Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan.
Department of Molecular Pathology, Yokohama City University, Yokohama, Japan.
JBJS Case Connect. 2020 Apr-Jun;10(2):e0624. doi: 10.2106/JBJS.CC.19.00624.
A 46-year-old woman presented with a mass in the lower leg and severe leukocytosis. Diffuse uptake in the bones was detected with F-fluorodeoxyglucose positron emission tomography with computed tomography (F-FDG PET/CT) imaging. The serum granulocyte-colony stimulating factor (G-CSF) was elevated, and immunostaining for G-CSF was positive. When diagnosed as G-CSF-producing undifferentiated pleomorphic sarcoma (UPS), a wide resection was performed. The leukocytosis and serum G-CSF were remarkably improved after tumor resection. No local recurrence or metastasis was detected.
We report the first case of inflammatory UPS in the extremity which demonstrated the neoplastic production of G-CSF. In our case, F-FDG PET/CT, the serum G-CSF, and immunostaining for G-CSF were useful for diagnosis.
一名 46 岁女性因小腿肿块和严重白细胞增多就诊。F-氟代脱氧葡萄糖正电子发射断层扫描与计算机断层扫描（F-FDG PET/CT）成像显示骨骼弥漫性摄取。血清粒细胞集落刺激因子（G-CSF）升高，G-CSF 免疫染色阳性。诊断为 G-CSF 产生的未分化多形性肉瘤（UPS）后，进行了广泛切除。肿瘤切除后，白细胞增多和血清 G-CSF 显著改善。未发现局部复发或转移。
我们报告了首例发生于四肢的炎症性 UPS，其表现为肿瘤性产生 G-CSF。在我们的病例中，F-FDG PET/CT、血清 G-CSF 和 G-CSF 免疫染色有助于诊断。
