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首页> 外文期刊>European thyroid journal >Excessive Leukocytosis Leading to a Diagnosis of Aggressive Thyroid Anaplastic Carcinoma: A Case Report and Relevant Review
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Excessive Leukocytosis Leading to a Diagnosis of Aggressive Thyroid Anaplastic Carcinoma: A Case Report and Relevant Review

机译：过量白细胞增多导致侵略性甲状腺类癌癌的诊断：案例报告和相关审查

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Introduction: Leukocytosis and particularly neutrophilia are usually caused by acute infection, inflammation, and myeloproliferative neoplasms. However, leukocytosis can also occur in patients with malignancy either due to bone marrow metastases or in the context of a paraneoplastic syndrome. Case Presentation: An 86-year-old female was admitted to our hospital due to marked leukocytosis (white blood cells [WBC] >40,000/mu L), neutrophilia, and monocytosis. She was afebrile and reported hoarseness and mild difficulty swallowing. Upon physical examination, lung auscultation revealed inspiratory wheezing and a non-tender mass was observed in the anterior midline of the neck. Blasts and immature WBC were not found, and polymerase chain reaction for the detection of BCR/ABL gene was negative. A mass (5.4 cm in diameter) of abnormal parenchymal composition with calcifications occupying the right lobe, was seen on thyroid ultrasound. Cytology, after fine-needle aspiration, showed an anaplastic thyroid carcinoma (ATC). The cervical and chest computed tomography scan revealed a low-density lesion with calcifications that shifts and presses the trachea and multiple lung nodular lesions bilaterally. Since the case was inoperable and the airway was severely obstructed, a DUMON stent was placed. Biopsy of specimens from the trachea lesion revealed a tumor with significant atypical cells and focal squamoid features. The patient's WBC increased to 72,470/mu L. Additionally, interleukin-6 (IL-6) was markedly elevated (20.2 pg/mL). The patient passed away due to respiratory arrest 55 days after her initial admission. Discussion: Excessive leukocytosis in a patient, having excluded infectious disease and myelodysplastic syndrome, could represent a manifestation of a paraneoplastic syndrome due to various cytokines secretion from the tumor. In our case, ATC synthesized and secreted IL-6, which seems to be the cause of severe leukocytosis.
机译：简介：白细胞增多症和特别是中性粒细胞菌通常是由急性感染，炎症和髓原瘤引起的。然而，由于骨髓转移或在平原综合征的背景下，恶性肿瘤患者也可以发生白细胞增多症。案例介绍：由于白细胞增多率为（白细胞[WBC]> 40,000 / mu L），中性粒细胞和单胞菌，由于白细胞增多症（白细胞[WBC]> 40,000 / mu），一名86岁的女性被录取到我们的医院。她被解散并报告了嘶哑，吞咽困难。体检后，肺听诊显示鼓舞性的喘息，在颈部前线观察到非柔软的肿块。未发现爆炸和未成熟的WBC，并检测BCR / ABL基因的聚合酶链反应为阴性。在甲状腺超声中看到占据右侧叶的异常实质组合物的质量（直径为5.4厘米）。细胞学，细针吸入后，显示出一种包塑性甲状腺癌（ATC）。宫颈和胸部计算断层扫描扫描显示出低密度的病变，钙化钙化，双侧移动和压制气管和多种肺结结病变。由于这种情况无法操作，并且气道严重阻碍，放置了一个杜松支架。气管病变的标本活组织检查显示出具有显着的非典型细胞和局灶性体积特征的肿瘤。患者的WBC增加到72,470 / mu L.此外，白细胞介素-6（IL-6）显着升高（20.2pg / ml）。患者因初步入院后55天而被呼吸逮捕。讨论：患者过量的白细胞增多，被排除的传染病和髓细胞转化综合征，由于各种细胞因子分泌来自肿瘤的各种细胞因子。在我们的情况下，ATC合成和分泌的IL-6，似乎是严重白细胞增多的原因。

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