RA is a progressive inflammatory autoimmune disease with articular and systemic effects. Its exact cause is unknown, but genetic and environmental factors are contributory. T cells, B cells and the orchestrated interaction of pro-inflammatory cytokines play key roles in the pathophysiology of RA. The release of cytokines, especially TNF-α, IL-6 and IL-1, causes synovial inflammation. In addition to their articular effects, pro-inflammatory cytokines promote the development of systemic effects, including production of acute-phase proteins (such as CRP), anaemia of chronic disease, cardiovascular disease and osteoporosis and affect the hypothalamic-pituitary-adrenal axis, resulting in fatigue and depression.
Ovarian cancer is the most common cause of gynecologic cancer death worldwide. Ninety-five percent of ovarian malignancies derive from epithelial cells. Dissemination of ovarian cancer is usually locoregional and occurs by invasion of adjacent viscera. Recurrence in the supradiaphragmatic lymph nodes is rare and only reported in a few cases in the literature. The authors describe the finding of a late metastasis in the cervical lymph nodes in a 56-year-old patient with ovarian serous cell carcinoma.
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