Korean J Pathol.  2011 Apr;45(2):205-208. 10.4132/KoreanJPathol.2011.45.2.205.

A Metastatic Granulocyte Colony-Stimulating Factor Producing Sarcomatoid Carcinoma of the Lung Causing Jejunal Intussusception: Report of a Case

• Hong ME
• Hong SA
• Kwon GY
• Lee TJ
• Park ES
• Cha SJ
• Do JH
• Yoo JH

• KMID: 1443756
• DOI: http://doi.org/10.4132/KoreanJPathol.2011.45.2.205

Abstract

A 75-year-old man was referred to our hospital with intestinal obstruction caused by intussusception. Abdominal computed tomography (CT) revealed seven polypoid masses in the small intestine, while chest CT revealed a mass in the right lower lobe. Preoperative laboratory tests showed white blood cell (WBC) and neutrophil differential counts of 63,630/mm3 and 95%, respectively. The serum granulocyte colony-stimulating factor (G-CSF) was 114 pg/mL, which was elevated (normal range, <18.1 pg/mL). After resection of the small bowel, the WBC count decreased to 20,510/mm3. The pathology showed a poorly differentiated carcinoma with sarcomatous components confirmed by positive immunostaining of cytokeratin (AE1/AE3) and vimentin in the small intestine. Furthermore, immunohistochemistry with specific monoclonal antibodies against G-CSF was positive. A lung biopsy revealed the same histological findings as the small intestine lesion. Therefore, the patient was diagnosed as having a G-CSF producing sarcomatoid carcinoma of the lung with metastasis to the small intestine.

Keyword

Carcinosarcoma; Granulocyte colony-stimulating factor; Metastasis; Intussusception

MeSH Terms

Aged
Antibodies, Monoclonal
Biopsy
Carcinosarcoma
Granulocyte Colony-Stimulating Factor
Granulocytes
Humans
Immunohistochemistry
Intestinal Obstruction
Intestine, Small
Intussusception
Keratins
Leukocytes
Lung
Neoplasm Metastasis
Neutrophils
Thorax
Vimentin
Antibodies, Monoclonal
Granulocyte Colony-Stimulating Factor
Keratins
Vimentin