Eosinophilia as a presenting symptom of the metastatic lung adenocarcinoma with an unknown primary localization

• Authors: Maciej Machaczka , Jerzy Hubert , Filip Kasina , Monika Klimkowska
• Languages of publication: EN

Abstracts

EN

Apparent hematological symptoms rarely dominate the clinical picture of an underlying non-hematological malignancy. Malignancy-associated eosinophilia can result from clonal or non-clonal proliferation of eosinophils. Here, we report the case of a 59-year-old man with metastatic adenocarcinoma of the lung with an unknown primary tumor site, which presented as hypereosinophilia, anemia, lymphadenopathy, weight loss, and malaise. Bone marrow biopsy disclosed metastatic adenocarcinoma positive in immunohistochemistry for cytokeratin 7. Further assessment of specimens obtained from the bronchoalveolar lavage and biopsy of the mediastinal lymph nodes confirmed the diagnosis of the metastatic lung cancer, although the primary tumor site remained undiscovered. This case underlines that eosinophilia may represent a rare primary manifestation of an undetected malignancy, and it is thus important to consider this as part of the differential diagnosis in patients presenting with unexplained eosinophilia.

Keywords

EN

Eosinophilia; Malignancy; Lung cancer; Adenocarcinoma

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2011
• Volume: 6
• Issue: 5
• Pages: 541-544

Dates

published

1 - 10 - 2011

online

9 - 8 - 2011

Contributors

author

Maciej Machaczka

author

Jerzy Hubert

• Collegium Medicum of the Jagiellonian University, Anny Street 12, 31-008, Krakow, Poland

author

Filip Kasina

• Collegium Medicum of the Jagiellonian University, Anny Street 12, 31-008, Krakow, Poland

author

Monika Klimkowska

• Department of Clinical Pathology and Cytology, Karolinska University Hospital Huddinge, SE-141, Stockholm, Sweden

References

• [1] Sheikh J, Weller PF. Advances in diagnosis and treatment of eosinophilia. Curr Opin Hematol 2009;16:3–8 http://dx.doi.org/10.1097/MOH.0b013e32831c841f[Crossref]
• [2] Tefferi A, Patnaik MM, Pardanani A. Eosinophilia: secondary, clonal and idiopathic. Br J Haematol 2006;133:468–492 http://dx.doi.org/10.1111/j.1365-2141.2006.06038.x[Crossref]
• [3] Roufosse F, Weller PF. Practical approach to the patient with hypereosinophilia. J Allergy Clin Immunol 2010;126:39–44 http://dx.doi.org/10.1016/j.jaci.2010.04.011[WoS][Crossref]
• [4] Gay JC, Athens JW. Variations of leukocytes in disease. In: Lee GR, Foerster J, Lukens J, Paraskevas F, Greer JP, Rodgers GM (eds). Wintrobe’s clinical hematology, 10th edition. Williams & Wilkins: Baltimore, Maryland, 1999, pp 1836–1861
• [5] Brigden ML. A practical workup for eosinophilia. You can investigate the most likely causes right in your office. Postgrad Med 1999;105(3):193–194,199–202,207–210 http://dx.doi.org/10.3810/pgm.1999.03.638[Crossref]
• [6] Abali H, Altundag MK, Engin H, Altundag OO, Türker A, Uner A, Ruacan S. Hypereosinophilia and metastatic anaplastic carcinoma of unknown primary. Med Oncol 2001;18:285–288 http://dx.doi.org/10.1385/MO:18:4:285[Crossref]
• [7] Stefanini M, Claustro JC, Motos RA, Bendigo LL. Blood and bone marrow eosinophilia in malignant tumors. Role and nature of blood and tissue eosinophil colony-stimulating factor(s) in two patients. Cancer 1991;68:543–548 http://dx.doi.org/10.1002/1097-0142(19910801)68:3<543::AID-CNCR2820680317>3.0.CO;2-3[Crossref]
• [8] Di Biagio E, Sánchez-Borges M, Desenne JJ, Suárez-Chacón R, Somoza R, Acquatella G. Eosinophilia in Hodgkin’s disease: a role for interleukin 5. Arch Allergy Immunol 1996;110:244–251 http://dx.doi.org/10.1159/000237294[Crossref]
• [9] Ashdhir P, Jain P, Pokharna R, Nepalia S, Sharma SS. Pancreatic cancer manifesting as liver metastases and eosinophillic leukemoid reaction: a case report and review of literature. Am J Gastroenterol 2008;103:1052–1054 http://dx.doi.org/10.1111/j.1572-0241.2007.01772_16.x[Crossref][WoS]
• [10] Ascensao JL, Oken MM, Ewing SL, Goldberg RJ, Kaplan ME. Leukocytosis and large cell lung cancer. A frequent association. Cancer 1987;60:903–905 http://dx.doi.org/10.1002/1097-0142(19870815)60:4<903::AID-CNCR2820600431>3.0.CO;2-6[Crossref]
• [11] Henry DW, Rosenthal A, McCarty DJ. Adenocarcinoma of the lung associated with eosinophilia and hidebound skin. J Rheumatol 1994;21:972–973
• [12] Xiao L, Luxi S, Ying T, Yizhi L, Lingyun W, Quan P. Diagnosis of unknown nonhematological tumors by bone marrow biopsy: a retrospective analysis of 10,112 samples. J Cancer Res Clin Oncol 2009;135:687–693 http://dx.doi.org/10.1007/s00432-008-0503-2[Crossref]

Identifiers

DOI

10.2478/s11536-011-0048-7