Limits...
Intralobar Pulmonary Sequestration Showing Increased Serum CA19-9.

Ahn YH, Song MJ, Park SH - Tuberc Respir Dis (Seoul) (2012)

Bottom Line: CA19-9 is occasionally elevated in serum in patiens with benign pulmonary diseases such as bronchiectasis, idiopathic interstitial pneumonia or collagen disease-associated pulmonary fibrosis.There have been some reports of elevation of CA19-9 in this lesion.He had no evidence of any malignant disease in pancreatobiliary or gastrointestinal tracts.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Plus Internal Medicine Clinic, Suncheon, Korea.

ABSTRACT
Carbohydrate antigen 19-9 (CA19-9) is a specific tumor marker of the biliary, pancreatic and gastrointestinal tracts. CA19-9 is occasionally elevated in serum in patiens with benign pulmonary diseases such as bronchiectasis, idiopathic interstitial pneumonia or collagen disease-associated pulmonary fibrosis. Intralobar pulmonary sequestration is an uncommon congenital lung anomaly. It is dissociated from the normal tracheobronchial tree and is supplied by an anomalous systemic artery. There have been some reports of elevation of CA19-9 in this lesion. We report a case of intralobar pulmonary sequestration with elevated serum CA19-9 in a 29-year-old man who was diagnosed with bronchiectasia of left lower lung field on general check up. He had no evidence of any malignant disease in pancreatobiliary or gastrointestinal tracts. Elevated serum CA19-9 level might be encountered with benign pulmonary disease such as pulmonary sequestration.

No MeSH data available.


Related in: MedlinePlus

Volume rendering image demonstrates an artery (arrow) originating from the descending aorta and supplying the intralobar pulmonary sequestration. Also note a large draining vein (double arrow) originating from the sequestration and draining into the left inferior pulmonary vein.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC3475460&req=5

Figure 3: Volume rendering image demonstrates an artery (arrow) originating from the descending aorta and supplying the intralobar pulmonary sequestration. Also note a large draining vein (double arrow) originating from the sequestration and draining into the left inferior pulmonary vein.

Mentions: A 29-year-old man visited our clinic for evaluation of abnormal finding in chest computed tomography (CT). One month ago visiting clinic, he had general check up in a medical examination center in Seoul. He was suspected of pneumonia and bronchiectasis in chest CT with elevated serum CA19-9 level. He was a company staff, a non-smoker and had no family history of pulmonary tuberculosis or bronchiectasis. He had no previous history of frequent pulmonary infection in his early years. At 20, he was diagnosed as pneumonia and admitted for 1 week without any information or comment on other pulmonary diseases. In the blood test from work place health examination checked 3 years and 1 year ago, CA19-9 level was found to be elevated over 300 U/mL, followed by esophagogastroduodenoscopy (EGD), colonoscopy, abdominal ultrasonography and CT with no specific abnormal finding found. He has been on observation since then. He appeared relatively healthy and neither sign of fever, chills, weight loss nor pulmonary or digestive symptom was observed at the time of visit. His blood pressure was 138/81 mm Hg, pulse rate 72/min, respiratory rate 20/min, and body temperature 36.4℃. There were no pains or rebound tenderness, or any palpable mass in the abdominal examination. No other specific abnormality was found other than minimal decrease of breathing sound in the left lower lung field in auscultation. All the result for blood test checked in the examination center 1 month ago were normal except elevated CA19-9 level to 626 U/mL. Complete blood count result at the visit were normal (white blood cell 6,200/mm3, hemoglobin 14.1 g/dL, and platelet 209,000/mm3). In the chemistry panel, aspartate aminotransferase 26 IU/L, alanine aminotransferase 33 IU/L, alkaline phosphatase 73 IU/L, total protein 8.3 g/dL, albumin 4.8 g/dL, total bilirubin 0.6 mg/dL, amylase 44 U/L, all of which were within reference range. Tumor markers tested at the same day with radioimmunoassay showed elevated CA19-9 level to 248.3 U/mL, but all the other results were within normal range (alpha fetoprotein 6.80 ng/mL, carcinoembryonic antigen [CEA] 3.1 ng/mL, CA125 24.4 U/mL). No other specific abnormality was found other than chronic superficial gastritis in the examinations including EGD and colonoscopy. In the abdominal ultrasonography and CT, all finding in intrahepatic bile duct, common bile duct, and pancreas were normal. Chest high-resolution CT at the medical examination showed emphysematous change with bronchiectasis (Figure 1), which were similar to the chest CT findings checked again in our clinic. However, left to left shunt formed by artery supplying blood flow from descending aorta to left lower pulmonary lobe (Figure 2) and venous outflow to left inferior pulmonary vein was identified and diagnosed as intralobar pulmonary sequestration (Figure 3).


