Mori Kousuke, Ohtsuki Yuji
Division of Internal Medicine, Syuso Public Hospital, 131 Nyuugawa, Tohyo City, Ehime, 799-1341, Japan.
Nihon Kokyuki Gakkai Zasshi. 2002 May;40(5):360-4.
A 64-year-old man was admitted to our hospital complaining of Hugh-Jones II dyspnea. Chest CT showed multiple diffuse patchy shadows in both lung fields. A diagnosis of pulmonary carcinomatous lymphangiosis was made on the basis of the presence of adenocarcinoma cells within the lymphatic vessels in transbronchial lung biopsy (TBLB) specimens. The primary site was a tumor in the stomach. It is very rare for pulmonary carcinomatous lymphangiosis to show multiple patchy shadows in CT. Tumor cells were positive for CA 19-9. There were high titers of carbohydrate antigens, SPAN-1, CA 19-9, SLX, CA 125 and CA 724 both in the bronchial alveolar fluid (BALF) and in the serum. SPAN-1, CA 19-9 and SLX titers were higher in the BALF than in the serum. In this case, liver metastasis had also occurred with carcinomatous lymphangiosis. This case is very interesting in that type I and II carbohydrate antigens were correlated with blood-borne metastasis.
一名64岁男性因主诉Hugh-Jones II级呼吸困难入住我院。胸部CT显示双肺野多发弥漫性斑片状阴影。经支气管肺活检（TBLB）标本的淋巴管内发现腺癌细胞，据此诊断为肺癌性淋巴管炎。原发部位是胃的肿瘤。肺癌性淋巴管炎在CT上表现为多发斑片状阴影非常罕见。肿瘤细胞CA 19-9呈阳性。支气管肺泡灌洗液（BALF）和血清中碳水化合物抗原SPAN-1、CA 19-9、SLX、CA 125和CA 724均呈高滴度。BALF中SPAN-1、CA 19-9和SLX滴度高于血清。该病例中，癌性淋巴管炎还伴有肝转移。该病例非常有趣，因为I型和II型碳水化合物抗原与血行转移相关。
