Immunohistochemical analysis of beta-defensin-2 expression in human lung tumors
The aim of this paper is to present research was directed on analysis of the expression patterns of human beta-defensin-2 (hBD-2) in human lung tumors.
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irk-123456789-323092012-04-17T12:24:45Z Immunohistochemical analysis of beta-defensin-2 expression in human lung tumors Shestakova, T. Zhuravel, E. Bolgova, L. Zaitsev, S. Efanova, O. Soldatkina, M. Pogrebnoy, P. Original contributions The aim of this paper is to present research was directed on analysis of the expression patterns of human beta-defensin-2 (hBD-2) in human lung tumors. 2010 Article Immunohistochemical analysis of beta-defensin-2 expression in human lung tumors / T. Shestakova, E. Zhuravel, L. Bolgova, S. Zaitsev, O. Efanova, M. Soldatkina, P. Pogrebnoy // Experimental Oncology. — 2010. — Т. 32, № 4. — С. 273–276. — Біліогр.: 10 назв. — англ. 1812-9269 http://dspace.nbuv.gov.ua/handle/123456789/32309 en Experimental Oncology Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України |
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Original contributions Original contributions Shestakova, T. Zhuravel, E. Bolgova, L. Zaitsev, S. Efanova, O. Soldatkina, M. Pogrebnoy, P. Immunohistochemical analysis of beta-defensin-2 expression in human lung tumors Experimental Oncology |
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The aim of this paper is to present research was directed on analysis of the expression patterns of human beta-defensin-2 (hBD-2) in human lung tumors. |
format |
Article |
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Shestakova, T. Zhuravel, E. Bolgova, L. Zaitsev, S. Efanova, O. Soldatkina, M. Pogrebnoy, P. |
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Shestakova, T. Zhuravel, E. Bolgova, L. Zaitsev, S. Efanova, O. Soldatkina, M. Pogrebnoy, P. |
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Shestakova, T. |
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Immunohistochemical analysis of beta-defensin-2 expression in human lung tumors |
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Immunohistochemical analysis of beta-defensin-2 expression in human lung tumors |
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Immunohistochemical analysis of beta-defensin-2 expression in human lung tumors |
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Immunohistochemical analysis of beta-defensin-2 expression in human lung tumors |
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Immunohistochemical analysis of beta-defensin-2 expression in human lung tumors |
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immunohistochemical analysis of beta-defensin-2 expression in human lung tumors |
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Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України |
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2010 |
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Immunohistochemical analysis of beta-defensin-2 expression in human lung tumors / T. Shestakova, E. Zhuravel, L. Bolgova, S. Zaitsev, O. Efanova, M. Soldatkina, P. Pogrebnoy // Experimental Oncology. — 2010. — Т. 32, № 4. — С. 273–276. — Біліогр.: 10 назв. — англ. |
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Experimental Oncology |
work_keys_str_mv |
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2025-07-03T12:49:26Z |
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Experimental Oncology 32, 273–276, 2010 (December) 273
Lung cancer is a leading cause of cancer-related
death worldwide. That’s why numerous studies are di-
rected on estimation of etiology of this disease, search
for tumor markers, and development of new strategies
for lung cancer treatment. It is well recognized now that
the etiology of lung cancer is closely related to smoking
habits and is often associated with chronic pulmonary
inflammation and underlying immune dysfunction.
However, little is known yet about involvement of in-
nate immunity molecules, in particular, defensins, in
lung tumorigenesis.
Defensins — cationic antimicrobial peptides — are
important components of mucosal immunity which
two major functions are thought to be direct antimi-
crobial action and modulation of innate and adaptive
immunity in response to pathogens. According to
accumulated evidences, expression of some alpha-
or beta-defensins may be altered or deregulated in
different tumor types, and these antimicrobials could
play a complex and poorly understood role in cancer
pathogenesis either promoting or suppressing tumor
cell growth [1, 2].
In normalcy, defensins participate in antimicrobial
protection of respiratory tract along with other defense
molecules [3]. Mailfunction or altered expression of
these peptide antibiotics has been well documented
in a number of chronic lung pathologies, in particular,
cystic fibrosis, reactive airway disease, tuberculosis and
many other lung infections [4]. There are some data evi-
dencing on reduced levels of beta-defensin-2 (hBD-2)
in sputum and pharyngeal washes of smokers versus
nonsmokers with acute pneumonia [5] what points on
possible smoking-dependent down-regulation of this
peptide in airway epithelium. At the same time, up-to-
date there are scarce data for defensin expression pat-
terns in lung cancer. In our recent pilot study [6] we have
recorded an altered expression of hBD-1-4 mRNAs in
lung cancer samples versus normal lung tissue.
