LWBK1006-41 LWW-Govindan-Review November 24, 2011 11:29
Chapter 41•Paraneoplastic Syndromes 521Question 41.25. A 59-year-old man, with 50 pack-year history of smoking, is found to
have a left upper lobe mass, detected incidentally on chest X-ray. He is
afebrile, and has a chronic productive cough and hemoptysis for the past
2 months. He is noted to have a white blood cell count of 20× 109 /L, with
90% neutrophils. All other cell lines are within normal limits. Leukocyte
alkaline phosphatase (LAP) level is elevated. What is the most likely cause
of his leukocytosis?
A. Bone marrow metastasis from lung cancer
B. Acute bronchitis
C. Hematopoietic cytokine release from his tumor
D. Chronic myelogenous leukemia (CML)