Paraneoplastic Hyperleukocytosis Mimicking Hematologic Malignancy Revealing a Localized Lung Cancer

Amira Marouf; Nicolas Chapuis; Anne Sophie Alary; Barbara Burroni; Olivier Kosmider; Marco Alifano; Didier Bouscary

doi:10.1016/j.athoracsur.2019.06.064

Paraneoplastic Hyperleukocytosis Mimicking Hematologic Malignancy Revealing a Localized Lung Cancer

Ann Thorac Surg. 2020 Mar;109(3):e203-e206. doi: 10.1016/j.athoracsur.2019.06.064. Epub 2019 Aug 10.

Authors

Amira Marouf¹, Nicolas Chapuis², Anne Sophie Alary³, Barbara Burroni⁴, Olivier Kosmider², Marco Alifano⁵, Didier Bouscary⁶

Affiliations

¹ Université Paris Descartes, Faculté de Médecine, Sorbonne Paris Cité, Paris, France; Service d'Hématologie, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France. Electronic address: amira.marouf@aphp.fr.
² Université Paris Descartes, Faculté de Médecine, Sorbonne Paris Cité, Paris, France; Service d'Hématologie Biologique, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France; INSERM U1016, Institut Cochin, Paris, France.
³ Université Paris Descartes, Faculté de Médecine, Sorbonne Paris Cité, Paris, France; Service d'Hématologie Biologique, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France.
⁴ Université Paris Descartes, Faculté de Médecine, Sorbonne Paris Cité, Paris, France; Service de Pathologie, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France.
⁵ Université Paris Descartes, Faculté de Médecine, Sorbonne Paris Cité, Paris, France; Service de Chirurgie Thoracique, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France.
⁶ Université Paris Descartes, Faculté de Médecine, Sorbonne Paris Cité, Paris, France; Service d'Hématologie, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France; INSERM U1016, Institut Cochin, Paris, France.

PMID: 31408646
DOI: 10.1016/j.athoracsur.2019.06.064

Abstract

Paraneoplastic leukemoid reaction is a challenging differential diagnosis when it presents at the time of diagnosis of cancer. Severe hyperleukocytosis with elevation of blood neutrophils and monocytes counts can evoke myeloid hematologic malignancies. We report the case of a patient who presented with blood and bone marrow features highly suggestive of chronic myelomonocytic leukemia. The diagnosis of primary lung sarcomatoid carcinoma was performed. Surgical removal of this tumor which will always remain the priority led to full normalization of blood cell count.

Publication types

Case Reports

MeSH terms

Diagnosis, Differential
Humans
Leukemia, Myelomonocytic, Chronic / pathology*
Leukemoid Reaction / pathology*
Lung Neoplasms / pathology*
Male
Middle Aged
Paraneoplastic Syndromes / pathology*