In this regard we aimed to analyze further the
expression patterns of hBD-2 in human lung tumor
samples using immunohistochemical approach.
MATERIALS AND METHODS
In the study, 31 samples of surgically resected
human lung tumors of different histological type were
studied. The tissue samples were obtained during the
surgical treatment of lung cancer patients cured in
the Thoracic Department of National Cancer Institute
(Kyiv, Ukraine) in 2001–2008 (Head of the Dept., prof.
V.L.Ganul). Immediately after surgical removal, tissue
samples were placed in liquid nitrogen and stored at
-70 oC until use. The patients did not receive chemo- or
radiotherapy prior to the surgery. All patients provided
an informed written consent to perform the study, and
the present research was approved by Ethic Board of
the Institute. Histological type and differentiation grade
of lung tumors has been estimated by clinical patholo-
gists (National Cancer Institute, Dept. Pathol. Anat. Dr.
E.N. Kovalchuk and Dr. I.N. Troitskaya). From 31 lung
tumor samples, 1 tumor was diagnosed as small-cell
lung cancer (SCLC), and 30 — as non-small cell lung
cancer (NSCLC). The last group of tumors included
1 case of clear cell large cell lung cancer, 9 cases of
squamous cell carcinoma (SCC), and 20 cases of ad-
enocarcinoma (AC). The clinico-pathological charac-
teristics of lung cancer cases are presented in Table 1.
Immunohistochemical analysis. Tumor tissue
samples were fixed in 4% formaldehyde for 24 h at
room temperature, then dehydrated in 50%, 70%, 80%,
90%, 96% spirits, treated with chloroform, saturated
with paraffin at 56 оС for 30 min and placed in paraffin
IMMUNOHISTOCHEMICAL ANALYSIS OF BETA-
DEFENSIN-2 EXPRESSION IN HUMAN LUNG TUMORS
T. Shestakova1,*, E. Zhuravel1, L. Bolgova2, S. Zaitsev2, O. Efanova1, M. Soldatkina1, P. Pogrebnoy1
1R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology of NAS of Ukraine,
Vasylkivska str. 45, Kyiv 03022, Ukraine
2National Cancer Institute, Ministry of Health of Ukraine, Lomonosova str. 33/43, Kyiv 03022, Ukraine
Aim: The present research was directed on analysis of the expression patterns of human beta-defensin-2 (hBD-2) in human lung
tumors. Materials and Methods: Specimens of surgically resected human lung tumors (n = 31) of different histological type (1 case
of small cell lung cancer, and 30 cases of non-small cell lung cancer (1 case of clear cell carcinoma, 9 cases of squamous cell carci-
noma (SCC), and 20 cases of adenocarcinoma (AC)) were analyzed for expression of hBD-2 with the use of immunohistochemical
analysis. Results: Immunohistochemical analysis has revealed that all lung tumor samples independently on their histological type
express hBD-2 peptide, however at different levels (from < 5% to 100% cells). According to our observations, low-differentiated
AC differs from moderately differentiated AC by significantly lower hBD-2 expression levels (p < 0.05). No correlation between
hBD-2 expression patterns and PCNA or Bcl-2 expression has been found. Conclusion: Human beta-defensin-2 expression levels
may depend on differentiation grade of lung adenocarcinoma.
Key Words: human beta-defensin-2, human lung tumors, lung squamous cell carcinoma, adenocarcinoma, expression.
*Correspondence: Fax: +380443581656;
E-mail: pogrebnoy@onconet.kiev.ua
Abbreviations used: AC — adenocarcinoma; hBD-2 — human beta-
defensin-2; HD — high differentiation; LD — low differentiation;
MD — moderate differentiation; NSCLC –non-small cell lung cancer;
SCC — squamous cell carcinoma; SCLC — small-cell lung cancer.
Exp Oncol 2010
32, 4, 273–276
274 Experimental Oncology 32, 273–276, 2010 (December)
blocks. 5 µm tissue slides were prepared with the use
of microtom REICHERT-JUNG Mod. 1140/Autocut.
Immunohistochemical analysis of protein expres-
sion has been performed on paraffin slides with the
use of a number of primary antibodies listed below,
EnVision System and DAB reagent (DAKO, Denmark).
