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JPTM > Volume 45(2); 2011 > Article
The Korean Journal of Pathology 2011;45(2): 205-208.
doi: https://doi.org/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.
Min Eui Hong, Soon Auck Hong, Gui Young Kwon, Tae Jin Lee, Eon Sub Park, Sung Jae Cha, Jae Hyuk Do, Jae Hyung Yoo
1Department of Pathology, Chung-Ang University College of Medicine, Seoul, Korea. esp@cau.ac.kr
2Department of General Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
3Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
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.
Key Words: Carcinosarcoma; Granulocyte colony-stimulating factor; Metastasis; Intussusception
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