1/32. Overexpression of CXC chemokines by an adrenocortical carcinoma: a novel clinical syndrome.A patient with adrenocortical carcinoma presented with fever, leukocytosis, and increased acute phase reactants. The tumor was infiltrated with neutrophils. Immunohistochemical staining of the tumor showed positive signal for epithelial neutrophil-activating protein-78, an angiogenic and chemotactic CXC chemokine. Conditioned medium from tumor-derived cells (RL-251) showed high concentration of IL-8, epithelial neutrophil-activating protein-78, Gro alpha, and Gro gamma, angiogenic CXC chemokines with a potential role in tumorigenesis. An adrenal cancer/severe combined immunodeficiency mouse chimera was developed. mice grew tumors rapidly, and circulating levels of IL-8 and epithelial neutrophil-activating protein-78 were detected. In contrast, animals transplanted with NCI-H295 cells, a nonchemokine-secreting cell line, grew tumors more slowly and did not have detectable chemokine levels. Similar to the patient, mice with RL-251 tumors developed marked leukocytosis and neutrophilia, and their tumors were infiltrated with neutrophils. mice were passively immunized with epithelial neutrophil-activating protein-78 antisera. A marked decrease in tumor growth was observed. Potential for chemokine production by other adrenocortical tumors was investigated by RT-PCR in archival material. Six of seven adrenal carcinomas and one of three adenomas had cDNA for IL-8; six of seven carcinomas and the three adenomas had cDNA for epithelial neutrophil-activating protein-78. We concluded that the clinical presentation of this case resulted from increased tumor production of chemotactic chemokines. Through their angiogenic and chemotactic properties these chemokines may play an important role in adrenal tumorigenesis.- - - - - - - - - - ranking = 1keywords = cancer (Clic here for more details about this article) |
2/32. Acute febrile neutrophilic dermatosis (sweet syndrome).We describe the third reported case of acute febrile neutrophilic dermatosis (sweet syndrome) in the united states. In the majority of reported cases, the patients were female. However, in our case and in the two cases reported previously in the united states, the patients were male. In two of these three male patients, a malignant neoplasm has been found, possibly as a coincidence.- - - - - - - - - - ranking = 0.042190130945372keywords = neoplasm (Clic here for more details about this article) |
3/32. Chronic lymphocytic leukemia presenting with extreme hyperleukocytosis and thrombosis of the common femoral vein.Very few case reports dealing with chronic lymphocytic leukemia (CLL) and hyperleukocytosis have been reported in the medical literature and none with venous thrombosis as a complication. Here, we describe a 73-year-old woman who presented with newly diagnosed CLL, leukostasis, and hyperleukocytosis (2000 x 10(9)/l), affecting the respiratory and nervous system. In addition, she also had deep vein thrombosis (DVT). Although hypercoagulability and thrombosis are well-described phenomena in solid tumors and in myeloproliferative neoplasms, CLL is generally not associated with an acquired coagulopathy. We hypothesize that in our patient the extreme number of circulating lymphocytes resulted in an abnormal accumulation of lymphocytes possibly causing stasis and occlusion of a larger vessel, which resolved after leukopheresis. The patient has since been successfully maintained with chemotherapy. We conclude that leukopheresis should be considered as the therapy of choice in CLL patients presenting with major complications of leukostasis.- - - - - - - - - - ranking = 0.042190130945372keywords = neoplasm (Clic here for more details about this article) |
4/32. Establishment of large cell lung cancer cell lines secreting hematopoietic factors inducing leukocytosis and thrombocytosis.We have established cell lines from a large cell carcinoma of the lung accompanied by marked granulocytosis and thrombocytosis, and have analyzed the factors with colony stimulating factor (CSF) activity produced by them. Analysis of the CSF activity present in the culture medium of the established cell lines demonstrated growth-stimulating activity on CMK cells, a human megakaryoblastic cell line and mouse bone marrow cells. A neutralization test with antibodies against G-, M- and GM-CSF indicated the stimulation for the proliferation of CMK and mouse bone marrow cells to be mediated partially by the CSFs. Furthermore, the measurement of GM-CSF and interleukin(IL)6 by enzyme-linked immunosorbent assay (ELISA) and northern blotting analysis indicated productions of G-, GM- and M-CSF and of IL6 from the cell lines but failed to exhibit IL3 gene expression. It is suggested that the cell lines could be of use in the study of CSFs and, also, that lymphokines act on leukocyte and platelet progenitor cells.- - - - - - - - - - ranking = 4keywords = cancer (Clic here for more details about this article) |
5/32. Myelokathexis and monocytosis in a patient with gastric cancer.A 66-year-old patient developed leukocytosis, neutrophilia and monocytosis following surgery for gastric carcinoma. The polymorphonuclear cells showed a marked shift to the right and abnormally hypersegmented or pyknotic nuclei, whereas the monocytes were vacuolized. The bone marrow was hypercellular with an increased number of multilobed polymorphonuclear cells. This myeloid cell defect is compatible with the nuclear abnormalities described as myelokathexis. The combination of the nuclear abnormalities of the polymorphonuclear cells with persistent monocytosis suggests the possibility of a paraneoplastic variant of myelodysplasia.- - - - - - - - - - ranking = 4keywords = cancer (Clic here for more details about this article) |
