Muscle biopsy findings predictive of malignancy in rare infiltrative dermatomyositis

Uchino, Makoto; Yamashita, Satoshi; Uchino, Katsuhisa; Mori, Akira; Hara, Akio; Suga, Tomohiro; Hirahara, Tomoo; Koide, Tatsuya; Kimura, En; Yamashita, Taro; Ueda, Akihiko; Kurisaki, Ryoichi; Suzuki, Junko; Honda, Shoji; Maeda, Yasushi; Hirano, Teruyuki; Ando, Yumiko

doi:10.1016/j.clineuro.2012.07.019

Cited by 9 publications

(7 citation statements)

References 22 publications

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“…In 2013, investigators from Japan [44] reported that specific muscle biopsy features may be associated with malignancy. In their study of muscle biopsies from 215 DM and PM patients, a small number of DM biopsies (20 %) included infiltrating inflammatory cells without perifascicular atrophy; out of this population, 45 % of the patients were diagnosed with malignancy.…”

Section: Risk Factors For Malignancy In Patients With Iimmentioning

confidence: 98%

Idiopathic Inflammatory Myopathies and Malignancy: a Comprehensive Review

Tiniakou

Mammen

2015

Clinic Rev Allerg Immunol

106

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The idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of autoimmune diseases (collectively known as myositis) affecting the skeletal muscles as well as other organ systems such as skin, lungs, and joints. The primary forms of myositis include polymyositis (PM), dermatomyositis (PM), and immune-mediated necrotizing myopathy (IMNM). Patients with these diseases experience progressive proximal muscle weakness, have characteristic muscle biopsy findings, and produce autoantibodies that are associated with unique clinical features. One distinguishing feature of these patients is that they are also known to have an increased risk of cancer. Since the first description of the association in 1916, it has been extensively reported in the medical literature. However, there have been significant variations between the different studies with regard to the degree of cancer risk in patients with IIM. These discrepancies can, in part, be attributed to differences in the definition of malignancy-associated myositis used in different studies. In recent years, significant advances have been made in defining specific features of IIM that are associated with the development of malignancy. One of these has been myositis-specific antibodies (MSAs), which are linked to distinct clinical phenotypes and categorize patients into groups with more homogeneous features. Indeed, patients with certain MSAs seem to be at particularly increased risk of malignancy. This review attempts a systematic evaluation of research regarding the association between malignancy and myositis.

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Section: Risk Factors For Malignancy In Patients With Iimmentioning

confidence: 98%

Idiopathic Inflammatory Myopathies and Malignancy: a Comprehensive Review

Tiniakou

Mammen

2015

Clinic Rev Allerg Immunol

106

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“…In these studies, dermatomyositis patients with malignancies had less inflammatory cell infiltration and regeneration, versus those without [9,14]. Sampson et al [17] reported that paraneoplastic necrotizing myopathy showed extensive necrosis but little or no lymphocytic infiltrate, possibly due to cytokine-mediated mechanisms of myocyte injury [18].…”

Section: Discussionmentioning

confidence: 99%

“…Uchino et al [9] found that the incidence of rare infiltrative-type muscle pathology may be a predictive marker of dermatomyositis or malignancy in dermatomyositis. The results indicated that a subset of muscle inflammation might be specifically associated with malignancy.…”

Section: Introductionmentioning

confidence: 99%

Complex repetitive discharge on electromyography as a risk factor for malignancy in idiopathic inflammatory myopathy

Kim

Nam

Kang

et al. 2014

Korean J Intern Med

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Background/AimsWe investigated the electromyography (EMG) findings and demographic, clinical, and laboratory features that may predict the development of malignancy in patients with idiopathic inflammatory myopathy (IIM).MethodsIn total, 61 patients, 36 with dermatomyositis and 25 with polymyositis, were included. Patients were divided into those with and without malignancies, and comparisons were made between the groups in terms of their demographic, clinical, laboratory, and EMG findings.ResultsThe frequencies of malignancies associated with dermatomyositis and polymyositis were 22% and 8%, respectively. Patients with malignancies showed a significantly higher incidence of dysphagia (odds ratio [OR], 21.50; 95% confidence interval [CI], 3.84 to 120.49), absence of interstitial lung disease (ILD; OR, 0.12; 95% CI, 0.01 to 0.98), and complex repetitive discharge (CRD) on the EMG (OR, 26.25; 95% CI, 2.67 to 258.52), versus those without. After adjustment for age, dysphagia and CRD remained significant, while ILD showed a trend for a difference but was not statistically significant. Multivariate analysis revealed that the CRD conferred an OR of 25.99 (95% CI, 1.27 to 531.86) for malignancy. When the frequency of malignancy was analyzed according to the number of risk factors, patients with three risk factors showed a significantly higher incidence of malignancy, versus those with fewer than two (p = 0.014).ConclusionsWe demonstrated for the first time that CRD on the EMG was an additional independent risk factor for malignancy in IIM. Further studies on a larger scale are needed to confirm the importance of CRD as a risk factor for malignancy in IIM.

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“…Another previous report reviewed the muscle biopsy findings in patients with PM and DM with or without malignancy (42). The author concluded that the incidence of rareinfiltrative type muscle pathology may be a predictive marker of DM with malignancy.…”

Section: Discussionmentioning

confidence: 99%

Gene Expression Profile of Inflammatory Myopathy with Malignancy is Similar to that of Dermatomyositis rather than Polymyositis

et al. 2016

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Objective An association has been reported between inflammatory myopathies (IMs), which include polymyositis (PM) and dermatomyositis (DM), and malignancy, and the concept of cancer-associated myositis (CAM) was recently proposed. We herein attempted to determine the features and etiologies of these myopathies. Methods We analyzed the gene expression levels via microarray and real-time quantitative reverse transcription polymerase chain reaction analyses to identify genes that were specifically upregulated or downregulated with suspected inflammatory involvement and verified the microarray data via an immunohistochemical (IHC) analysis in additional cases. Patients We selected 14 patients with the following conditions: PM without malignancy (n=3), DM without malignancy (n=3), CAM (n=3), and Controls (no pathological changes or malignancy; n=5). Results PM was distinct from DM and CAM in a clustering analysis and exhibited the highest numbers of overexpressed genes and specific pathologies in a gene ontology analysis. The IHC analysis confirmed the gene expression results. Conclusion PM is associated with severe inflammatory pathological findings, primarily in the cell-mediated immune system. DM and CAM exhibit similarities in the gene expression and IHC results, which suggest that humoral immunity is the main etiology for both myopathies, indicating the importance of cancer screening in patients with IMs, particularly DM.

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Muscle biopsy findings predictive of malignancy in rare infiltrative dermatomyositis

Cited by 9 publications

References 22 publications

Idiopathic Inflammatory Myopathies and Malignancy: a Comprehensive Review

Idiopathic Inflammatory Myopathies and Malignancy: a Comprehensive Review

Complex repetitive discharge on electromyography as a risk factor for malignancy in idiopathic inflammatory myopathy

Gene Expression Profile of Inflammatory Myopathy with Malignancy is Similar to that of Dermatomyositis rather than Polymyositis

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