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伴有类白血病反应的食管腺癌:一例报告

Esophageal adenocarcinoma with leukemoid reaction: a case report.

作者信息

Yu Ge, Ji Huaijun, Meng Chuizheng, Huang Yixuan, Gao Guogang, Liu Chuanping, Wang Shanlei, Zhang Lei, Ju Jin

机构信息

Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China.

出版信息

J Cardiothorac Surg. 2019 Apr 8;14(1):66. doi: 10.1186/s13019-019-0893-z.

Abstract

BACKGROUND

Leukemoid reaction (LR) is defined as a reactive leucocytosis with WBC counts exceeding 50,000/mm, and a significant increase in early neutrophil precursors. LR may be a paraneoplastic manifestation of various malignant tumors. Tumor-related LR is a kind of neoplastic syndrome, unrelated to an infection or other diseases.

CASE PRESENTATION

A 74-year-old male visited a local doctor with a 20-day history of progressive dysphagia. The complete blood count revealed leucocytosis. Bone marrow aspirates and a biopsy confirmed LR and excluded chronic myelogenous leukemia. Following radical esophagectomy for an adenocarcinoma the WBC counts successively decreased to 10,450/mm and 8670/mm within 1 week and 1 month, respectively.

CONCLUSION

We report a rare case of esophageal adenocarcinoma complicated with excessive leucocytosis caused by paraneoplastic LR; we also present a review of literature and an investigation of the clinical features. To our knowledge, this is the first report of LR associated with esophageal adenocarcinoma.

摘要

背景

类白血病反应(LR)定义为白细胞计数超过50,000/mm³的反应性白细胞增多,且早期中性粒细胞前体显著增加。LR可能是各种恶性肿瘤的副肿瘤表现。肿瘤相关的LR是一种肿瘤综合征,与感染或其他疾病无关。

病例介绍

一名74岁男性因进行性吞咽困难20天就诊于当地医生。全血细胞计数显示白细胞增多。骨髓穿刺和活检确诊为LR,并排除了慢性粒细胞白血病。在对腺癌进行根治性食管切除术后,白细胞计数在1周和1个月内分别相继降至10,450/mm³和8670/mm³。

结论

我们报告了一例罕见的食管腺癌合并副肿瘤性LR导致的白细胞增多症病例;我们还对文献进行了综述并对临床特征进行了研究。据我们所知,这是第一例与食管腺癌相关的LR报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dc9/6454710/8e3b99677557/13019_2019_893_Fig1_HTML.jpg

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