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Updated: Aug 9, 2026
Single-cell Analysis of Immunophenotype and Cytokine Production in Peripheral Whole Blood via Mass Cytometry
Published on: June 26, 2018
[Patient with intravascular lymphomatosis: Changes with time in concentrations of serum cytokines]
Akiko Aoki1, Shigeru Ono, Atsuhisa Ueda
1First Department of Internal Medicine, Yokohama City University School of Medicine.
Insights
This study monitored serum cytokines in a patient with intravascular lymphomatosis (IVL). Elevated interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) suggest cytokine levels may aid early IVL diagnosis.
Area of Science:
- Oncology
- Immunology
- Pathology
Background:
- Intravascular lymphomatosis (IVL) is a rare B-cell malignancy.
- Clinical diagnosis of IVL is challenging due to nonspecific symptoms and laboratory findings.
Observation:
- A 62-year-old male patient presented with malaise, arthralgia, and fever, initially diagnosed with dermatomyositis.
- Initial treatment with corticosteroids and immunosuppressants provided temporary relief, but the patient's condition progressively worsened, leading to death ten months later.
- Postmortem examination confirmed B-cell type intravascular lymphomatosis.
Findings:
- Serum analysis revealed elevated levels of inflammatory cytokines, specifically interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha).
- Interferon-gamma (IFN-y) levels were high only terminally, while interleukin-2 (IL-2) was undetectable.
- Serum interleukin-4 (IL-4) showed a slight elevation. Elevated C-reactive protein (CRP) and hypoalbuminemia correlated with increased inflammatory cytokine levels.
Implications:
- The dynamic changes and concentrations of serum cytokines, including IL-6, TNF-alpha, and IFN-y, may serve as crucial biomarkers for early IVL diagnosis.
- Monitoring cytokine profiles could potentially improve diagnostic timelines for this challenging hematologic malignancy.
Abstract:
Serum cytokines were evaluated in a patient with intravascular lymphomatosis (IVL). A 62-year-old man was admitted to our hospital for his general malaise, arthralgia, and high-grade fever. He was diagnosed as dermatomyositis, initially. His symptoms were improved by high dose of corticosteroid and immunosuppressive therapy. However his condition deteriorated gradually, and died ten months after the onset of symptoms. Postmortem examination revealed IVL (B cell type). The serum concentrations of inflammatory cytokines, IL-6 and TNF-alpha, were elevated. Level of serum IFN-y was high only at the end of his illness. Serum IL-2 was not detected during the course. Serum IL-4 was slightly elevated. Elevated CRP and hypoalbuminemia might be related to the elevation of these inflammatory cytokines. The clinical diagnosis of IVL is usually difficult because of the absence of specific clinical manifestations and laboratory findings. The time course and/or concentrations of serum cytokines could be a key to make an early diagnosis.
