Hypereosinophilic Syndrome with Liver Involvement in Advanced Lung Cancer

嗜伊紅性白血球超增多症候群（Hypereosinophilic syndrome）合併肝臟侵犯－晚期肺癌的罕見表現

胡釋文(Shih-Wen Hu) ； 蔡子修(Tzu-Hsiu Tsai) ； 施金元(Jin-Yuan Shih)

《胸腔醫學》 30卷4期 (2015/08) Pp. 253-260

摘要

嗜伊紅性白血球增多是實質固態癌（solid cancer）的腫瘤附屬症候群之一，大約可見於3%左右的肺癌病人。而嗜伊紅性白血球超增多症候群，則定義為當血中的嗜伊紅性白血球每微升高於1,500顆、合併組織中有嗜伊紅性白血球浸潤並造成器官損傷。在肺癌病患中，同時患有嗜伊紅性白血球超增多症候群是極少見的。我們提出討論的個案為一位新診斷的晚期肺腺癌病患，同時發現有嚴重的血中嗜伊紅性白血球增多、及肝臟內嗜伊紅性白血球浸潤造成的肝功能異常。此病患在接受化學治療後，血中顯著增加的嗜伊紅性白血球及肝功能異常，皆獲得改善，暗示著此種腫瘤附屬症候群與癌症嚴重程度上有著某種關連。此病患後來病況急速惡化亦顯示嗜伊紅性白血球超增多症候群可能反映腫瘤的高度侵襲性，而為不良預後的指標。

關鍵字

嗜伊紅性白血球超增多症候群 ； 腫瘤附屬症候群 ； 肺癌

並列摘要

Eosinophilia is a paraneoplastic syndrome of solid cancer, and is present in approximately 3% of patients with lung cancer. Hypereosinophilic syndrome is defined when marked blood (≥ 1.5×10^3/μL) and tissue eosinophilia results in a wide variety of organ damage and/ or dysfunction. In patients with lung cancer, hypereosinophilic syndrome is extremely rare. Here, we present a case of advanced lung adenocarcinoma with severe blood eosinophilia and associated eosinophilic hepatitis. The marked blood eosinophilia and associated liver dysfunction resolved after disease control with platinum-based cytotoxic chemotherapy, suggesting that this paraneoplastic phenomenon is linked to tumor extent. However, the rapid disease progression and short survival in our case suggests that reactive hypereosinophilic syndrome may be a poor prognostic indicator associated with aggressive tumors.

並列關鍵字

eosinophilia ； hypereosinophilic syndrome ； paraneoplastic syndrome ； lung cancer