Premium
Carcinosarcoma of the liver producing granulocyte‐colony stimulating factor
Author(s) -
Aita Kumi,
Seki Kunihiko
Publication year - 2006
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.2006.01979.x
Subject(s) - carcinosarcoma , pathology , autopsy , immunohistochemistry , granulocyte colony stimulating factor , leukocytosis , medicine , carcinoma , biology , chemotherapy
An autopsy case of carcinosarcoma of the liver producing granulocyte‐colony stimulating factor (G‐CSF) is reported. The patient, a 74‐year‐old Japanese man, presented with multiple liver masses. His serum G‐CSF was elevated to 286 pg/mL and a marked leukocytosis of 19 100/µL was observed. The patient had a rapidly aggravated clinical course and died 57 days after admission. Autopsy revealed a liver carcinosarcoma composed both of hepatocellular carcinoma (HCC) and sarcomatous elements immunoreactive with α‐smooth muscle actin and desmin. Immunohistochemistry revealed positive staining of G‐CSF in the cytoplasm of HCC, whereas none of the spindle cells was positively stained. Production of G‐CSF was also confirmed by enzyme‐linked immunosorbent assay, using the frozen tumor tissue taken at the autopsy. Similar to the majority of G‐CSF‐producing tumors in the literature, only the epithelial elements of the present case were immunopositive for G‐CSF. Although a monoclonal origin of carcinosarcomas has generally been proposed, heterologous differentiation from a single clone might lead to the production of G‐CSF only in the epithelial element in the present case. It is suggested that G‐CSF was associated with the high‐grade transformation of the epithelial elements, as well as the reported phenomenon of conventional HCC producing G‐CSF.