Leucocytosis in a case of Lung Cancer: Infection or Paraneoplastic Syndrome? - Dilemma in Diagnosis and Treatment
- Author:
Sudipta Pandit
;
Sabyasachi Choudhury
;
Sibes Kumar Das
;
Saumen Nandi
- Publication Type:Case Reports
- Keywords:
Paraneoplastic syndrome, Leucocytosis, Lung cancer
- From:
The Medical Journal of Malaysia
2012;67(5):542-544
- CountryMalaysia
- Language:English
-
Abstract:
A 65 year old male smoker was diagnosed with squamous
cell carcinoma of upper lobe of the right lung complicated
with Horner’s syndrome and gradually increasing
leucocytosis. Alhough the inflammatory biomarker level in
serum was low, there was no definite way to determine the
cause of the leucocytosis (whether infection or hematologic
paraneoplastic syndrome). After empirical antibiotic therapy, his fever subsided but the leucocytosis persisted. It was difficult for us to take a decision regarding the priority of the treatment of infection or the lung cancer. Only after the first cycle chemotherapy, did the leucocytosis rapidly drop down. Normal serum procalcitonin level and quick response
to chemotherapy indicated that leucocytosis was a
manifestation of paraneoplastic syndrome. Treating the
underlying cancer is the first step.