The slides were twice deparaffinized with xylol (by
20 min), twice washed with 96% ethanol by 10 min, and
washed with distilled water. The slides were placed in
citrate buffer for 30 min and incubated in water bath
at 95 ̊ С. To block endogenous peroxidase activity, the
slides were treated with Peroxidase-Blocking Reagent
(DAKO, Denmark) according to instructions of the
manufacturer.
Incubation with primary antibodies (rat polyclonal
anti-hBD-2-Abs (Santa-Cruz, USA) 1 : 100; mouse
monoclonal anti-PCNA-Abs (Dako, Denmark) — 1 :
200; mouse monoclonal anti-Bcl-2 (Dako, Den-
mark) — 1 : 200) was carried out for 1 h at room tem-
perature in humidified atmosphere. To detect binding
of primary antibodies, the slides were incubated
with visualization system EnVision System (DAKO,
Denmark) for 1 h at room temperature in humidified
atmosphere. Then peroxidase activity was developed
using diaminobenzidine solution (DAB, DakoCytoma-
tion, Denmark). Cell nuclei were stained with Meyer’s
hematoxylin. As negative control, the slides treated
with normal mouse serum followed by DAB, were used.
Microscopic examination was done with the use of Carl
Zeiss Jena microscope (Germany).
The level of protein expression was evaluated by
the percent of positive cells or/and by intensity of
immunostaining with the use of H-score (counted as
follows: H-score = 1 x W + 2 x M + 3 x S, where W, M,
S are the percents of cells with weak, moderate and
strong staining intensity respectively).
Statistical analysis. The statistical significance of
the differences between the values (percent of hBD-
2-positive cells, expressed as M±m) was assessed by
the Student’s t-test. Values p < 0.05 were considered
statistically significant.
RESULTS
In our research we have studied expression of
hBD-2 in 31 lung tumor tissue samples from the
same patients. In order to find possible association
of hBD-2 expression with the processes of lung cell
proliferation or apoptosis, expression of proliferation
cell nuclear antigen (PCNA) and antiapoptotic Bcl-
2 protein has been studied as well.
Lung tumor samples were represented by histologi-
cally heterogenous group composed from 1 sample of
SCLC and 30 samples of NSCLC; the latest group was
composed from 1 case of clear cell large cell, 9 cases
of SCC (8 low differentiatied (LD) tumors, 1 moder-
ately differentiated (MD) tumors), and 20 cases of AC
(6 LD AC, 6 MD AC, 2 of MD/LD AC, 1 case of mixed
AC + SCC type, 1 case of papillary cancer, 2 cases of
bronchoalveolar highly differentiatied (HD) cancer, and
2 cases of AC with the regions of clear cell carcinoma)
(Table 1).
Table 1. The data for lung cancer patients and lung tumor samples used
in the study
N Case Gen-
der Age TNM clas-
sification Histological type
Differ-
entiation
grade
Addition-
al infor-
mation
1 A M 52 T2N0M0 Small cell lung
cancer
PL
2 B M - T2N0M0 Clear cell large
cell lung cancer
PL
3 C1 M 62 T2N0M0 SCC LD CL
4 C2 M 72 T2N2M1 SCC LD PL
5 C3 M 68 T1N0M0 SCC LD PL
6 C4 M 58 T2N2M0 SCC LD PL
7 C5 M 68 T2N0M0 SCC LD PL
8 C6 M 78 T2N0M0 SCC LD PL
9 C7 M 57 T2N1M0 SCC LD PL
10 C8 M 57 T2N0M0 SCC LD CL
11 C10 M 50 T2N1M0 SCC MD PL
12 D1 F 67 T2N0M0 AC LD PL
13 D2 M 72 T3N2M0 AC MD PL
14 D3 M 57 T2N0M0 Papillary AC with
mucus production
LD PL
15 D4 M 59 T2N0M0 AC MD PL
16 D6 M 54 T2N1M0 AC MD PL
17 D7 F 54 T1N0M0 AC LD PL
18 D8 M 55 T2N0M0 AC LD PL
19 D9 M 56 T2N2M0 AC LD PL
20 D10 M 41 T1N0M0 AC LD PL
21 D11 M 76 T2N1M0 AC with regions
of solid clear cell
cancer
LD PL
22 D12 F 63 T2N1M0 AC MD/LD PL
23 D13 M 44 T2N1M0 AC MD/LD PL
24 D14 M 40 T2N1M0 AC MD PL
25 D15 M 65 T2N1M0 Mixed type (AC +
SCC)
PL
26 D16 M 54 T2N2M0 AC MD PL
27 D17 F 64 T2N2M0 AC MD PL
28 D18 M 69 T3N0M0 AC LD PL
29 D19 F 63 T1N0M0 Bronchoalveolar
cancer
HD PL
30 D20 F 60 T1N0M0 Bronchoalveolar
cancer
HD PL
31 D21 M 63 T2N2M0 AC with regions
of solid clear cell
cancer
LD PL
Notes: tumor differentiation: LD — low-differentiated; MD — moderately-dif-
ferentiated; HD — highly-differentiated; SCC — squamous cell carcinoma;
AC — adenocarcinoma; PL — peripheral localization, CL — central localization.
