胸部外科

Abstract

A 52-year-old man with a history of heavy smoking was hospitalized for evaluation of fever.Pulmonary abscess was initially suspected by computed tomography (CT) showing an ovoid,well-demarcated nodule of 61mm in diameter with coarse calcification in S2a of the right lung.The patient was treated with antibiotics,but no improvement was seen in inflammatory reactionsor lesion size. Marked leukocytosis and high level of granulocyte colony stimulating factor (GCSF)was shown by laboratory examination. To improve patient condition and ensure correctdiagnosis,right upper lobectomy of the lung was performed. Pleomorphic carcinoma of the lungwas subsequently diagnosed. G-CSF producing tumor was suspected,since the normalization ofserum G-CSF level followed by the improvement of both fever and inflammatory reaction wasobserved postoperatively. We also present herein a review of 22Japanese cases of pleomorphiccarcinoma producing G-CSF of the lung, characterized by leukocytosis.