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Paraneoplastic Leukemoid Reaction in Solid Tumors

Chakraborty, Subhankar MD, PhD*; Keenportz, Brent MD; Woodward, Suzette MD; Anderson, Jay MD; Colan, David MD

American Journal of Clinical Oncology: June 2015 - Volume 38 - Issue 3 - p 326–330
doi: 10.1097/COC.0b013e3182a530dd
Review Articles

Leukemoid reaction is defined as leucocytosis >50,000/μL. When it occurs in association with a malignancy, and infection or leukemia has been ruled out, it is termed as paraneoplastic leukemoid reaction. A patient presented with fatigue, generalized weakness, and abdominal distension and was incidentally noted to have a white blood cell count of 139,000/μL. Leukemia was ruled out by peripheral smear and flow cytometry. Computed tomography–guided biopsy of thickened omentum revealed poorly differentiated metastatic carcinoma. He died 3 days after admission with a peak white blood cell count of 180,000/μL. Previous reports and pathophysiology of paraneoplastic leukemoid reaction are reviewed.

*Department of Internal Medicine, University of Nebraska Medical Center, Omaha

Department of Pathology, Saint Francis Medical Center

Internal Medical Associates of Grand Island, Grand Island, NE

The authors declare no conflicts of interest.

Reprints: Subhankar Chakraborty, MD, PhD, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE- 68198-2055. E-mail:

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