1/15. Granulocyte colony stimulating factor-producing diffuse malignant mesothelioma of pleura.We report the rare case of a 61-year-old man with a diffuse malignant mesothelioma of mixed subtype which produced granulocyte colony-stimulating factor (G-CSF). The white blood cell (WBC) was elevated to 85,100/mm3 without any evidence of infection, and the G-CSF level in the pleural effusion was also increased at 13,200 pg/ml. The lobes of the lung were encased in a tumor. Histopathologically, the tumor cells were of a polymorphous morphology with an epithelial and sarcomatoid mixed pattern. immunohistochemistry showed that the tumor cells were positive for vimentin, cytokeratin, epithelial membrane antigen, thrombomodulin, and G-CSF, and negative for carcinoembryonic antigen (CEA), CD34, and surfactant apoprotein-A.- - - - - - - - - - ranking = 1keywords = granulocyte (Clic here for more details about this article) |
2/15. leukemoid reaction response to chemotherapy and radiotherapy in a patient with cervical carcinoma.A white blood cell count more than 50 x 10(9)/l associated with a cause outside the bone marrow is termed a leukemoid reaction. Although it simulates leukemia, most of its causes are benign. Malignancy as a cause of a leukemoid reaction is still a medical dilemma. It is thought to be attributed to granulocyte colony-stimulating factor (G-CSF) secreted by the tumor cells. To our knowledge this is the first time a leukemoid reaction has been reported in association with cervical cancer. We even managed to monitor the leukemoid reaction response to chemotherapy and radiotherapy.- - - - - - - - - - ranking = 1keywords = granulocyte (Clic here for more details about this article) |
3/15. granulocyte colony-stimulating factor-producing cutaneous angiosarcoma with leukaemoid reaction arising on a burn scar.We report a 46-year-old man with a giant tumour in a burn scar on his buttock. Pathological examination revealed that the dermis was filled with anastomosing vascular channels and round- or spindle-type atypical cells, which were compatible with the diagnosis of cutaneous angiosarcoma. Based on prominent leucocytosis (up to 113 000 microL-1), we measured serum granulocyte colony-stimulating factor (G-CSF). The highly elevated serum G-CSF of 303 ng L-1 (normal, 6.1-21.5 ng L-1) and positive immunohistochemical staining of the tumour tissue for G-CSF indicated that G-CSF was produced by the cutaneous angiosarcoma. To our knowledge, this is the first reported case of G-CSF-producing cutaneous angiosarcoma.- - - - - - - - - - ranking = 1keywords = granulocyte (Clic here for more details about this article) |
4/15. Intense paraneoplastic neutrophilic leukemoid reaction related to a G-CSF-secreting lung sarcoma.A white blood cell count more than 50 x 10(9)/l, not related to bone marrow involvement, is termed leukemoid reaction. We report on the first case of an undifferentiated sarcoma of the lung associated with an intense paraneoplastic neutrophilic leukemoid reaction related to the production of granulocyte colony-stimulating factor (G-CSF). A radiography and a computed tomography scan of the chest revealed a well-limited voluminous and heterogeneous low-density mass of the left lung. The patient died of multiorgan failure related to uncontrolled progressive tumor growth after admission and two cycles of chemotherapy. The patient's G-CSF serum concentration was dramatically elevated (6,538 pg/ml) compared to serum levels observed in normal controls and patients with elevated leukocytosis (31 and 387 pg/ml, respectively). The G-CSF concentration dramatically increased after the first cycle of chemotherapy and during the subsequent neutropenia, as a result of the tumor lyses as well as of disruption of the physiological negative feedback mechanism. Adjunction of the patient's serum to CD34 cell cultures induced a 12.3-fold increase in CD15 cells, demonstrating the serum's capacity to induce myeloid differentiation.- - - - - - - - - - ranking = 1keywords = granulocyte (Clic here for more details about this article) |
5/15. Alcoholic hepatitis with leukemoid reaction after surgery.Alcoholic hepatitis (AH) is a clinicopathologic syndrome resulting from an excessive intake of alcohol. Leukemoid reactions (LRs) are characterized by a strikingly elevated granulocyte count over 40,000-50,000 cells/mm(3). Although a leukocytosis of 15,000-18,000 cells/mm(3) is frequently seen in AH, LRs are rare in this context. AH-associated LRs are a sign of poor prognosis and have a high mortality. A 64-year-old male with a history of heavy alcohol intake underwent a right hemicolectomy for cecal carcinoma. Preoperative laboratory data were normal with the exception of an albumin of 2.1 g/dL. liver biopsies that were taken because of a nodular appearance revealed micronodular cirrhosis, steatohepatitis, and mallory bodies. Postoperatively, the patient developed a leukocytosis that progressively increased to 72.6 cells/mm(3). He also developed signs of impaired hepatic and renal function. Extensive workup failed to reveal a source of infection. A trial of intravenous antibiotics had no impact on the leukocytosis. methylprednisolone at a dose of 40 mg IV daily was started on postoperative day 9. The patient experienced a progressive decline in white blood count (WBC), which reached 25.2/mm(3) on postoperative day 14. However, he died on postoperative day 16. We conclude that the patient had AH-associated LR in the postoperative period, but died despite successful treatment of the LR with steroids.- - - - - - - - - - ranking = 1keywords = granulocyte (Clic here for more details about this article) |
