Multiple cytokines-producing pleomorphic carcinoma of lung with metastasis to the small intestine

A 58-year-old man underwent upper lobectomy for primary pleomorphic carcinoma of the lung. Nine months later, the pleomorphic carcinoma was recurred with marked peripheral leukocytosis and an elevated C-reactive protein. Chest and abdominal computed tomography (CT) revealed enlarged mediastinal lymph nodes and a bulky tumor in the small intestine. An enterectomy was performed and the intestinal tumor was removed. Immunostaining revealed tumor cells positive for G-CSF and TNF-α as well as an increased level of serum G-CSF and TNF-α. We describe a rare case of G-CSF and TNF-α producing pleomorphic carcinoma of the lung with metastasis to the small intestine.