ABSTRACT
Extragonadal germ cell tumors are germ cell tumors with no evidence of a primary tumor within the gonads, most often located in the mediastinum or retroperitoneum. We present an extragonadal yolk sac tumor that presented as an adrenal carcinoma and required left adrenalectomy, nephrectomy, and significant IVC thrombectomy. This case, to our knowledge, is the first documented case of extragonadal yolk sac tumor originating from the adrenal gland.
Subject(s)
Adrenal Gland Neoplasms/surgery , Endodermal Sinus Tumor/surgery , Adrenal Gland Neoplasms/diagnostic imaging , Adrenal Gland Neoplasms/pathology , Adrenalectomy , Aged , Endodermal Sinus Tumor/diagnostic imaging , Endodermal Sinus Tumor/pathology , Humans , Magnetic Resonance Imaging , Male , Nephrectomy , Renal Veins/diagnostic imaging , Renal Veins/pathology , Thrombectomy , Vena Cava, Inferior/diagnostic imaging , Vena Cava, Inferior/pathology , Vena Cava, Inferior/surgeryABSTRACT
Pseudomonasaeruginosa causes lung infections in patients with cystic fibrosis (CF). The Pseudomonas quinolone signal (PQS) compound is a secreted P. aeruginosa virulence factor that contributes to the pathogenicity of P. aeruginosa We were able to detect PQS in sputum samples from CF patients infected with P. aeruginosa but not in samples from uninfected patients. We then tested the hypothesis that PQS induces oxidative stress in host cells by determining the ability of PQS to induce the production of reactive oxygen species (ROS) in lung epithelial cells (A549 and primary normal human bronchial epithelial [NHBE]) cells and macrophages (J774A.1 and THP-1). ROS production induced by PQS was detected with fluorescent probes (dichlorodihydrofluorescein diacetate, dihydroethidium, and MitoSOX Red) in conjunction with confocal microscopy and flow cytometry. PQS induced ROS production in lung epithelial (A549 and NHBE) cells and macrophages (J774A.1 and THP-1 cells). NHBE cells were sensitive to PQS concentrations as low as 500 ng/ml. PQS significantly induced early apoptosis (P < 0.05, n = 6) in lung epithelial cells, as measured by annexin/propidium iodide detection by flow cytometry. However, no change in apoptosis upon PQS treatment was seen in J774A.1 cells. Heme oxygenase-1 (HO-1) protein is an antioxidant enzyme usually induced by oxidative stress. Interestingly, incubation with PQS significantly reduced HO-1 and NrF2 expression in A549 and NHBE cells but increased HO-1 expression in J774A.1 cells (P < 0.05, n = 3), as determined by immunoblotting and densitometry. These PQS effects on host cells could play an important role in the pathogenicity of P. aeruginosa infections.