小腸転移をきたし血清G-CSF高値を呈した原発性肺癌の1例 [in Japanese] A CASE OF G-CSF PRODUCING LUNG CANCER WITH METASTASIS TO THE SMALL INTESTINE [in Japanese]
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症例は41歳の男性. 2003年7月,検診にて胸部異常影を指摘され当院を受診した.精査の結果,原発性肺癌(低分化型腺癌)と診断され,同年9月右上葉切除術(ND2a)を行った.外来にて経過観察中の2004年1月,白血球増多と貧血を認めた.精査にて血清G-CSFの上昇と小腸転移を認め,小腸切除術を行った.術後血清G-CSFは正常化し,白血球も正常化したが,術後2週間で腹膜播種にて再発し開腹術後45日目に死亡した. G-CSF産生肺癌および肺癌の小腸転移は比較的稀であり,若干の文献的考察を加えて報告する.
A 41-year-old man was admitted to the hospital because of an abnormal shadow on a chest X-ray film. Following close exprolation, right upper lobectomy was performed with a diagnosis of lung cancer. Histological examination revealed poorly differentiated adenocarcinoma (p-T2NOMO, stage IB). Four months after the operation, marked leukocytosis and anemia were noted. Serum G-CSF level was elevated. Abdominal CT scan revealed metastasis to the small intestine and enterectomy was performed. Both serum G-CSF and WBC were normalized after the operation. However 14 days after the operation, peritoneal dissemination was found and the patient died 45 days after the operation. Enzyme immunoassay demonstrated an apparent increase of G-CSF in serum. Immunohistological examination showed positive staining for G-CSF. Since G-CSF producing lung cancer as well as metastasis of lung cancer to the small intestine is comparatively rare, this case is reported with some bibliographical comments.
- The journal of the Japanese Practical Surgeon Society
The journal of the Japanese Practical Surgeon Society 67(10), 2351-2355, 2006-10-25
Japan Surgical Association