Intralobar Pulmonary Sequestration Showing Increased Serum CA19-9.

Ahn YH, Song MJ, Park SH - Tuberc Respir Dis (Seoul) (2012)

Volume rendering image demonstrates an artery (arrow) originating from the descending aorta and supplying the intralobar pulmonary sequestration. Also note a large draining vein (double arrow) originating from the sequestration and draining into the left inferior pulmonary vein.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3475460&req=5

Figure 3: Volume rendering image demonstrates an artery (arrow) originating from the descending aorta and supplying the intralobar pulmonary sequestration. Also note a large draining vein (double arrow) originating from the sequestration and draining into the left inferior pulmonary vein.
Mentions: A 29-year-old man visited our clinic for evaluation of abnormal finding in chest computed tomography (CT). One month ago visiting clinic, he had general check up in a medical examination center in Seoul. He was suspected of pneumonia and bronchiectasis in chest CT with elevated serum CA19-9 level. He was a company staff, a non-smoker and had no family history of pulmonary tuberculosis or bronchiectasis. He had no previous history of frequent pulmonary infection in his early years. At 20, he was diagnosed as pneumonia and admitted for 1 week without any information or comment on other pulmonary diseases. In the blood test from work place health examination checked 3 years and 1 year ago, CA19-9 level was found to be elevated over 300 U/mL, followed by esophagogastroduodenoscopy (EGD), colonoscopy, abdominal ultrasonography and CT with no specific abnormal finding found. He has been on observation since then. He appeared relatively healthy and neither sign of fever, chills, weight loss nor pulmonary or digestive symptom was observed at the time of visit. His blood pressure was 138/81 mm Hg, pulse rate 72/min, respiratory rate 20/min, and body temperature 36.4℃. There were no pains or rebound tenderness, or any palpable mass in the abdominal examination. No other specific abnormality was found other than minimal decrease of breathing sound in the left lower lung field in auscultation. All the result for blood test checked in the examination center 1 month ago were normal except elevated CA19-9 level to 626 U/mL. Complete blood count result at the visit were normal (white blood cell 6,200/mm3, hemoglobin 14.1 g/dL, and platelet 209,000/mm3). In the chemistry panel, aspartate aminotransferase 26 IU/L, alanine aminotransferase 33 IU/L, alkaline phosphatase 73 IU/L, total protein 8.3 g/dL, albumin 4.8 g/dL, total bilirubin 0.6 mg/dL, amylase 44 U/L, all of which were within reference range. Tumor markers tested at the same day with radioimmunoassay showed elevated CA19-9 level to 248.3 U/mL, but all the other results were within normal range (alpha fetoprotein 6.80 ng/mL, carcinoembryonic antigen [CEA] 3.1 ng/mL, CA125 24.4 U/mL). No other specific abnormality was found other than chronic superficial gastritis in the examinations including EGD and colonoscopy. In the abdominal ultrasonography and CT, all finding in intrahepatic bile duct, common bile duct, and pancreas were normal. Chest high-resolution CT at the medical examination showed emphysematous change with bronchiectasis (Figure 1), which were similar to the chest CT findings checked again in our clinic. However, left to left shunt formed by artery supplying blood flow from descending aorta to left lower pulmonary lobe (Figure 2) and venous outflow to left inferior pulmonary vein was identified and diagnosed as intralobar pulmonary sequestration (Figure 3).

Bottom Line: CA19-9 is occasionally elevated in serum in patiens with benign pulmonary diseases such as bronchiectasis, idiopathic interstitial pneumonia or collagen disease-associated pulmonary fibrosis.There have been some reports of elevation of CA19-9 in this lesion.He had no evidence of any malignant disease in pancreatobiliary or gastrointestinal tracts.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Plus Internal Medicine Clinic, Suncheon, Korea.

ABSTRACT
Carbohydrate antigen 19-9 (CA19-9) is a specific tumor marker of the biliary, pancreatic and gastrointestinal tracts. CA19-9 is occasionally elevated in serum in patiens with benign pulmonary diseases such as bronchiectasis, idiopathic interstitial pneumonia or collagen disease-associated pulmonary fibrosis. Intralobar pulmonary sequestration is an uncommon congenital lung anomaly. It is dissociated from the normal tracheobronchial tree and is supplied by an anomalous systemic artery. There have been some reports of elevation of CA19-9 in this lesion. We report a case of intralobar pulmonary sequestration with elevated serum CA19-9 in a 29-year-old man who was diagnosed with bronchiectasia of left lower lung field on general check up. He had no evidence of any malignant disease in pancreatobiliary or gastrointestinal tracts. Elevated serum CA19-9 level might be encountered with benign pulmonary disease such as pulmonary sequestration.

No MeSH data available.


Related in: MedlinePlus