[Rapid progression of adenocarcinoma of the lung in a patient with high levels of granulocyte colony-stimulating factor].

A 51-year-old man was referred and admitted to our hospital for further examination of an abnormal shadow on a chest X-ray film. One month before admission, a chest X-ray film had shown no abnormality. On admission, chest X-ray films and computed tomograms showed a tumor shadow in the right hilum, obstructive pneumonia in the right upper lobe, and a right-sided pleural effusion. Cytological examination of the pleural offusion revealed adenocarcinoma. The patients was given supportive care. The tumor grew rapidly and by the 13th hospital day it occupied whole right upper lobe. The patient died on the 21st day after admission. The white blood cell count had increased to 26540/mm3 as the adenocarcinoma grew. Serum granulocyte colony-stimulating factor (G-CSF), which increases the number of neutrophils in blood in vivo was examined. The serum G-CSF level reached 112 pg/ml. On immunohistochemical examination, the tumor cells stained positively with anti-G-CSF monoclonal antibody. The growth of this tumor was more rapid than expected for adenocarcinoma of the lung. These findings suggest that G-CSF induced growth of the tumor.