Neutrophilia associated with anaplastic carcinoma of the thyroid: Production of macrophage colony-stimulating factor (M-CSF) and interleukin-6

Cancers associated with marked neutrophilia are relatively rare. We report here two cases of anaplastic thyroid carcinoma associated with neutrophilia . We measured the concentrations of granulocyte colony-stimulating factor ( G-CSF), macrophage CSF (M-CSF), granulocyte-macrophage CSF (GM-CSF), interl eukin-1 alpha (IL-1 alpha), IL-1 beta, IL-6, and tumor necrosis factor-alph a (TNF-alpha) in sera, pleural effusion, cyst fluid of the thyroid carcinom a region, or culture supernatants of carcinoma cells. Maximum levels of ele vated white blood cell counts reached 106.1 x 10(9)/L (neutrophils 103.0 x 10(9)/L) in case 1 and 62.3 x 10(9)/L (neutrophils 57.9 x 10(9)/L) in case 2. Acute-phase reactants were elevated to various degrees, and hypercalcemi a was found in both cases. IL-6, G-CSF, and M-CSF seemed to play the princi pal roles in neutrophilia in case I, and the elevated levels of IL-6 and M- CSF seemed to mainly contribute to neutrophilia in case 2. Immunohistochemi cal staining revealed that carcinoma cells themselves produce IL-6 regardle ss of the types of carcinoma cells. To our knowledge, this is the first rep ort describing the contribution of M-CSF to neutrophilia in patients with t hyroid carcinoma.