副肿瘤性高白细胞血症酷似血液系统恶性肿瘤，揭示局限性肺癌。

Paraneoplastic Hyperleukocytosis Mimicking Hematologic Malignancy Revealing a Localized Lung Cancer.

机构信息

Université Paris Descartes, Faculté de Médecine, Sorbonne Paris Cité, Paris, France; Service d'Hématologie, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France.

Université Paris Descartes, Faculté de Médecine, Sorbonne Paris Cité, Paris, France; Service d'Hématologie Biologique, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France; INSERM U1016, Institut Cochin, Paris, France.

出版信息

Ann Thorac Surg. 2020 Mar;109(3):e203-e206. doi: 10.1016/j.athoracsur.2019.06.064. Epub 2019 Aug 10.

DOI:10.1016/j.athoracsur.2019.06.064

PMID:31408646

Abstract

Paraneoplastic leukemoid reaction is a challenging differential diagnosis when it presents at the time of diagnosis of cancer. Severe hyperleukocytosis with elevation of blood neutrophils and monocytes counts can evoke myeloid hematologic malignancies. We report the case of a patient who presented with blood and bone marrow features highly suggestive of chronic myelomonocytic leukemia. The diagnosis of primary lung sarcomatoid carcinoma was performed. Surgical removal of this tumor which will always remain the priority led to full normalization of blood cell count.

摘要

癌相关性类白血病反应是一种具有挑战性的鉴别诊断，尤其在癌症诊断时出现时。严重的白细胞增多，伴有血液中性粒细胞和单核细胞计数升高，可能会引发髓系血液系统恶性肿瘤。我们报告了一例患者，其血液和骨髓特征高度提示慢性粒单核细胞白血病。诊断为原发性肺肉瘤样癌。手术切除该肿瘤始终是首要任务，这导致血细胞计数完全恢复正常。