Unusual morphologies of blood eosinophils in GM-CSF-producing lung cancer.
Unusual morphologies of blood eosinophils in GM-CSF-producing lung cancer.
复制标题
产生 GM-CSF 的肺癌中血液嗜酸性粒细胞的异常形态。
DOI：
10.1093/qjmed/hcaa144
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Nakayama K.
中科院分区：
文献类型：
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作者：
Izumiya Y;Okuda Y;Ueki S;Takeda M;Sato K;Nakayama K.
一名 71 岁男性曾因全身不适就诊，被转诊至我们医院接受治疗。胸部计算机断层扫描（CT）显示双肺散布结节状阴影，纵隔和肺门淋巴结肿胀。对左肺门淋巴结进行穿刺活检，诊断为原发性肺腺癌。血液检查显示白细胞计数升高（60,800/μl），并伴有明显的嗜酸性粒细胞增多（53.0%）。嗜酸性粒细胞增多反应性原因（例如寄生虫感染）的筛查结果为阴性。骨髓中未观察到发育不良和原始细胞。由于患者 WT-1 基因呈阴性，因此未诊断出骨髓增生异常综合征 (MDS)。没有检测到其他提示血液恶性肿瘤的基因异常，例如 FIP1L1-PDGFRA。血清学研究显示IL-5和G-CSF的水平在参考范围内，并且GM-CSF的血清水平显着升高（145pg/ml）。左肺门淋巴结活检也显示 GM-CSF 免疫染色呈阳性。该患者被诊断患有产生 GM-CSF 的肺癌。此外，他的外周血嗜酸性粒细胞表现出不寻常的形态异常，包括 https://mc.手稿中央。 com/qjm
A 71-year-old man who had previously consulted a physician for general malaise was referred to our hospital for treatment. Chest computed tomography (CT) showed nodular shadows scattered throughout both lungs and swelling of the mediastinum and hilar lymph nodes. A needle biopsy of the left hilar lymph node was performed and primary lung adenocarcinoma was diagnosed. Blood tests revealed an elevated white blood cell count (60,800/µl) with a marked eosinophilia (53.0%). Screening for reactive causes of eosinophilia such as parasite infection were negative. No dysplasia and no blasts were observed in the bone marrow. Myelodysplastic syndrome (MDS) was not diagnosed because the patient was negative for the WT-1 gene. No other gene abnormalities suggesting hematologic malignancies, such as FIP1L1-PDGFRA, were detected. Serological studies revealed levels of IL-5 and G-CSF were within the reference ranges and a markedly elevated serum level (145pg/ml) of GM-CSF. Positive immunostaining for GM-CSF, in biopsy of a left hilar lymph node, was also demonstrated. The patient was diagnosed with GM-CSF-producing lung cancer. Additionally, his peripheral blood eosinophils showed unusual morphological abnormalities, including https://mc. manuscriptcentral. com/qjm