2001 Volume 41 Issue 6 Pages 677-680
Background: Recently, some cases of lung tumors producing granulocyte colony-stimulating factors (G-CSFs) have been reported. Most of the tumors were carcinomas such as large cell carcinomas. We report a rare case of pulmonary sarcoma producing G-CSF.
Case: A 65-year-old man complaining of fever was transferred to our hospital for further examination of an abnormal shadow on chest X-ray film. His laboratory data on admission showed marked leukocytosis (31900/μl), 95% of which consisted of neutrophils. Percutaneous biopsy yielded a diagnosis of an undifferentiated malignant tumor in his chest. After confirming that there was no distant metastasis, he underwent upper right lobectomy with chest wall resection. The surface of the excised tumor showed marked yellowish area of necrosis and hemorrhage with scattered abscess. Pathological examination of the resected specimen revealed that the tumor consisted of two different components, namely, large cell carcinoma with giant cells and spindle cell sarcomatous lesions infiltrated with multiple neutrophils. More than 90% of the tumor consisted of sarcomatous lesions although there was some variation in both components. Immunohistochemically, the spindle cell component was stained with Vimentin, muscle-specific actin (MSA), and both components were stained by the anti-rhG-CSF monoclonal antibody. On admission, the serum G-CSF level was 37.8pg/ml, which increased to 38.9pg/ml immediately before surgery and decreased to 77.9pg/ml after surgery. The post operative chemotherapy had no effect and he died 4 months after surgery.
Conclusion: This appears to be a rare case of pulmonary sarcoma producing G-CSF. We measured the serum G-CSF levels at several points during his clinical course. The serum G-CSF levels may have been related to the development of the tumor.
