BACKGROUND: Marked leukocytosis is occasionally observed in patients with a ma lignant nonhematopoietic tumor. Granulocyte colony-stimulating factor (G-CSF)m ay be responsible for this phenomenon. We report a case of ...BACKGROUND: Marked leukocytosis is occasionally observed in patients with a ma lignant nonhematopoietic tumor. Granulocyte colony-stimulating factor (G-CSF)m ay be responsible for this phenomenon. We report a case of G-CSF-producing squ amous cell carcinoma of the cervix that showed marked leukocytosis. CASE: A 71- year-old Japanese woman was admitted for further investigation for leukocytosis . Her white blood cell (WBC) count had been gradually increasing over a period o f 10 months. Laboratory data on admission revealed marked leukocytosis, with a W BC count of 30,400/μL, which consisted primarily of mature granulocytes (93%). Her serum G-CSF level was significantly elevated. However, there was no eviden ce of infection or hematopoietic disorders. Further examinations showed stage II Ib cervical cancer. The pathological diagnosis was squamous cell carcinoma of th e nonkeratinizing type. Immunohistochemical staining of the biopsied specimens c onfirmed the production of G-CSF protein by the tumor cells. The patient was su ccessfully treated by radiation therapy. Her WBC count returned to a normal leve l (3,700/μL). Her serum G-CSF level also decreased. The patient is alive witho ut evidence of recurrence at 8 months after the treatment. CONCLUSION: It is sug gested that the leukocytosis manifested in this patient was due to G-CSF produc ed by the tumor. It was possible to use the WBC count and serum G-CSF levels as additional tumor markers.展开更多
文摘BACKGROUND: Marked leukocytosis is occasionally observed in patients with a ma lignant nonhematopoietic tumor. Granulocyte colony-stimulating factor (G-CSF)m ay be responsible for this phenomenon. We report a case of G-CSF-producing squ amous cell carcinoma of the cervix that showed marked leukocytosis. CASE: A 71- year-old Japanese woman was admitted for further investigation for leukocytosis . Her white blood cell (WBC) count had been gradually increasing over a period o f 10 months. Laboratory data on admission revealed marked leukocytosis, with a W BC count of 30,400/μL, which consisted primarily of mature granulocytes (93%). Her serum G-CSF level was significantly elevated. However, there was no eviden ce of infection or hematopoietic disorders. Further examinations showed stage II Ib cervical cancer. The pathological diagnosis was squamous cell carcinoma of th e nonkeratinizing type. Immunohistochemical staining of the biopsied specimens c onfirmed the production of G-CSF protein by the tumor cells. The patient was su ccessfully treated by radiation therapy. Her WBC count returned to a normal leve l (3,700/μL). Her serum G-CSF level also decreased. The patient is alive witho ut evidence of recurrence at 8 months after the treatment. CONCLUSION: It is sug gested that the leukocytosis manifested in this patient was due to G-CSF produc ed by the tumor. It was possible to use the WBC count and serum G-CSF levels as additional tumor markers.
