Tumor associated tissue eosinophilia: a case report with review
Keywords:Tumor associated tissue eosinophilia, Oral squamous cell carcinoma, Tumor associated blood eosinophilia, Eosinophils, prognostic indicator
Cancer is one of the most deadly diseases. Even today a lot of research is going on to understand the various aspects of this neoplasm in order to improve the treatment modalities and thus the life of the affected. The role of tumor associated tissue eosinophilia (TATE) has gained much impetus as it is believed to play important role in the biological behavior of the tumor. There are contradictory reports with respect to malignancy and hence its functional role remains ambiguous. We report a case of oral squamous cell carcinoma (OSCC) with TATE and review of literature of the same. A 58 year old female patient presented with a shallow ulcer on the palate. On clinical examination, left submandibular lymph nodes were enlarged and tender on palpation with slightly raised surface temperature. Fine needle aspiration cytology from submandibular lymph nodes was suggestive of squamous cell carcinoma. Incisional biopsy from ulcer confirmed the diagnosis of moderately differentiated squamous cell carcinoma, with the striking feature of tissue eosinophilia. Haematological investigations revealed differential & absolute eosinophil count which was not significant. The review of literature revealed contradictory findings with respect to TATE as a prognostic factor in OSCC patients. It has been found to have a favourable, a poorer or even no influence on patient’s outcome, thus remaining a matter of controversy.
Leighton SEJ, Teo JGC, Leung SF, Cheung AYK, Lee JCK, Hassel CAV. Prevalence and prognostic significance of tumor-associated tissue eosinophilia in nasopharyngeal carcinoma. Cancer. 1996;77:436–40.
Dorta RG, Landman G, Kowalski LP, Lauris JRP, Latorre MRDO, Oliveira DT. Tumour-associated tissue eosinophilia as a prognostic factor in oral squamous cell carcinomas. Histopathology 2002;41(2):152–7.
Oliveira DT, Tjioe KC, Assao A et al. Tissue eosinophilia and its association with tumoral invasion of oral cancer. Int J Surg Pathol. 2009;17(3):244–9.
Jain M, Kasetty S, Sudheendhra US, Tijare M, Khan S, Desai A. Assessment of Tissue Eosinophilia as a Prognostic indicator in Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma – An Image Analysis Study. Pathol Res Int. 2014;507512:1-6.
Lowe D, Jorizzo J, and Hutt MSR. Tumour-associated eosinophilia: a review. J Clin Pathol. 1981;34(12):1343–8.
Saraswathi TR, Nalinkumar S, Ranganathan K, Umadevi R, Elizabeth J. Eosinophils in health and disease: an overview. J Oral Maxillofacial Pathol. 2003;7(2):31–3.
Samoszuk M. Eosinophils and human cancer. Histol Histopathol. 1997;12(3):807–12.
Hogan SP, Rosenberg HF, Moqbel R, Phipps S, Foster PS, Lacy P, et al. Eosinophils: biological properties and role in health and disease. Clin Experimental Allergy. 2008;38(5):709–50.
Pereira MC, Oliveira DT, Kowalski LP. The role of eosinophils and eosinophil cationic protein in oral cancer: a review. Arch Oral Biol. 2011;56(4):353–8.
Debta P, Debta FM, Chaudhary M, Dani A. Evaluation of Infiltration of Immunological cell (tumour associated tissue eosinophils and mast cells) in oral squamous cell carcinoma by using special stains. Br J Med Med Res. 2012;2(1):75–85.
Kita H. The eosinophil: a cytokine-producing cell? J Allergy Clin Immunol. 1996;97(4):889–92.
Rothenberg ME, Hogan SP. The eosinophil. Annual Rev Immunol. 2006;24:147–74.
Ma HL, Whitters MJ, Jacobson BA, Donaldson DD, Collins M, and Dunussi-Joannopoulos K. Tumor cells secreting IL-13 but not IL-13Rα2 fusion protein have reduced tumorigenicity in vivo. Int Immunol 2014;16(7):1009–17.
Oppenheim JJ, Yang D. Alarmins: chemotactic activators of immune responses. Current Opinion Immunol. 2005;17(4):359–65.
Yang D, Chen Q, Su SB, Zhang P, Kurosaka K, Caspi RR, et al. Eosinophil-derived neurotoxin acts as an alarmin to activate the TLR2-MyD88 signal pathway in dendritic cells and enhances Th2 immune responses. J Experimental Med. 2008;205(1):79–90.
Conticello C, Pedini F, Zeuner A, Patti M, Zerilli M, Stassi G, et al. Il-4 protects cells from anti-CD95 and chemotherapeutic agents via upregulation of antiapoptotic proteins. J Immunol. 2004;172(9):5467–77.
Puxeddu I, Ribatti D, Crivellato E, Levi-Schaffer F. Mast cells and eosinophils: a novel link between inflammation and angiogenesis in allergic diseases. J Allergy Clin Immunol. 2005;116(3):531–6.
Volpert OV, Fong T, Koch AE, Peterson JD, Waltenbaugh C, Tepper RI, et al. Inhibition of angiogenesis by interleukin 4. J Experimental Med. 1998;188(6):1039–46.
Mosser DM, Zhang X. Interleukin-10: new perspectives on an old cytokine. Immunological Rev. 2008;226(1):205–18.
Munn DH, Mellor AL. Indoleamine 2,3-dioxygenase and tumor-induced tolerance. J Clin Investigation. 2007;117(5):1147–54.
Tian M, Schiemann WP. The TGFβ paradox in human cancer: an update. Future Oncol. 2009;5(2):259–71.
Odemuyiwa SO1, Ghahary A, Li Y, Puttagunta L, Lee JE, Musat-Marcu S, et al. Cutting edge: human eosinophils regulate T cell subset selection through indoleamine 2,3-dioxygenase. J Immunol. 2004;173(10):5909–13.