Skip to content
BY-NC-ND 3.0 license Open Access Published by De Gruyter Open Access August 9, 2011

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

  • Maciej Machaczka EMAIL logo , Jerzy Hubert , Filip Kasina and Monika Klimkowska
From the journal Open Medicine

Abstract

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.

[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.0b013e32831c841f10.1097/MOH.0b013e32831c841fSearch in Google Scholar

[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.x10.1111/j.1365-2141.2006.06038.xSearch in Google Scholar

[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.2010.04.01110.1016/j.jaci.2010.04.011Search in Google Scholar

[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 Search in Google Scholar

[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.1999.03.63810.3810/pgm.1999.03.638Search in Google Scholar

[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:18:4:28510.1385/MO:18:4:285Search in Google Scholar

[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;2-310.1002/1097-0142(19910801)68:3<543::AID-CNCR2820680317>3.0.CO;2-3Search in Google Scholar

[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/10.1159/00023729410.1159/000237294Search in Google Scholar

[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.x10.1111/j.1572-0241.2007.01772_16.xSearch in Google Scholar

[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;2-610.1002/1097-0142(19870815)60:4<903::AID-CNCR2820600431>3.0.CO;2-6Search in Google Scholar

[11] Henry DW, Rosenthal A, McCarty DJ. Adenocarcinoma of the lung associated with eosinophilia and hidebound skin. J Rheumatol 1994;21:972–973 Search in Google Scholar

[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/s00432-008-0503-210.1007/s00432-008-0503-2Search in Google Scholar

Published Online: 2011-8-9
Published in Print: 2011-10-1

© 2011 Versita Warsaw

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Downloaded on 1.3.2024 from https://www.degruyter.com/document/doi/10.2478/s11536-011-0048-7/html
Scroll to top button