The study has been performed on paraffin em-
bedded tissue blocks of the lung tumors with the use
of immunohistochemical approach (Table 2, Fig. 1).
Immunohistochemical analysis has revealed that
the studied SCC cases of peripheral localization are
characterized by moderate to very-high expression of
hBD-2 (6 from 7 cases), while 2 cases of SCCs local-
ized in bronchus express low levels of hBD-2 protein (<
10%). High percent of cells expressing PCNA or/and
Bcl-2 proteins was detected just in 1/3 of SCC cases.
Immunohistochemical analysis of hBD-2 expres-
sion in AC samples has shown that AC of LD grade
differs from AC of MD grade by lower hBD-2 expres-
sion (p < 0.05) (Table 2, Fig. 1). PCNA and Bcl-2 ex-
pression levels differ between the AC samples in a
wide range (however, both markers were negative in
HD bronchoalveolar cancer). There was observed no
significant correlation between expression levels of
mentioned above markers.
Experimental Oncology 32, 273–276, 2010 (December) 275
Table 2. Immunohistochemical analysis of hBD-2, PCNA, Bcl-2 expres-
sion in human lung tumor samples
№ Case
Expression level
hBD-2 PCNA Bcl-2
% positive cells H-scoring % positive cells % positive cells
Small cell lung cancer
1 A < 5% 5 90% 80%
Non-small cell lung cancer:
Clear cell large cell lung cancer
2 B 15% 15 95% 50%
Squamous cell carcinoma (LD)
3 C1 10% 10 15% 30%
4 C2 20% 25 20% 7%
5 C3 58% 130 32% 25%
6 C4 45% 85 55% 60%
7 C5 100% 241 64% 60%
8 C6 50% 118 - 6%
9 C7 100% 200 0.5% 5%
10 C8 10% 15 20% 10%
Squamous cell carcinoma (MD)
11 C10 40% 65 50% 10%
Adenocarcinoma (LD)
12 D1 < 5% 10 50% 25%
13 D7 30% 56 80% 40%
14 D8 20% 29 40% 40%
15 D9 < 5% 3 35% 35%
16 D10 15% 30 20% 40%
17 D18 40% 172 35% 20%
Adenocarcinoma (MD)
18 D2 23% 137 60% 60%
19 D4 < 5% 3 ND ND
20 D6 50% 100 60% 60%
21 D14 98% 219 - 25%
22 D16 90% 196 - 70%
23 D17 98% 138 - 10%
Adenocarcinoma (MD/LD)
24 D12 50% 110 10% < 5%
25 D13 50% 142 50% 50%
AC with regions of solid clear cell cancer
26 D11 35% 64 30% 0.5%
27 D21 100% 150 40% 40%
Bronchoalveolar cancer (HD)
28 D19 45% 78 - 3%
29 D20 81% 216 1% -
Mixed type (AC + SCC)
30 D15 100% 111 25% 10%
Papillary AC
31 D3 10% 81 30% 15%
According to the data of IHC analysis, beta-defen-
sin-2 is distributed in tumor cell cytoplasm as well as
in perinuclear space (Fig. 2).
DISCUSSION
Involvement of human antimicrobial peptides, in
particular, defensins in antimicrobial protection of
airways has been in spite of interest of many scientific
groups. The patterns of hBD-2 expression in surface
epithelial cells of human lung and bronchus has been
firstly described in 1998 in the detailed research of
Bals et al [7] who have showed hBD-2 up-regulation in
conditions of chronic inflammation. In a short time the
molecular mechanisms of hBD-2 induction in respira-
tory hTBE cells via NF-kB activation with involvement of
CD14 and TLR has been reported in the study of Beker
et al [8]. Since then, mailfunction or altered levels of
defensins have been reported in several pulmonary
disorders, in particular, pulmonary fibrosis, panbron-
chiolitis, alveolar proteinosis, acute respiratory distress
syndrome, lung transplantation, etc [9]; at present time
the exact role of defensins, multifunctional molecules
with direct antimicrobial activity and immunomodula-
tory properties, in lung disorders is not fully understood
and remains largely unstudied in lung cancer.