6/32. Production of granulocyte-macrophage colony-stimulating factor in two patients with lung cancer, leukocytosis, and eosinophilia.leukocytosis in association with malignancy has been well described, but the cause is not known. One potential explanation is production of a colony-stimulating factor by the tumor, and this has been demonstrated in vitro. The authors report two patients with lung cancer, leukocytosis, and eosinophilia. The pleural fluid of both patients contained malignant cells and biologically active granulocyte-macrophage colony-stimulating factor (GM-CSF), as demonstrated by radioimmunoassay, enzyme-linked immunosorbent assay (ELISA), and colony-forming unit-granulocyte-macrophage (CFU-GM) assay. To determine whether GM-CSF is normally detectable in pleural fluid, the authors performed assays on an additional 11 patients with pleural effusions of various origins but without peripheral blood leukocytosis and eosinophilia; only 1 patient had a detectable level of GM-CSF (i.e., greater than or equal to 0.1 ng/ml). Because GM-CSF usually is not present in pleural fluid, the authors postulate that the high levels of GM-CSF found in the pleural fluid of these two patients was produced by their tumors, and production of GM-CSF by their lung cancers likely caused the leukocytosis with eosinophilia.- - - - - - - - - - ranking = 6keywords = cancer (Clic here for more details about this article) |
7/32. Squamous cell carcinoma of the cervix producing granulocyte colony-stimulating factor.BACKGROUND: Marked leukocytosis is occasionally observed in patients with a malignant nonhematopoietic tumor. granulocyte colony-stimulating factor (G-CSF) may be responsible for this phenomenon. We report a case of G-CSF-producing squamous cell carcinoma of the cervix that showed marked leukocytosis. CASE: A 71-year-old Japanese woman was admitted for further investigation for leukocytosis. Her white blood cell (WBC) count had been gradually increasing over a period of 10 months. Laboratory data on admission revealed marked leukocytosis, with a WBC count of 30,400/microL, which consisted primarily of mature granulocytes (93%). Her serum G-CSF level was significantly elevated. However, there was no evidence of infection or hematopoietic disorders. Further examinations showed stage IIIb cervical cancer. The pathological diagnosis was squamous cell carcinoma of the nonkeratinizing type. Immunohistochemical staining of the biopsied specimens confirmed the production of G-CSF protein by the tumor cells. The patient was successfully treated by radiation therapy. Her WBC count returned to a normal level (3,700/microL). Her serum G-CSF level also decreased. The patient is alive without evidence of recurrence at 8 months after the treatment. CONCLUSION: It is suggested that the leukocytosis manifested in this patient was due to G-CSF produced by the tumor. It was possible to use the WBC count and serum G-CSF levels as additional tumor markers.- - - - - - - - - - ranking = 1keywords = cancer (Clic here for more details about this article) |
8/32. Oncological emergencies in the pediatric intensive care unit.The overall 5-year survival rate of children with cancer has now reached 77%, an increase of about 45% in the past 25 years. Newer therapies, including hematopoietic cell transplantation and cutting edge chemotherapeutics evolving in the form of molecular and biological cell targeted agents, are being researched and developed and are responsible for the change in survival rates over time. Also, despite the national trend toward hospice and palliative care, children with chronic and life threatening illnesses, continue to die in the hospital setting, often in the intensive care unit. Previous studies of children with complications of cancer and its therapy document poor outcomes among those who do require intensive care. These trends are changing, however, currently leaving a hopeful, optimistic view of the outcome in children with cancer complications admitted to the pediatric intensive care unit. It is imperative that nurses and intensive care staff understand pediatric cancer and its potential emergent consequences in order to respond to the symptoms of life threatening events.- - - - - - - - - - ranking = 4keywords = cancer (Clic here for more details about this article) |
9/32. Gastric adenosquamous carcinoma producing granulocyte-colony stimulating factor.We report a case of adenosquamous carcinoma of the stomach that produced granulocyte-colony stimulating factor (G-CSF). The patient, who had an admission diagnosis of advanced gastric cancer, had marked leukocytosis without evidence of infection. After leukemia and metastatic leukemoid reaction were excluded by bone marrow examination, a G-CSF-producing cancer was suspected as the cause of the abnormally elevated serum G-CSF level. The resected stomach tumor was histologically diagnosed as adenosquamous carcinoma; positive expression of G-CSF by tumor cells was shown with immunohistochemical detection, which confirmed the preoperative diagnosis. Recurrent disease in the liver and lymph nodes, accompanied by leukocytosis and re-elevation of serum G-CSF, developed just 3 months after the curative gastrectomy and adjuvant chemotherapy. All of the recurrent disease was resected, restoring normal levels of serum G-CSF. The patient survived for almost 2 years after the initial surgery with extensive chemotherapy, including weekly treatment with paclitaxel, before finally succumbing to liver failure secondary to extensive liver metastasis.- - - - - - - - - - ranking = 2keywords = cancer (Clic here for more details about this article) |
10/32. A case of uterine cervical cancer presenting with granulocytosis.Granulocytosis occurs in 40% of patients with lung and gastrointestinal cancers, 20% of patients with breast cancer, 30% of patients with brain tumor and ovarian cancer and 10% of patients with renal cell carcinoma. Granulocytosis occurs because of production of G-CSF, GM-CSF and IL-6. Uterine cervical carcinoma with granulocytosis as a paraneoplastic syndrome, however, has been rarely reported. We recently witnessed a case of invasive squamous cell carcinoma of the uterine cervix with granulocytosis. leukocytosis developed up to 69,000/microL, and then normalized after chemo-radiotherapy. There was no evidence of infection, tumor necrosis, glucocorticoid administration, or myeloproliferative disease by examination of a bone marrow aspirate when granulocytosis appeared. This phenomenon was probably associated with the secretion of hematopoietic growth factors such as G-CSF, GM-CSF and IL-6 by the tumor. We suggest that, like some other solid tumors, cervical cancer can present with granulocytosis as a paraneoplastic syndrome.- - - - - - - - - - ranking = 8keywords = cancer (Clic here for more details about this article) |
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