6/15. leukemoid reaction in pancreatic cancer: a case report and review of the literature.CONTEXT: The presentation of pancreatic cancer with a leukemoid reaction is rare with no prior reports in the English language literature. CASE REPORT: We report a case of advanced pancreatic cancer presenting with leukemoid reaction. granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor levels were normal while interleukin-6 was elevated. The patient had no evidence of infection. The leukemoid reaction correlated with tumor response. CONCLUSION: This is the first case report in the English literature of a leukemoid paraneoplastic syndrome in a patient with pancreatic cancer. A clear correlation between tumor response, serum carbohydrate antigen 19-9 levels and leukemoid reaction is documented.- - - - - - - - - - ranking = 1keywords = granulocyte (Clic here for more details about this article) |
7/15. histiocytosis and a leukaemoid response. A case report.A patient with all the clinical signs of Letterer-Siwe disease is reported. The patient was unusual in that he had a severe leukaemoid reaction. To our knowledge, only 2 similar patients with reticulo-endotheliosis, histiocytic skin infiltration and leukaemoid reaction have been reported. It is possible that the disorder may represent a variant of the histiocytic proliferative disorders, characterized by both histiocytic and myeloid hyperplasia, and is thus similar to myelomonocytic leukaemia. However, it differs from the latter condition in that there is proliferation of monocytes and granulocytes in soft tissues rather than in the blood.- - - - - - - - - - ranking = 1keywords = granulocyte (Clic here for more details about this article) |
8/15. Granulocytosis associated with tumor cell production of colony-stimulating activity.A patient with metastatic soft tissue sarcoma presented with a leukemoid reaction. The elevated white blood cell count was due to an increase in bands and mature segmented neutrophils. The degree of granulocytosis correlated with the tumor burden. There was no evidence of superimposed infection and the degree of bone marrow involvement by metastatic tumor was minimal. A cell line derived from the sarcoma produces granulocyte-macrophage colony-stimulating activity (CSA) in vitro. Although CSA could not be detected in serum, the findings in this patient suggest that the leukemoid reaction was due to tumor production of CSA.- - - - - - - - - - ranking = 1keywords = granulocyte (Clic here for more details about this article) |
9/15. leukemoid reaction associated with parenteral nutrition.A hematological picture simulating that seen in cases of leukemia often occurs in a variety of conditions. We recently treated a patient who had a leukemoid reaction in the peripheral blood while he was on parenteral nutrition. Throughout the period of treatment with parenteral nutrition, an abnormal shift towards immaturity in the neutrophilic granulocytes was seen, and the degree of this shift appeared to depend on the caloric intake. Moreover, the hematological picture resembling that seen in cases of leukemia disappeared shortly after discontinuation of the parenteral nutrition, and immature cells were no longer apparent. We assumed that the excess glucose-related calories included in parenteral nutrition produced the leukemoid reaction in this patient who was being surgically treated for carcinoma of the colon with hepatic metastasis.- - - - - - - - - - ranking = 1keywords = granulocyte (Clic here for more details about this article) |
10/15. Power of the MAC (morphology-antibody-chromosomes) method in distinguishing reactive and clonal cells: report of a patient with acute lymphatic leukemia, eosinophilia, and t(5;14).We present a patient with acute lymphatic leukemia, eosinophilia, and a 5;14-translocation, a rare but well-documented condition. In order to clarify whether granulocytes were involved in the disease, we applied the MAC (Morphology-Antibody-chromosomes) technique to samples of the bone marrow and, during a central nervous system relapse, to those of the cerebrospinal fluid. The karyotype of the blast cells was 47,XY, X,t(5;14)(q31;q32),i(7)(q10). interphase cytogenetic study by in situ hybridization with an X-specific alphoid probe revealed the abnormality in CD10, CD19, and TdT (terminal deoxynucleotidyl transferase) positive lymphoid cells, whereas CD13 positive, sudan black B positive, eosinophilic, and basophilic granulocytes as well as monocytes and small lymphocytes did not have the abnormality. Our results show that the eosinophilic and basophilic granulocytes in this subtype of acute leukemia do not belong to the malignant clone but are reactive. This study also confirmed the usefulness of the MAC technique in distinguishing neoplastic and reactive cells in malignancy.- - - - - - - - - - ranking = 3keywords = granulocyte (Clic here for more details about this article) |
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