Iwata T, Araki H, Kushima R, Date S, Tanaka S
Department of Urology, Saiseikai Shigaken Hospital.
Hinyokika Kiyo. 1999 Dec;45(12):847-50.
A case of bladder tumor producing granulocyte colony-stimulating factor (G-CSF) is reported. A 78-year-old male presented with macroscopic hematuria. Cystoscopy demonstrated a large bladder tumor. Drip infusion pyelography and computerized tomography of the chest, abdomen and pelvis revealed right hydronephrosis, but did not reveal any metastasis. Total cystectomy and construction of bilateral cutaneous ureterostomy was performed. Histologically, the tumor consisted of sarcomatoid carcinoma with foci of transitional cell carcinoma (G3 > G2), showing marked infiltration of polymorphonuclear leukocytes. Immunohistochemical examination revealed a high concentration of G-CSF in the tumor specimen. Preoperatively, the white blood cell, count in the peripheral blood and serum G-CSF concentration were elevated, 45,400/mm3 and 73.4 pg/ml, respectively. After surgery these values became normal. This is the 19th reported case of G-CSF producing bladder tumor in Japan. The prognosis of the reported cases of G-CSF producing bladder tumor has been very poor. Fourteen of the reported 19 cases died within one year. This patient should be carefully followed up.
报告了一例产生粒细胞集落刺激因子（G-CSF）的膀胱肿瘤病例。一名78岁男性出现肉眼血尿。膀胱镜检查发现一个大的膀胱肿瘤。静脉肾盂造影以及胸部、腹部和骨盆的计算机断层扫描显示右肾积水，但未发现任何转移。进行了全膀胱切除术及双侧皮肤输尿管造口术。组织学检查显示，肿瘤由伴有移行细胞癌灶（G3>G2）的肉瘤样癌组成，可见多形核白细胞显著浸润。免疫组化检查显示肿瘤标本中G-CSF浓度很高。术前，外周血白细胞计数和血清G-CSF浓度升高，分别为45400/mm³和73.4 pg/ml。术后这些值恢复正常。这是日本第19例报告的产生G-CSF的膀胱肿瘤病例。已报告的产生G-CSF的膀胱肿瘤病例预后非常差。报告的19例病例中有14例在一年内死亡。该患者应密切随访。
