[A case of G-CSF-producing large cell carcinoma of the lung with gastric metastasis].
We report a rare surgically-treated case of G-CSF-producing large cell carcinoma of the lung with gastric metastasis. A 65-year-old male was admitted to our hospital because of fever, anemia and epigastralgia. Chest X-ray examination and CT scanning revealed a round mass shadow (8 cm) in contact with the chest wall in the right upper lung field and metastasis to the mediastinal lymph nodes. Laboratory examination showed a WBC of 16,800/mm3, CRP of 11.6 mg/dl, and a serum G-CSF of 90 pg/ml. Upper gastrointestinal series and gastroscopy showed an ulcerating submucosal tumorous lesion in the pyloric antrum. The lung carcinoma was treated by right upper lobectomy with chest wall resection. After 1 month, gastrectomy was performed. After the operation, the WBC normalized, and the CRP and serum G-CSF levels decreased. Histopathological examination demonstrated a poorly differentiated large cell carcinoma in the lung and a metastatic lesion in the stomach. Immunohistochemical staining with anti-G-CSF mono-clonal antibody showed negative results in the lung but positive results in the stomach. He was discharged 3 weeks after gastrectomy but died of aggravation of the general condition associated with local recurrence in the chest wall 2 months after discharge.
Department of Surgery, Tottori Prefectural Kosei Hospital, Kurayoshi, Japan.
T
T
Fukata
S
S
Fukino
E
E
Hayashi
K
K
Okada
N
N
Tamai
H
H
Nakashima
D000368:Aged; D014408:Biomarkers, Tumor / Q000096:biosynthesis*; D018287:Carcinoma, Large Cell / Q000378:metabolism* / Q000556:secondary* / Q000601:surgery; D005743:Gastrectomy; D016179:Granulocyte Colony-Stimulating Factor / Q000096:biosynthesis*; D006801:Humans; D008175:Lung Neoplasms / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D008297:Male; D009364:Neoplasm Recurrence, Local; D011013:Pneumonectomy; D013274:Stomach Neoplasms / Q000556:secondary* / Q000601:surgery
D014408:Biomarkers, Tumor; D016179:Granulocyte Colony-Stimulating Factor