A Case of Giant Cell Carcinoma of the Lung Accompanying Hyperleukocytosis.

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Hyperleukocytosis was accompanied with lung cancer possessing cellular biological diversity. Giant cell carcinoma of the lung was found in a 68-year-old man. The tumor, with a doubling time of one month, was removed by right middle and lower bilobectomy with mediastinal lymph node dissection. Five months after the operation, recurrence was found in the right hemithorax and mediastinum, and accompanying hyperleukocytosis (the number of leukocytes was 63, 180/mm<SUP>3</SUP>, of which neutrophils were more than 95%). Furthermore, fever, anemia, thrombocytosis, hypoproteinemia, and high values of CRP, LDH, and ALP were detected. No malignant cells were found in the bone marrow. As the tumor developed in size and metastasized to the contralateral lung, the number of leukocytes increased to 169, 700/mm<SUP>3</SUP> two weeks later, when the patient died of the cancer. A high concentration of G-CSF in the blood was measured (0.66ng/ml). However, immuno-histochemical examination of the resected tumor with antirecombinant human G-CSF antibody did not reveal G-CSF in the tumor cell itself. The tumor might produce some kind of granulocyte poietic factor different from G-CSF, which was responsible for hyperleukocytosis in this case.
特定非営利活動法人日本肺癌学会の論文