title: Pleomorphic carcinoma of the lung producing granulocyte colony-stimulating factor: report of a case.
abstract: We herein report a case of acute respiratory distress syndrome (ARDS) that appeared to be related to a granulocyte colony-stimulating factor (G-CSF)-producing lung cancer. A 77-year-old man with arterial sclerotic obstruction (ASO) underwent reconstructive surgery of the left femoral artery. He developed ARDS on the 5th postoperative day, which resolved following mechanical ventilation with steroid pulse treatment. Four months later, he was admitted with a fever and right arm pain. Chest computed tomography showed a malignant lesion in the right apical lung, and percutaneous needle biopsy demonstrated adenocarcinoma. Laboratory data revealed neutrophilia with elevated serum G-CSF levels. He underwent a right upper lobectomy with chest wall resection, and administration of sivelestat sodium to treat his postoperative pre-acute lung injury state. Pathology revealed a G-CSF-producing pleomorphic carcinoma. Retrospectively, a tumor shadow was noted on chest X-ray at the time of ARDS just after ASO surgery. The relationship between an abnormal G-CSF level and ARDS was considered, and the implications are herein discussed.
authors.affiliation: Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Wada
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Yoshida
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Ishibashi
authors.forename: Teruaki
authors.initials: T
authors.lastname: Mizobuchi
authors.forename: Yasumitsu
authors.initials: Y
authors.lastname: Moriya
authors.forename: Hidehisa
authors.initials: H
authors.lastname: Hoshino
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Okamoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzuki
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Shibuya
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshino
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000150:complications / Q000378:metabolism* / Q000473:pathology*; D016179:Granulocyte Colony-Stimulating Factor / Q000378:metabolism*; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000378:metabolism* / Q000473:pathology*; D008297:Male; D012128:Respiratory Distress Syndrome / Q000209:etiology*
chemical_list: D016179:Granulocyte Colony-Stimulating Factor