CSF producing gall bladder cancer: case report and characteristics of the CSF produced by tumor cells

Due to an increase in mature neutrophils, a 72-year-old female with gall bladder cancer showed leukocytosis of up to 1.32 X 10(11)/l; hypercalcemia was up to 7.7 mEq/l in her terminal stage. Leukocyte counts and calcium values increased as the tumor progressed. There was no sign of infection or bone marrow metastasis. Cultured cells from the tumor tissue produced high colony-stimulating factor (CSF) activity into the supernatant. The tumor cell-conditioned medium stimulated exclusively granulocytic colonies. The study of this patient shows that leukocytosis was caused by the CSF produced by tumor cells. Approximately 90% of CSF activity was lost by heat treatment at 60 degrees C for 30 min. The CSF was stable over a pH range of 3-11 and was inactivated by treatment with proteolytic enzymes, but was not affected by treatment with DNase or neuraminidase. Molecular weight of the CSF, demonstrated by fractionation using Sephacryl S-200, was approximately 27,000 to 30,000.