下腿部に発生した白血病反応を伴う未分化多形肉腫によるG-CSF産生：症例報告．

G-CSF Production by Undifferentiated Pleomorphic Sarcoma with Leukemoid Reaction Occurred in the Lower Leg: A Case Report.

• Kenta Hayashida
• Yusuke Kawabata
• Ikuma Kato
• Michiaki Suzuki
• Masanobu Takeyama
• Yutaka Inaba

抄録

症例:

46歳女性が下腿部に腫瘤と重度の白血球症を呈した．骨へのびまん性の取り込みは、F-FDG PET/CT（Computed Tomography）画像を用いたF-フルオロデオキシグルコースポジトロン断層撮影で検出された。血清顆粒球-コロニー刺激因子（G-CSF）が上昇し，G-CSFの免疫染色が陽性であった．G-CSF産生性未分化多形肉腫（UPS）と診断された場合、広汎切除を行った。腫瘍切除後、白血球数、血清G-CSFは著しく改善した。局所再発や転移は認められなかった。

CASE: A 46-year-old woman presented with a mass in the lower leg and severe leukocytosis. Diffuse uptake in the bones was detected with F-fluorodeoxyglucose positron emission tomography with computed tomography (F-FDG PET/CT) imaging. The serum granulocyte-colony stimulating factor (G-CSF) was elevated, and immunostaining for G-CSF was positive. When diagnosed as G-CSF-producing undifferentiated pleomorphic sarcoma (UPS), a wide resection was performed. The leukocytosis and serum G-CSF were remarkably improved after tumor resection. No local recurrence or metastasis was detected.

結論:

四肢に炎症性UPSを発症し、G-CSFの産生が認められた最初の症例を報告する。本症例では、F-FDG PET/CT、血清G-CSF、G-CSFの免疫染色が診断に有用であった。

CONCLUSION: We report the first case of inflammatory UPS in the extremity which demonstrated the neoplastic production of G-CSF. In our case, F-FDG PET/CT, the serum G-CSF, and immunostaining for G-CSF were useful for diagnosis.