Unique cytologic features of thyroiditis caused by immune checkpoint inhibitor therapy for malignant melanoma  

作　　者：Trevor E.Angell Le Min Tad J.Wieczorek F.Stephen Hodi 

机构地区：[1]Division of Endocrinology,Diabetes,and Hypertension,Brigham and Women’s Hospital,Boston,MA,USA [2]Department of Pathology,Brigham and Women’s Hospital,Boston,MA,USA [3]Department of Medical Oncology,Dana-Farber Cancer Institute,Boston,MA,USA

出　　处：《Genes & Diseases》2018年第1期46-48,共3页基因与疾病（英文）

基　　金：NIH K08 HD070957(PI:Le Min,Mentor:Ursula Kaiser)。

摘　　要：Blockade of immune checkpoint molecules to reverse cancer-induced immune suppression can improve anti-tumor immune responses in cancer patients.Monoclonal antibodies targeting two such molecules,Programmed cell death protein 1(PD-1)and cytotoxic T-lymphocyte associated protein 4(CTLA-4)have shown clinical benefit in the treatment of advanced malignancies,including metastatic melanoma.Adverse effects of these immune checkpoint inhibitors include immune-related adverse events(irAE),of which one of the most common is autoimmune thyroiditis.Though thyroiditis is increasingly recognized,there are no reports of the pathological findings that occur in immunotherapy-induced thyroiditis.We present a case of immunotherapy-induced thyroiditis demonstrating its unique cytopathologic features.A 51-year-old woman with metastatic melanoma was found to have a suppressed TSH and elevated free thyroxine concentration 14 days after starting treatment with nivolumab(PD-1 antagonist)plus ipilimumab(CTLA-4 antagonist)therapy.A thyroid biopsy was performed based on ultrasound findings and cytopathology revealed unique features including abundant clusters of necrotic cells,lymphocytes and CD163-positive histiocytes.This case reports cytopathologic features found in immune checkpoint inhibitor related thyroiditis.These appear to be unique findings and may help inform future research regarding the pathophysiology and mechanisms of this condition.

关 键 词：THYROIDITIS PD-1 CTLA-4 IPILIMUMAB Nivolumab CYTOLOGY 

分 类 号：R73[医药卫生—肿瘤]