Rationale:COVID-19 usually presents with flu-like symptoms and signs,but some rare presentations like leukemoid symptoms cannot be ignored.Patient’s concerns:A 37-year-old female presented to the outpatient departmen...Rationale:COVID-19 usually presents with flu-like symptoms and signs,but some rare presentations like leukemoid symptoms cannot be ignored.Patient’s concerns:A 37-year-old female presented to the outpatient department with flu-like symptoms.Diagnosis:The RT-PCR test for SARS-CoV-2 infection was positive,while complete blood cell and peripheral blood smear showed leukemoid reaction.Intervention:Paracetamol and fexofenadine for flu-like symptoms and leukemoid presentation.Outcomes:On the 10th day,the patient was asymptomatic and RT-PCR was negative.So the patient was discharged and leukemoid presentation subsided after clearance of viral disease.Lessons:COVID-19 has a myriad of presentations,and unusual symptoms/signs especially in this pandemic could be induced by COVID-19 infection.展开更多
Paraneoplastic leukemoid reaction is a rare syndrome defined by a leukocyte count exceeding 50 Giga/Liter(G/L), mostly described with progressive lung or renal carcinoma. We report a case of a 68-year-old man with rec...Paraneoplastic leukemoid reaction is a rare syndrome defined by a leukocyte count exceeding 50 Giga/Liter(G/L), mostly described with progressive lung or renal carcinoma. We report a case of a 68-year-old man with recurrent pancreatic carcinoma presenting a leukemoid reaction with a white blood cell count of 63.87 G/L without identified infectious, iatrogenic or hematologic causes. His overall condition quickly degraded and he died three weeks after the discovery of the leukemoid reaction. This is the first case in French literature of leukemoid reaction in a patient with pancreatic carcinoma with poor prognostic value.展开更多
BACKGROUND Sarcomatoid hepatocellular carcinoma (SHC) combined with paraneoplastic leukemoid reaction (PLR), which is associated with a poor prognosis, is rarely seen in the clinic. Here, we report the case of a patie...BACKGROUND Sarcomatoid hepatocellular carcinoma (SHC) combined with paraneoplastic leukemoid reaction (PLR), which is associated with a poor prognosis, is rarely seen in the clinic. Here, we report the case of a patient in the above situation. CASE SUMMARY A 75-year-old female patient with a past medical history of hypertension and cerebral infarction paid a hospital visit as a result of right upper quadrant abdominal pain and anorexia for two months. Laboratory examination revealed a white blood cell (WBC) count of 43790/μL, which was then increased up to 77050/μL. In addition, the results of bone marrow examination suggested a leukemoid reaction. Computed tomography (CT) revealed a focal hepatic mass, which was confirmed through pathological examination to be an SHC postoperatively. In addition, the WBC count had fallen to a normal level before she left the hospital. However, the patient died two and a half months after the second hospital admission. CONCLUSION This is a rare case of SHC combined with PLR, both of which have an extremely poor prognosis.展开更多
Renal cell carcinoma represents the 16th cause of death by cancer. It is one of the most frequent kidney tumors. This tumor could behave as a good mimicker, and is frequently associated with paraneoplastic syndromes. ...Renal cell carcinoma represents the 16th cause of death by cancer. It is one of the most frequent kidney tumors. This tumor could behave as a good mimicker, and is frequently associated with paraneoplastic syndromes. Metastases to peritoneum, mesentery or omentum are very rare. Sarcomatoid renal cell carcinoma is a high-grade undifferentiated component that can be found in any subtypes of renal cell carcinoma, and is associated with an aggressive behavior and a poor prognosis. We present the case of a 59-year-old male, diabetic patient, with nephron preserved left nephrectomy through lumbotomy seven years ago, upper pole renal carcinoma, admitted to the emergency department with indeterminate shock. He underwent a diagnostic laparoscopy and then open surgery due to findings where a greater omentum subtotal infarction. Omentum microscopic examination resulted in vaguely differentiated neoplasia, with sarcomatoid like cells, highly positive to CD10 inmunolabeling. Even though renal cell carcinomas have unusual clinical presentations, this case is unique because of the convergence of extremely rare manifestations such as the combination of malignant ascites, peritoneal carcinomatosis, and contralateral suprarenal gland metachronous metastases at the major omentum with paraneoplastic syndrome type leukemoid reaction;which have not been reported previously in literature.展开更多
