fatal outcome due to ileus. The findings suggest T-cell immune attack of glioblastoma may prolong survival, but also suggest T-cell autoimmune diseases such as lymphocytic ganglionitis could become a risk with the future use of immune-targeted therapies for glioblastoma.
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Affiliation(s)
| | - Kevin R Anderson
- Departments of Pathology, Harvard Medical School, Boston, MA, USA
| | - Matthew P Anderson
- Departments of Pathology, Harvard Medical School, Boston, MA, USA; Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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Vial G, Rivière E, Raymond AA, James C, Di-Tommaso S, Dugot-Senant N, Dupuy JW, Yacoub M, Parrens M, Saltel F, Viallard JF. Antigenic Mimicry in Paraneoplastic Immune Thrombocytopenia. Front Immunol 2019; 10:523. [PMID: 30967864 PMCID: PMC6439352 DOI: 10.3389/fimmu.2019.00523] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/26/2019] [Indexed: 01/25/2023] Open
Abstract
The association of immune thrombocytopenia (ITP) with cancer has been reported, but the causality of tumor cells in paraneoplastic ITP pathogenesis and maintenance has never been established. We analyzed the unusual case of refractory ITP and coincident urothelial tumor of the kidney with circulating high titer anti-GPIIBIIIA autoantibodies. Intriguingly, after nephrectomy, the patient recovered fully and her anti-GPIIBIIIA autoantibodies disappeared. Proteomic and immunohistochemistry analyses revealed erratic GPIIB expression by the tumor cells, suggesting possible antigenic mimicry chronically stimulating the immune system and leading to this patient's refractory ITP. Such previously unreported findings provide proof-of-concept that requires further confirmation with the prospective study of a larger number of patients.
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Affiliation(s)
- Guillaume Vial
- Internal Medicine and Infectious Diseases Department, Haut Lévêque Hospital, University Hospital Centre of Bordeaux, Pessac, France
| | - Etienne Rivière
- Internal Medicine and Infectious Diseases Department, Haut Lévêque Hospital, University Hospital Centre of Bordeaux, Pessac, France.,INSERM, Biology of Cardiovascular Diseases, U1034, Pessac, France.,Biology of Cardiovascular Diseases, U1034, University of Bordeaux, Pessac, France
| | | | - Chloé James
- INSERM, Biology of Cardiovascular Diseases, U1034, Pessac, France.,Biology of Cardiovascular Diseases, U1034, University of Bordeaux, Pessac, France.,Laboratory of Hematology, University Hospital Centre of Bordeaux, Pessac, France
| | | | | | - Jean-William Dupuy
- Centre de Génomique Fonctionnelle, Plateforme Protéome, Université de Bordeaux, Bordeaux, France
| | - Mokrane Yacoub
- Pathology Department, Pellegrin Hospital, CHU Bordeaux, Bordeaux, France
| | - Marie Parrens
- Pathology Department, Haut Lévêque Hospital, University Hospital Centre of Bordeaux, Pessac, France
| | - Fréderic Saltel
- INSERM U1053, Oncoprot, Bordeaux University, Bordeaux, France
| | - Jean-François Viallard
- Internal Medicine and Infectious Diseases Department, Haut Lévêque Hospital, University Hospital Centre of Bordeaux, Pessac, France.,INSERM, Biology of Cardiovascular Diseases, U1034, Pessac, France.,Biology of Cardiovascular Diseases, U1034, University of Bordeaux, Pessac, France
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