To our knowledge, our study is among the first ones
where beta-defensin-2 expression has been recorded
in human lung tumor samples with the use of immu-
nohistochemical analysis. It has been revealed that all
lung tumor samples independently on their histological
type express hBD-2 peptide, however at different lev-
els (from < 5% to 100% cells). In the majority of cases
hBD-2 expression is moderate, in 4 cases very low (<
5% cells), and nearly in 1/3 of cases it is very high (close
to 100% of cells, or > 200 by H-score). These data are
a b
c d
Fig.1. Immunohistochemical analysis of hBD-2 expression in lung squamous cell carcinoma (cases C4 (a), C5 (b)) and lung ad-
enocarcinoma (cases D18 (c), D21(d))
276 Experimental Oncology 32, 273–276, 2010 (December)
in some agreement with observations of Arimura et al.
[10] who have recorded significantly elevated concen-
trations of hBD-1 and high concentrations of hBD-2 in
blood serum of lung cancer patients compared to pa-
tients with pneumonia and healthy donors, and the data
of our earlier pilot study that has documented the fact
that an up-regulation of hBD-1 and hBD-2 mRNAs is a
frequent event in both lung SCC and AC compared to
normal lung tissue samples [6]. Unfortunately, as far as
the data on the history of the patients studied in present
study (concominant lung pathologies, smoking habits)
were unavailable, there are no grounds to speculate on
possible causes of elevated expression of the defensin
in lung tumor tissues.
The hBD-2 expression levels in these samples
seem to be not correlated with expression of prolif-
eration marker PCNA and antiapoptotic Bcl-2 pro-
tein. Interestingly, we have detected also that in lung
adenocarcinoma hBD-2 expression depend on tumor
differentiation grade — low differentiated tumors differ
from moderately differentiated ones by significantly
lower percent of hBD-2 expressing cells (p < 0.05).
Functional significance of human defensin-2 up-
regulation in lung tumor cells and possible relation
between its expression and tumor differentiation grade
remain to be studied in further researches.
ACKNOWLEDGEMENT
The authors wish to express their sincere gratitude
to Dr. O.V. Yurchenko (IEPOR NASU) for her expertized
assistance and valuable advices in the IHC research.
The work was supported in part by NASU grant U002243
“Fundamental Problems of Genomics and Proteomics”.
REFERENCES
1. Bullard RS, Gibson W, Bose SK, et al. Functional
analysis of the host defense peptide human beta defensin-1:
new insight into its potential role in cancer. Mol Immunol
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2. Droina N, Hendrab J-B, Ducoroyb P, et al. Human
defensins as cancer biomarkers and antitumour molecules. J
Proteomics 2009; 72: 918–27.
3. Doss M, White MR, Tecle T, et al. Human defensins and
LL-37 in mucosal immunity. J Leukocyte Biol 2010; 87: 79–92.
4. Rogan MP, Geraghty P, Greene CM, et al. Antimicrobial
proteins and polypeptides in pulmonary innate defense. Respir
Research 2006; 7: 29.
5. Herr C, Beisswenger C, Hess C, et al. Suppression of pul-
monary innate host defense in smokers. Thorax 2009; 64: 144–9.
6. Shestakova T, Zhuravel E, Bolgova L, et al. Expression
of human beta-defensins-1-4 in human lung tumors: a pilot
study. Exp Oncol 2008; 30: 153–6.
7. Bals R, Wang X, Wu Z, et al. Human beta-defensin 2 is
a salt-sensitive peptide antibiotic expressed in human lung. J
Clin Invest 1998; 102: 874–80.
8. Becker MN, Diamond G, Verghese MW, et al. CD14-
dependent lipopolysaccharide-induced beta-defensin-2 ex-
pression in human tracheobronchial epithelium. J Biol Chem
2000; 275: 29731–6.
9. Beisswenger C, Bals R. Antimicrobial peptides in lung
inflammation. Chem Immunol Allergy 2005; 86: 55–71.
10. Arimura Y, Ashitani J, Yanagi S, et al. Elevated serum
beta-defensins concentrations in patients with lung cancer.
Anticancer Res 2004; 24: 4051-7.