Neutrophilic leukocytosis above 50 × 109/l exclude leukemia, defines a leukemoid reaction (LR). It is associated with several diseases. Although it simulates leukemia, most of the causes are benign. Tumor-related...Neutrophilic leukocytosis above 50 × 109/l exclude leukemia, defines a leukemoid reaction (LR). It is associated with several diseases. Although it simulates leukemia, most of the causes are benign. Tumor-related LR is more common. It is associated with ranulocyte colony-stimulating factor (G-CSF) secreted by the tumor cells. A 38-year-old woman, presented with advanced breast cancer and leukocytosis (79.9 × 103/uL) was found. After completion of MRM, the condition of leukocytosis subsided. Two months later, tumor local relapse was found and white blood cells (WBC) rose again. After completion of wide excision, the condition of leukocytosis subsided again. We think this case was associated with leukemoid reaction.展开更多
Introduction: Leukemoid reactions in cancer are rare and associated with a poor prognosis. The mechanism driving paraneoplastic leukemoid reactions appears to be gain-of-function granulocyte-colony stimulating factor ...Introduction: Leukemoid reactions in cancer are rare and associated with a poor prognosis. The mechanism driving paraneoplastic leukemoid reactions appears to be gain-of-function granulocyte-colony stimulating factor (G-CSF) secretion by tumour cells. Case Presentation: A 57-year-old male smoker presented with a one-year history of painless frank hematuria and three kilograms weight loss. Cystoscopy revealed a high-grade urothelial carcinoma with sarcomatoid differentiation. The patient was treated by radical cystoprostatectomy, bilateral pelvic lymph node dissection and formation of an ileal conduit. In the absence of bone marrow infiltrations, recurrence of the urothelial carcinoma three months later was associated with a paraneoplastic leukemoid reaction with a white blood cell count peaking at 82.62 × 109/l. Unfortunately, his condition continued to deteriorate and he died shortly thereafter. Conclusion: Monitoring of white blood cell counts in paraneoplastic leukemoid reactions can be a useful indicator of response of the malignancy to chemotherapy or radiotherapy and an indication of relapse after treatment. Paraneoplastic leukemoid reactions are caused by G-CSF secretion by tumour cells and are associated with a poor prognosis. Whether G-CSF signaling plays a role in the aggressive nature of these cancers is currently unknown.展开更多
文摘Rationale:COVID-19 usually presents with flu-like symptoms and signs,but some rare presentations like leukemoid symptoms cannot be ignored.Patient’s concerns:A 37-year-old female presented to the outpatient department with flu-like symptoms.Diagnosis:The RT-PCR test for SARS-CoV-2 infection was positive,while complete blood cell and peripheral blood smear showed leukemoid reaction.Intervention:Paracetamol and fexofenadine for flu-like symptoms and leukemoid presentation.Outcomes:On the 10th day,the patient was asymptomatic and RT-PCR was negative.So the patient was discharged and leukemoid presentation subsided after clearance of viral disease.Lessons:COVID-19 has a myriad of presentations,and unusual symptoms/signs especially in this pandemic could be induced by COVID-19 infection.
基金Supported by The University Caen Basse Normandie,14000 Caen,France
文摘Paraneoplastic leukemoid reaction is a rare syndrome defined by a leukocyte count exceeding 50 Giga/Liter(G/L), mostly described with progressive lung or renal carcinoma. We report a case of a 68-year-old man with recurrent pancreatic carcinoma presenting a leukemoid reaction with a white blood cell count of 63.87 G/L without identified infectious, iatrogenic or hematologic causes. His overall condition quickly degraded and he died three weeks after the discovery of the leukemoid reaction. This is the first case in French literature of leukemoid reaction in a patient with pancreatic carcinoma with poor prognostic value.
