Intralobar Pulmonary Sequestration Presenting Increased Serum CA19-9 and CA125.

Fifth Department of Internal Medicine, Tokyo Medical University, Inashiki-gun, Ibaraki.
Internal Medicine (Impact Factor: 0.9). 11/2002; 41(10):875-8. DOI: 10.2169/internalmedicine.41.875
Source: PubMed


A 39-year-old man was admitted to our hospital for further evaluation of a consolidated shadow and clarification of the cause of serum tumor marker elevation (CA19-9 496.2 U/ml, CA125 160.6 U/ml). Chest computed tomography revealed a well-defined homogeneous nodule in the left S(10). Angiography showed one aberrant artery, branching from the ascending aorta. Intralobar pulmonary sequestration was diagnosed and the sequestrated lung was resected. Microscopic findings of the sequestrated lung showed a mucus-containing cystically dilated bronchus, which was covered with ciliated cylindrical epithelium. Immunohistochemical staining showed positive staining for CA19-9 and CA125 in both the ciliated cylindrical epithelium and mucus. Serum values of tumor markers returned to their normal range after surgery.

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    • "Although comparable cases have been previously reported in Japan and Korea (10–15), the exact mechanism of the condition remains a controversial subject. Previously, Yagyu et al (16) inferred that CA19-9 may be synthesized and secreted by normal bronchial epithelial cells, and gradually accumulates in the sequestrated lung with no congestion in the normal bronchial tree. In the current case, immunohistochemistry demonstrated weak staining of CA19-9 in the normal bronchial epithelia, however, marked staining was identified in the sequestrated lung tissue, particularly in the mucus of the cysts. "
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