Granulocyte colony-stimulating factor-producing lung cancer complicated with antiphospholipid antibody syndrome: a case report.

No reports on granulocyte colony-stimulating factor-producing lung cancer associated with antiphospholipid antibody syndrome. A 73-year-old man was referred to our department to undergo surgery for lung cancer in the right upper lobe. His examination results suggested that his condition was caused by an elevated white blood cell count and an increased inflammatory response due to granulocyte colony-stimulating factor production. The presence of antiphospholipid antibody syndrome was suspected, and the decrease in coagulation factors was considered to be inhibited by the lupus anticoagulant. Perioperatively, the patient was treated with heparin and steroids, and a thoracoscopically assisted right upper lobectomy was performed. Postoperatively, histopathological examination revealed pleomorphic carcinoma, and the patient tested negative for anticardiolipin IgG antibodies. In lung cancer patients with elevated white blood cell counts, fever, and an inflammatory response, granulocyte colony-stimulating factor-producing lung cancer is an important differential diagnosis. Additionally, when coagulation abnormalities are observed preoperatively, a thorough examination is necessary to prepare for perioperative management.

[Pulmonary pleomorphic carcinoma with rapid growth causing death in a short period after surgery; report of a case].

Pleomorphic carcinoma is rare in the primary lung cancer with a poor prognosis. We reported a resected case of pleomorphic carcinoma of the lung with rapid progression. A 62-year-old male with a tumor shadow in the right lung which had not been noted 9 months before was referred to our hospital. The abnormal shadow was not noted 9 months ago. The tumor located in the right lower lobe and rapidly enlarged from 7.5 cm to 9.5 cm in a month. Right pneumonectomy was necessary, because of the intrapulmonary metastasis in the right upper lobe. Pathological findings showing spindle cells with massive necrosis, were consistent with a diagnosis of pleomorphic carcinoma. Only by 45 days after operation, local recurrence and metastases to the brain, right adrenal gland and small intestine were found, resulting in death at 67 days after operation.

[Comparison between predicted equations obtained by standard Japanese values and present predicted equations for vital capacity and forced expiratory volume in one second].

Until recently, predicted values of vital capacity (VC) and forced expiratory volume in one second (FEV1) have been calculated with Baldwin's equation (VC-B) and Berglund's equation (FEV1-B) respectively, in Japan. Due to several problems using these equations, new prediction equations of VC (VC-J) and FEV1 (FEV1-J), which were created using data from healthy Japanese, were provided by the Japanese Respiratory Society in 2001. In the present study, we studied the validity of these prediction equations. Also, we compared the outcomes of patients who match respiratory handicap "indexes" with VC-B and VC-J. The subjects were all adult patients whose respiratory function was tested in Asahikawa Medical College Hospital between 1998 and 2006. Cases which were diagnosed as contractive respiratory disorder increased approximately 2-fold when %VC was calculated with VC-J compared with VC-B. Grade 4 or higher respiratory handicap scores increased 20% if the index was calculated with VC-J compared with VC-B. There was no significant difference in mortality between the respiratory handicap grade 3 scores calculated with VC-J and VC-B. Also, there was no significant difference in mortality between grade 4 respiratory handicap scores calculated with VC-J and VC-B. These findings suggest that the prediction equations using Japanese data increase the number of predicted respiratory disorders, and those additional cases have the same prognoses as those cases diagnosed with the former criteria.

Renal abscess with Morganella morganii complicating leukemoid reaction.

We report a case of leukemoid reaction (LR) complicating renal abscess caused by Morganella morganii infection in an 80-year-old man. On administration, laboratory tests revealed white blood cell count of 76160 /microL and C reactive protein 3.09 mg/dL. Although chronic myeloid leukemia was suspected, bcr/abl fusion transcript was not observed. Contrast enhanced computer tomography imaging of the abdomen showed abscess in the right kidney. M. morganii was detected repeatedly in material of liquid from the abscess and arterial blood culture. To our knowledge, this is the first case of M. morganii infection complicating LR.