文摘BACKGROUND Sarcomatoid hepatocellular carcinoma (SHC) combined with paraneoplastic leukemoid reaction (PLR), which is associated with a poor prognosis, is rarely seen in the clinic. Here, we report the case of a patient in the above situation. CASE SUMMARY A 75-year-old female patient with a past medical history of hypertension and cerebral infarction paid a hospital visit as a result of right upper quadrant abdominal pain and anorexia for two months. Laboratory examination revealed a white blood cell (WBC) count of 43790/μL, which was then increased up to 77050/μL. In addition, the results of bone marrow examination suggested a leukemoid reaction. Computed tomography (CT) revealed a focal hepatic mass, which was confirmed through pathological examination to be an SHC postoperatively. In addition, the WBC count had fallen to a normal level before she left the hospital. However, the patient died two and a half months after the second hospital admission. CONCLUSION This is a rare case of SHC combined with PLR, both of which have an extremely poor prognosis.
文摘Renal cell carcinoma represents the 16th cause of death by cancer. It is one of the most frequent kidney tumors. This tumor could behave as a good mimicker, and is frequently associated with paraneoplastic syndromes. Metastases to peritoneum, mesentery or omentum are very rare. Sarcomatoid renal cell carcinoma is a high-grade undifferentiated component that can be found in any subtypes of renal cell carcinoma, and is associated with an aggressive behavior and a poor prognosis. We present the case of a 59-year-old male, diabetic patient, with nephron preserved left nephrectomy through lumbotomy seven years ago, upper pole renal carcinoma, admitted to the emergency department with indeterminate shock. He underwent a diagnostic laparoscopy and then open surgery due to findings where a greater omentum subtotal infarction. Omentum microscopic examination resulted in vaguely differentiated neoplasia, with sarcomatoid like cells, highly positive to CD10 inmunolabeling. Even though renal cell carcinomas have unusual clinical presentations, this case is unique because of the convergence of extremely rare manifestations such as the combination of malignant ascites, peritoneal carcinomatosis, and contralateral suprarenal gland metachronous metastases at the major omentum with paraneoplastic syndrome type leukemoid reaction;which have not been reported previously in literature.
文摘Neutrophilic leukocytosis above 50 × 109/l exclude leukemia, defines a leukemoid reaction (LR). It is associated with several diseases. Although it simulates leukemia, most of the causes are benign. Tumor-related LR is more common. It is associated with ranulocyte colony-stimulating factor (G-CSF) secreted by the tumor cells. A 38-year-old woman, presented with advanced breast cancer and leukocytosis (79.9 × 103/uL) was found. After completion of MRM, the condition of leukocytosis subsided. Two months later, tumor local relapse was found and white blood cells (WBC) rose again. After completion of wide excision, the condition of leukocytosis subsided again. We think this case was associated with leukemoid reaction.
文摘Introduction: Leukemoid reactions in cancer are rare and associated with a poor prognosis. The mechanism driving paraneoplastic leukemoid reactions appears to be gain-of-function granulocyte-colony stimulating factor (G-CSF) secretion by tumour cells. Case Presentation: A 57-year-old male smoker presented with a one-year history of painless frank hematuria and three kilograms weight loss. Cystoscopy revealed a high-grade urothelial carcinoma with sarcomatoid differentiation. The patient was treated by radical cystoprostatectomy, bilateral pelvic lymph node dissection and formation of an ileal conduit. In the absence of bone marrow infiltrations, recurrence of the urothelial carcinoma three months later was associated with a paraneoplastic leukemoid reaction with a white blood cell count peaking at 82.62 × 109/l. Unfortunately, his condition continued to deteriorate and he died shortly thereafter. Conclusion: Monitoring of white blood cell counts in paraneoplastic leukemoid reactions can be a useful indicator of response of the malignancy to chemotherapy or radiotherapy and an indication of relapse after treatment. Paraneoplastic leukemoid reactions are caused by G-CSF secretion by tumour cells and are associated with a poor prognosis. Whether G-CSF signaling plays a role in the aggressive nature of these cancers is currently unknown.