Copyright © Experimental Oncology, 2010
a
b
с
Fig. 2. Immunohistochemical analysis of hBD-2 expression in
lung squamous cell carcinoma (case C7 (a)) and lung adeno-
carcinoma (cases D14 (b), D16 (c))
Experimental Oncology 32, 277–279, 2010 (December) 277
Isolated splenic metastasis is rare in colorectal
cancer. Malign melanoma, breast and ovarian cancers
are the most common solid tumors in which splenic
metastasis occurs [1]. Isolated splenic metastasis may
be synchronous or metachronous. The rates of iso-
lated splenic metastasis are reported as 4.4% for colon
cancer and 1.6% for rectum cancer. It is ge nerally
diagnosed while evaluating asymptomatic cancer
patients with increasing levels of carcinoembryonic
antigen (CEA). In this report, our aim is to report two
cases with atypical metastasis.
Case 1. A 58-year old male patient was admitted to
the hospital with ileus a year ago. Hemicolectomy was
performed after the diagnosis of colon carcinoma. His-
topathology revealed colon adenocarcinoma without
lymph node involvement (stage III). He was given adju-
vant 5-flurouracil (5-FU)-based chemotherapy. He had
a CEA level elevation [4.62 ng/mL (N: 0–3.4)] in blood
serum fifteen months after hemicolectomy without any
evidence of local or distant metastasis on evaluation.
However, a splenic mass was diagnosed 5 months
later. Splenectomy was performed, and histopathology
revealed the metastasis of colon adenocarcinoma in
the spleen. A 3.5 x 3 x 2.5 cm size tumor was located
just beneath the capsule of the spleen (Fig. 1, a, b).
Chemotherapy which consisted of 5-FU, leucovorine
(LV) and oxaliplatin (FOLFOX-4) was given. He had a
second relapse in the splenic localization (5.5 x 3 cm)
after 11 months of first relapse. An increased uptake of
18-fluorodeoxyglucose (18-FDG) was observed only
in this lesion with standardized uptake value (SUVmax)
of 11.7 on 18-FDG-positron emission computerized
tomography (18-FDG-PET-CT) (Fig. 2). Palliative che-
motherapy including 5-FU, LV, irinotecan (FOLFIRI) and
bevacizumab was started. The patient has no evidence
of progression for 7 months after the second relapse.
Case 2. A 51-year old male patient was admitted
with 2 months of constipation and hematochezia. He
was diagnosed as having rectal adenocarcinoma with
bilateral lung metastasis and a solitary nodular lesion
(1.8 x 1.5 cm) in the upper pole of right kidney. Renal
mass SUVmax was 13.1 on 18-FDG-PET-CT (Fig. 3).
Renal aspiration biopsy was performed to determine
TWO CASES WITH ATYPICAL METASTASIS IN COLORECTAL
CANCER: SPLENIC AND RENAL METASTASIS
M. Dogan1,*, G. Ozal1, C. Ekinci2, G. Utkan1, Y. Urun1, B. Yalcin1, F. Icli1
1Department of Medical Oncology, Cebeci Hospital, Ankara University School of Medicine, 06590,
Dikimevi, Ankara, Turkey
2Department of Pathology, Ankara University School of Medicine, 06590, Sıhhiye, Ankara, Turkey
Atypical metastasis, such as splenic and renal metastasis is rare in colorectal cancer. There have been case reports of colorectal
cancer patients with isolated splenic metastasis, even after years of surgery in the literature. Aim: To report two colorectal cancer
cases with atypical metastasis. Results: The first patient was a 58-year old man who had isolated splenic metastasis after 20 months
of surgery. The other one was a 51-year old male patient with both lung and renal metastasis at rectal cancer diagnosis. Splenic
and renal metastases have been histopathologically documented in both of them. The first patient was given chemotherapy after
splenectomy. The other one had also multiple lung metastases besides renal metastasis. He received palliative chemotherapy.
Key Words: atypical metastasis, isolated splenic metastasis, renal metastasis.
Received:
*Correspondence: Fax: +903123192283;
E-mail: mutludogan1@yahoo.com
Abbreviations used: 5-FU — 5-flurouracil; 18-FDG — 18-fluorodeoxy-
glucose; CEA — carcinoembryonic antigen; CT — computerized to-
mography; PET-CT — positron emission computerized tomography.
Exp Oncol 2010
32, 4, 277–279
CASE REPORT
a
b
Fig. 1. Focal necrosis and atypical prismatic tumor cells with
abortive organization, hematoxylin and eosin staining — 10X
(a), 40X (b)
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