Two Cases of Granulocyte-colony-stimulating Factor-producing Lung Cancer

━━ Background. Granulocyte-colony-stimulating factor (G-CSF)-producing lung cancer is associated with a poor prognosis. Case. Case 1: A 68-year-old man was admitted to our hospital due to bloody sputum and arthralgia in his right shoulder. A large mass was identified in his right upper lobe. It was diagnosed as lung cancer (poorly-differentiated non-small cell, stage IV) by CT-guided needle lung biopsy. Although he received systemic chemotherapy, the disease progression was not controllable. He died 3 months after the diagnosis. Case 2: A 64year-old man presented with an invasive lesion in the right lower lobe. It was diagnosed as lung cancer (adenocarcinoma, stage IIB). Although partial pneumonectomy and lymph-adenectomy were performed, the postoperative pathology showed vessel invasion of the chest wall. Despite the administration of systemic chemotherapy, the patient’s the disease progression was not controllable. He died 7 months after the diagnosis. Serum examinations revealed that both cases had leukocytosis and a high concentration of G-CSF. In addition, the tumor cells were positively stained with anti-recombinant human G-CSF monoclonal antibody. Conclusion. Further investigation is therefore necessary to elucidate the prognosis of G-CSF producing lung cancer. (JJLC. 2016;56:227-231) KEY WORDS━━G-CSF, Lung cancer, Leukocytosis, Prognosis Corresponding author: Akina Komatsu. Received January 11, 2016; accepted March 25, 2016. 要旨━━背景.G-CSF 産生肺癌は予後不良であること が知られている.症例.症例 1は 68 歳,男性.血痰と右 肩痛で受診し,精査の結果非小細胞肺癌 cT3N0M1b (OSS)stage IV と診断し,全身化学療法を行うも奏効せ ず,3か月で永眠した.症例 2は 64 歳,男性.健診胸部 異常陰影で受診,EGFR遺伝子変異陰性の低分化肺腺癌 cT3N0M0 stage IIB と診断し,腫瘍切除後に化学療法を 行うも 7か月で永眠した.いずれも白血球増多,血清GCSF 高値,免疫組織学的G-CSF 陽性を認めた.結論.GCSF 産生肺癌は腫瘍の浸潤と増大が速く臨床上留意す べきであり,さらなる臨床症例の集積および基礎研究の 発展による治療法確立が望まれる. 索引用語━━顆粒球コロニー刺激因子(G-CSF),肺癌, 白血球増多症,予後 1東京慈恵会医科大学葛飾医療センター呼吸器内科;2神奈川県 立循環器呼吸器病センター呼吸器内科;3東京慈恵会医科大学第三 病院呼吸器内科;4東京慈恵会医科大学柏病院呼吸器内科. 論文責任者:小松あきな. 受付日:2016 年 1 月 11 日,採択日:2016 年 3 月 25 日. (肺癌.2016;56:227-231) 2016 The Japan Lung Cancer Society Granulocyte-colony-stimulating Factor-producing Lung Cancer―Komatsu et al 228 Japanese Journal of Lung Cancer―Vol 56, No 3, Jun 20, 2016―www.haigan.gr.jp Table 1. The Laboratory Data on Admission