Holtzman R N, Heymann A D, Bordone F, Marinoni G, Barillari P, Wahl S J
Department of Neurosurgery, College of Physicians & Surgeons, Columbia University, NY, USA.
Arch Pathol Lab Med. 2001 Jul;125(7):944-7. doi: 10.5858/2001-125-0944-CAACAI.
A 58-year-old Italian man was incidentally discovered to have an elevated carbohydrate antigen 19-9 (CA-19-9) level of 132 U/mL on routine blood testing. Multisystem imaging studies revealed multiple benign-appearing cysts of the liver and single cysts in the pancreas and kidney parenchyma. Throughout 14 months, fluctuations were observed in the elevated serum CA-19-9 levels from 99 to 450 U/mL. Serum carcinoembryonic antigen (CEA) and other tumor markers were normal. Laparoscopy disclosed multiple cystic lesions on the surface of the liver, on the serosal surface of the ileum, and in the mesentery. Electron microscopy characterized the cells as mesothelial. The pathologic diagnosis was benign multicystic mesothelioma of the peritoneum (BMMP). Aspirated fluid from the liver cyst revealed CA-19-9 levels at 28 500 U/mL, strongly linking the elevated serum CA-19-9 levels with mesothelial cyst secretion. Immunostaining was positive for CA-19-9, CEA, and cancer antigen 125 (CA-125). We believe this is the first documented instance of CA-19-9 and CEA secretion in BMMP.
一名58岁的意大利男子在常规血液检测中意外发现其碳水化合物抗原19-9（CA-19-9）水平升高，为132 U/mL。多系统影像学检查显示肝脏有多个外观良性的囊肿，胰腺和肾实质有单个囊肿。在14个月的时间里，观察到血清CA-19-9水平在99至450 U/mL之间波动。血清癌胚抗原（CEA）和其他肿瘤标志物均正常。腹腔镜检查发现肝脏表面、回肠浆膜表面和肠系膜有多个囊性病变。电子显微镜检查将这些细胞鉴定为间皮细胞。病理诊断为腹膜良性多囊性间皮瘤（BMMP）。从肝囊肿抽出的液体显示CA-19-9水平为28500 U/mL，有力地证明了血清CA-19-9水平升高与间皮囊肿分泌有关。免疫染色显示CA-19-9、CEA和癌抗原125（CA-125）呈阳性。我们认为这是BMMP中CA-19-9和CEA分泌的首例文献记载病例。
