title: Anaplastic carcinoma of the pancreas producing granulocyte-colony stimulating factor: a case report.
abstract: BACKGROUND
  The granulocyte-colony stimulating factor-producing tumor was first reported in 1977, however, anaplastic pleomorphic type carcinoma of the pancreas producing granulocyte-colony stimulating factor is still rare.
  
  
  METHODS
  A 63-year-old man was admitted to our hospital with body weight loss (-10 kg during months) and upper abdominal pain from 3 weeks. Abdominal computed tomography demonstrated a pancreatic tumor 10 cm in size and multiple low-density areas in the liver. On admission, the peripheral leukocyte count was elevated to 91,500/mm3 and the serum concentration of granulocyte-colony stimulating factor was 134 pg/mL (normal, < 18.1 pg/mL). Based on liver biopsy findings, the tumor was classified as an anaplastic pleomorphic-type carcinoma. Immunohistochemical staining showed that pancreatic carcinoma cells were positive for granulocyte-colony stimulating factor. The patient developed interstitial pneumonia, probably caused by granulocyte-colony stimulating factor, and died 11 days after admission.
  
  
  CONCLUSIONS
  This is a rare case report of anaplastic pleomorphic-type carcinoma of the pancreas producing granulocyte-colony stimulating factor and confirmed by immunohistochemistry.
authors.affiliation: Gastroenterology Division, Yokohama City University Hospital, Kanazawa-ku Yokohama, Japan.nakajima-tky@umin.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Abe
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kubota
authors.forename: Shoji
authors.initials: S
authors.lastname: Yamanaka