Non‐small‐cell lung cancer associated with excessive eosinophilia and secretion of interleukin‐5 as a paraneoplastic syndrome

Abstract

Eosinophilia associated with solid tumors is an infrequent occurrence. The pathogenesis of tumor-associated eosinophilia is not well understood. Interleukin-5 (IL-5) is a cytokine that has been implicated in the development of eosinophilia in mice and humans. However, there is little data associating IL-5 production with eosinophilia in the presence of tumor. We report, in a patient with locally advanced NSCLC, the presence of excessive eosinophilia and elevated serum IL-5 levels at diagnosis. Immunohistochemical staining of the primary tumor showed large amounts of intracellular IL-5. Both eosinophil count and IL-5 levels normalized after surgical removal of the tumor. Tumor-associated eosinophilia observed in this case is mediated by IL-5. The production of IL-5 is related to the presence of the tumor. Am. J. Hematol. 82:234-237, 2007. V V C 2006 Wiley-Liss, Inc.

Clinico-Pathological Profile and Haematological Abnormalities Associated with Lung Cancer in Bangalore, India

“…IL-5 has been implicated as a causative factor for eosinophilia in lung cancer. Especially non small cell lung cancer is associated with excessive eosinophilia (Pandit et al, 2007).…”

Hematologic Abnormalities Associated With Lung Carcinoma

“…Interleukin-5 has been implicated as a causative factor. 15 Cryoglobulinemia has also been known to accompany various solid tumors, including lung cancer. In 1961, Domz and Chapman reported a case of cryoglobulinemia and digital gangrene that resolved following surgical resection of a non-metastatic lung adenocarcinoma.…”

Diagnostic Complexities of Eosinophilia

“…[29][30][31] The phenomenon is not specific to any particular tumor type, and a broad spectrum of primary tumors have been implicated. [29][30][31][32][33] Instead, paraneoplastic eosinophilia appears to be closely related to tumor stage. In the mid-1940s, Isaacson and Rapoport 29 first noted that blood eosinophilia is a poor prognostic sign and, in almost all cases, is associated with advanced metastatic disease.…”

“…Various mechanisms have been proposed to explain this association, including a response to tumor necrosis, an effect of bone marrow metastasis, and local stimulation by the tumor itself. 33 Granulocyte macrophage colony-stimulating factor, IL-3, and IL-5 have all been implicated, and some tumors are capable of producing these growth factors directly. 33,34 Consistent with these observations, eosinophilia may disappear after surgical excision and reappear with recurrence.…”

“…33 Granulocyte macrophage colony-stimulating factor, IL-3, and IL-5 have all been implicated, and some tumors are capable of producing these growth factors directly. 33,34 Consistent with these observations, eosinophilia may disappear after surgical excision and reappear with recurrence. 29 Because paraneoplastic eosinophilia is generally limited to advanced disease, high-resolution imaging to identify occult tumors is unlikely to provide high-yield diagnostic studies in most cases of unexplained eosinophilia.…”