Extreme leucocytosis and splenomegaly in metastasised melanoma.
A 63-year-old woman presented to the internist with fatigue, cough, low-grade fever, splenomegaly and leucocytosis up to 130 x 10(9)/l. Although a diagnosis of chronic myelogenous leukaemia was initially entertained, she turned out to have a metastasised melanoma. The differential diagnosis and workup is discussed, as well as potential mechanisms by which the tumour could have induced the leucocytosis, such as the production of G-CSF or similar mediators, and the prognostic significance of this phenomenon.
de Wolff
J F
JF
Department of Internal Medicine, Diaconessenhuis, Leiden, The Netherlands. jfdwolff@doctors.org.uk
Planken
E V
EV
den Ottolander
G J
GJ
D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007964:Leukocytosis / Q000150:complications*; D008545:Melanoma / Q000150:complications / Q000175:diagnosis / Q000556:secondary*; D012878:Skin Neoplasms / Q000473:pathology*; D013163:Splenomegaly / Q000150:complications*