Department of General Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases Osaka, Japan.
Department of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases Osaka, Japan.
Thorac Cancer. 2015 Jan;6(1):105-9. doi: 10.1111/1759-7714.12140. Epub 2015 Jan 7.
This report presents a case of malignant pleural mesothelioma (MPM) producing granulocyte colony-stimulating factor (G-CSF) that was treated by tumor resection. A 76-year-old male presented with a huge right-side chest wall tumor, along with a slight fever and chest wall pain. Laboratory findings showed an increased white blood cell count (64600 cells/μL) and C-reactive protein level (20.57 mg/dL). The patient underwent surgical removal of the tumor along with tissue from the chest wall and histopathological analysis led to a diagnosis of sarcomatous type of MPM. Immunohistochemical findings for both anti-human G-CSF and interleukin-6 monoclonal antibodies were positive. Although the general condition of the patient quickly improved after surgery, local recurrence occurred two months later and he died of respiratory failure seven months after the operation, though surgery provided symptom relief. G-CSF-producing MPMs usually show a poor prognosis, though less-invasive surgery may be considered for relief of symptoms.
本报告介绍了一例产生粒细胞集落刺激因子 (G-CSF) 的恶性胸膜间皮瘤 (MPM) 病例,该病例通过肿瘤切除进行治疗。一名 76 岁男性出现巨大右侧胸壁肿瘤,伴有轻度发热和胸痛。实验室检查发现白细胞计数(64600 个/μL)和 C 反应蛋白水平(20.57mg/dL)升高。患者接受了肿瘤连同胸壁组织的手术切除,组织学分析导致诊断为肉瘤样型 MPM。抗人 G-CSF 和白细胞介素-6 单克隆抗体的免疫组织化学检测均呈阳性。尽管患者在手术后很快恢复了一般状况,但两个月后出现局部复发,术后七个月因呼吸衰竭死亡,尽管手术缓解了症状。产生 G-CSF 的 MPM 通常预后较差,但对于缓解症状,可能需要考虑采用侵袭性较小的手术。