title: Pancreatic cancer associated with granulocyte-colony stimulating factor production confirmed by immunohistochemistry.
abstract: We report an 83-year-old man with pancreatic body cancer of 4.5 cm in diameter. Peripheral leukocyte count was 15,700/microl and the serum concentration of granulocyte-colony stimulating factor (G-CSF) was 123 pg/ml (normal, 6.0-21.9 pg/ml) on admission. Furthermore, not only K-ras codon 12 (GGT --> GAT) but also p53 at codon 247 (CGG --> CCG) mutations were identified in the pancreatic juice aspirated endoscopically. We performed chemotherapy with two courses of 5-fluorouracil, pirarubicin hydrochloride, and mitomycin-C, resulting in no beneficial effect. After the second course the patient developed interstitial pneumonia, probably caused by anticancer drugs, and died 4 months after the tumor was detected. In the autopsy tissue, the tumor macroscopically occupied the pancreas body and was 7 x 6 x 5 cm in size. Histopathologic diagnosis of the tumor was poorly differentiated adenosquamous carcinoma. Immunohistochemical staining of the autopsy tissue showed that pancreatic cancer cells were positive for G-CSF. This is the first case report of G-CSF-positive pancreatic cancer confirmed by immunohistochemistry.
authors.affiliation: Department of Internal Medicine and Medical Oncology, Kanazawa University, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ohtsubo
authors.forename: H
authors.initials: H
authors.lastname: Mouri
authors.forename: J
authors.initials: J
authors.lastname: Sakai
authors.forename: M
authors.initials: M
authors.lastname: Akasofu
authors.forename: Y
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: H
authors.initials: H
authors.lastname: Watanabe
authors.forename: T
authors.initials: T
authors.lastname: Gabata
authors.forename: Y
authors.initials: Y
authors.lastname: Motoo
authors.forename: T
authors.initials: T
authors.lastname: Okai
authors.forename: N
authors.initials: N
authors.lastname: Sawabu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018196:Carcinoma, Adenosquamous / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D017809:Fatal Outcome; D016158:Genes, p53 / Q000235:genetics; D011905:Genes, ras / Q000235:genetics; D016179:Granulocyte Colony-Stimulating Factor / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009154:Mutation; D010190:Pancreatic Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000473:pathology
chemical_list: D016179:Granulocyte Colony-Stimulating Factor