Bronchogenic Adenocarcinoma with Severe Eosinophilia
AbstractHypereosinophilia is defined as eosinophil count more than 1500 per microliter that can be associated with tissue and organ damage, regardless of the underlying cause. There are various categories of diseases that are able to cause eosinophilia. Solid tumor-associated hypereosinophilia is an unusual manifestation in patients with cancer. Cytokines namely granulocytes macrophages stimulating factor (GM-CSF), interleukin 3 (IL- 3), and interleukin 5 (IL-5) may play an important role in the pathogenesis of eosinophilia development. Here, we describe a 70-year-old man with metastatic adenocarcinoma of the lung presenting with fever, weight loss, shortness of breath, and severe hypereosinophilia. In patients with compatible clinical findings and associated risk factor(s), it is important to consider lung adenocarcinoma as a differential diagnosis in patients with unexplained eosinophilia and lung symptoms with associated risk factors.
Roufosse F, Weller PF. Practical approach to the patient with hypereosinophilia. J Allergy Clin Immunol 2010; 126(1): 39-44.
Tefferi A. Blood eosinophilia: A new paradigm in disease classification, diagnosis, and treatment. Mayo Clin Proc 2005; 80(1): 75-83.
Beeson PB. Cancer and eosinophilia. N Engl J Med 1983; 309(13): 792-3.
Remacle P, Bruart J, Henneghien C. Bronchial cancer and hypereosinophilia. Eur Respir J 1988; 1(2): 191-2.
Seradj MH, Naderi N, Peiman S, Saffar H. Metastatic transitional cell carcinoma of the skin presenting as painful zosteriform eruptions. Oxf Med Case Reports 2015; 2015(5): 281-3.
Alamdari A, Naderi N, Peiman S, Shahi F. Non-Hodgkin lymphoma with primary involvement of skeletal muscle. Int J Hematol Oncol Stem Cell Res 2014; 8(3): 55-7.
Staszewski H. Hematological paraneoplastic syndromes. Semin Oncol 1997; 24(3): 329-33.
Rothenberg ME. Eosinophilia. N Engl J Med 1998; 338(22): 1592 600.
Tefferi A, Patnaik MM, Pardanani A. Eosinophilia: Secondary, clonal and idiopathic. Br J Haematol 2006; 133(5): 468-92.
Anagnostopoulos GK, Sakorafas GH, Kostopoulos P, Margantinis G, Tsiakos S, Terpos E, et al. Disseminated colon cancer with severe peripheral blood eosinophilia and elevated serum levels of interleukine-2, interleukine-3, interleukine-5, and GM-CSF. J Surg Oncol 2005; 89(4): 273-5.
Todenhofer T, Wirths S, von Weyhern CH, Heckl S, Horger M, Hennenlotter J, et al. Severe paraneoplastic hypereosinophilia in metastatic renal cell carcinoma. BMC Urol 2012; 12: 7.
Rojas GJ, Castro DM, Vigo-Guevara GL, Ferrua M, BarrigaMaldonado V, RottaEscalante R. Hypereosinophilic encephalopathy with multiple cerebral infarctions in neighbouring vascular territories associated with prostate cancer. Rev Neurol 2006; 43(12): 762-4.
Ando J, Sugimoto K, Tamayose K, Ando M, Kojima Y, Oshimi K. Cytokine-producing sarcoma mimics eosinophilic leukaemia. Eur J Haematol 2007; 78(2): 169-70.
Manelis G, Aderka D. Eosinophilia associated with malignant tumors of the bronchus and stomach. Harefuah 1976; 90(5): 213-5.
Machaczka M, Hubert J, Kasina F, Klimkowska M. Eosinophilia as a presenting symptom of the metastatic lung adenocarcinoma with an unknown primary localization. Cent Eur J Med 2011; 6(5): 541-4.
Lu J, Rodgers C. Eosinophilia in a patient with lung adenocarcinoma-a case study. New Zealand J Med Lab Sci 2013; 67(2): 56-7.
El-Osta H, El-Haddad P, Nabbout N. Lung carcinoma associated with excessive eosinophilia. J Clin Oncol 2008; 26(20): 3456-7.
Motilal B, Savita A, Takhar R. Peripheral eosinophilia in a case of adenocarcinoma lung: A rare association. J Assoc Chest Physicians 2015; 3(2): 60-2.
Kayar Y, Baysal B, Kayar NB, Kyio NH, Mahdi NM, Unver N, et al. Hypereosinophilia induced by lung adenocarcinoma: A rare case. J Carcinog Mutagen 2015; 6: 216.
Watanabe M, Ono K, Ozeki Y, Tanaka S, Aida S, Okuno Y. Production of granulocytemacrophage colony-stimulating factor in a patient with metastatic chest wall large cell carcinoma. Jpn J Clin Oncol 1998; 28(9): 559-62.
Antman KS, Griffin JD, Elias A, Socinski MA, Ryan L, Cannistra SA, et al. Effect of recombinant human granulocyte-macrophage colonystimulating factor on chemotherapyinduced myelosuppression. N Engl J Med 1988; 319(10): 593-8.
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): 234-7.