Leucocytosis and Stroke in a Lung Cancer Patient

  • Neha Akkad Department of Internal Medicine, Washington University, St. Louis, MO, USA
  • Yang Jiang Division of Hematology and Oncology, University of California Los Angeles, Los Angeles, CA, USA
  • Daniel Shin Division of Hematology and Oncology, University of California Los Angeles, Los Angeles, CA, USA

Keywords

Haematology/oncology, non-small-cell lung cancer, leucocytosis, eosinophilia

Abstract

Significant leucocytosis in the setting of an underlying malignancy may be attributed to several causes and is not uncommon; however, extreme leucocytosis (>50×109 cells/l) and hypereosinophilia is less common and may represent a paraneoplastic syndrome. The underlying mechanism is thought to be bone marrow stimulation by tumour-produced cytokines, most notably interleukin-5 (IL-5) and granulocyte-macrophage colony-stimulating factor (GM-CSF). This paraneoplastic syndrome is likely reflective of extensive disease and dissemination, and options for treatment are limited but include tumour resection, corticosteroids and hydroxyurea. In this report, we discuss an unusual case of known stage III lung adenocarcinoma presenting with an ischaemic stroke and extreme leucocytosis and hypereosinophilia. 

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References

Kanaji N, Watanabe N, Kita N, Bandoh S, Tadokoro A, Ishii T, et al. Paraneoplastic syndromes associated with lung cancer. World J Clin Oncol 2014;5(3):197–223.

Lo CH, Jen YM, Tsai WC, Chung PY, Kao WY. Rapidly evolving asymptomatic eosinophilia in a patient with lung adenocarcinoma causes cognitive disturbance and respiratory insufficiency: case report. Oncol Lett 2013;5(2):495–498.

Riesenberg H, Muller F, Gorner M. Leukemoid reaction in a patient with adenocarcinoma of the lung: a case report. J Med Case Rep 2012;6:211.

Granger JM, Kontoyiannis DP. Etiology and outcome of extreme leukocytosis in 758 nonhematologic cancer patients: a retrospective, single-institution study. Cancer 2009;115(17):3919–3923.

Abughanimeh O, Tahboub M, Abu Ghanimeh M. Metastatic lung adenocarcinoma presenting with hypereosinophilia. Cureus 2018;10(6):e2866.

Pandit R, Scholnik A, Wulfekuhler L, Dimitrov N. Non-small-cell lung cancer associated with excessive eosinophilia and secretion of interleukin-5 as a paraneoplastic syndrome. Am J Hematol 2007;82(3):234–237.

Klimek M. Pulmonary lymphangitis carcinomatosis: systematic review and meta-analysis of case reports, 1970-2018. Postgrad Med 2019;131(5):309–318.

Kasuga I, Makino S, Kiyokawa H, Katoh H, Ebihara Y, Ohyashiki K. Tumor-related leukocytosis is linked with poor prognosis in patients with lung carcinoma. Cancer 2001;92(9):2399–2405.

Schernberg A, Mezquita L, Boros A, Botticella A, Caramella C, Besse B, et al. Neutrophilia as prognostic biomarker in locally advanced stage III lung cancer. PLoS One 2018;13(10):e0204490.

Published: 2020-08-14

Issue: Vol 7 No 11 (view)

Section: Articles

How to cite:
1.
Akkad N, Jiang Y, Shin D. Leucocytosis and Stroke in a Lung Cancer Patient. EJCRIM 2020;7 doi:10.12890/2020_001872.