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669 INCREASED COLONY STIMULATING ACTIVITY IN THE PLASMA OF A PATIENT WITH LYMPHOEPITHELIOMA METASTATIC TO THE LIVER

Leukocytosis with predominance of polymorphonuclear leukocytes occurs in a variety of primary or metastatic hepatic tumors without apparent explanation. A 17-year-old male with lymphoepithelioma developed marked leukocytosis following the onset of liver metastases. In order to gain insight into the origin of the leukocytosis, granulopoietic colony stimulating activity (CSA) of patient's plasma and leukocytes were examined and compared to control. Leukocyte conditioned media (LCM) was prepared by the double layer culture method. The assay consisted of non-adherent marrow cells from normal individuals cultured in methylcellulose, fetal calf serum and α-media. With the various CSA sources in this system, the number of granulocytic colony forming units (CFU-C) is proportional to the amount of CSA present and therefore allows for quantitative comparisons. The number of CFU-C produced with the patient's plasma was significantly higher (P<0.001) than those obtained from the patient's LCM or from control plasma or LCM. The size and distribution of colony type was similar irrespective of the source of CSA. Major sources of CSA in man are macrophages and monocytes. Thus identification of a stronger stimulatory activity in plasma as compared to LCM indicates the presence of a major new source of CSA in this patient. The fact that leukocytosis paralleled the onset of liver metastases suggests that a CSA derived from tumor products or secondary to hepatocellular damage may be responsible for this finding.