Hypereosinophilia driven by GM-CSF in large-cell carcinoma of the lung

doi:10.1016/j.lungcan.2012.02.014

Lung Cancer

Volume 76, Issue 3, June 2012, Pages 493-495

https://doi.org/10.1016/j.lungcan.2012.02.014 Get rights and content

Abstract

In contrast to leukocytosis, paraneoplastic hypereosinophilia is uncommon in lung cancer. We present a patient with large-cell carcinoma of the lung, in which cancer cells generate large amounts of GM-CSF leading to a leukemoid reaction with prominent hypereosinophilia and potentially involved in autocrine tumor stimulation.

Introduction

Lung carcinoma associated with hypereosinophilia is rare. The mechanism of eosinophilia and the role of eosinophils in such cases are unknown. We report here a case where carcinoma cells produce large amounts of GM-CSF most likely driving eosinophilia and possibly tumor growth.

Section snippets

Case report

A 61-year-old man was admitted with dyspnoea, a massive pleural effusion on the right side and marked granulocytosis with hypereosinophilia. His personal history revealed previous smoking until about 20 years ago, but was otherwise unremarkable. Physical examination showed mild tachypnea and signs of pleural effusion on the right side. The leukocyte count on admission was 77,400/μl with 30–40% mostly hypersegmented, vacuolized, and partly degranulated eosinophils on microscopic examination (

Discussion

Tumor-associated, paraneoplastic leukocytosis is not uncommon in non-small-cell lung carcinoma and has been associated with high G-CSF levels and poor prognosis [6]. Hypereosinophilic leukocytosis is less frequent. We now document a neoplastic GM-CSF production as an underlying mechanism. Very few cases of elevated GM-CSF levels and hypereosinophilia in patients with lung cancer have been described so far [7], [8], [9]. It is known, however, that therapeutic application of GM-CSF to

Conflicts of interest

The authors declare no conflicts of interest.

Acknowledgements

We thank Ms. E. Kozlowski (Institute of Pharmacology, University of Bern) for technical assistance. This study was supported by the Swiss National Science Foundation (grant no. 310030_129640) and Allergie-Stiftung Ulrich Müller-Gierok, Bern, Switzerland.

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Case reportHypereosinophilia driven by GM-CSF in large-cell carcinoma of the lung

Abstract

Introduction

Section snippets

Case report

Discussion

Conflicts of interest

Acknowledgements

Kidney Int

J Allergy Clin Immunol

Hypereosinophilic syndrome: a multicenter, retrospective analysis of clinical characteristics and response to therapy

J Allergy Clin Immunol

Abnormal clones of T cells producing interleukin-5 in idiopathic eosinophilia

N Engl J Med

cIAP-2 and survivin contribute to cytokine-mediated delayed eosinophil apoptosis

Eur J Immunol

Case report
Hypereosinophilia driven by GM-CSF in large-cell carcinoma of the lung