Ishikawa Hiroaki, Anzai Mari, Kishimoto Ayaka, Namiki Tomohiro, Nakagawa Ryusei, Sunabe Hiroya, Inui Toshihide, Watanabe Hiroko, Dai Yuichi, Sakamoto Tohru
Department of Respiratory Medicine Tsukuba Memorial Hospital Tsukuba Japan.
Department of Diagnostic Pathology Tsukuba Memorial Hospital Tsukuba Japan.
Respirol Case Rep. 2025 Jul 1;13(7):e70263. doi: 10.1002/rcr2.70263. eCollection 2025 Jul.
We present the case of a 56-year-old woman diagnosed with allergic bronchopulmonary aspergillosis (ABPA) who showed multiple nodular shadows on a chest x-ray. The patient displayed increased blood eosinophil counts and elevated serum levels of tumour markers including carcinoembryonic antigen (CEA), squamous cell carcinoma (SCC) antigen, and sialyl Lewis X (SLX). Computed tomography revealed that these abnormal shadows reflected central bronchiectasis with mucus plugs. The patient was started on prednisolone, which immediately normalised peripheral blood eosinophils. In contrast, serum CEA, SCC antigen, and SLX levels decreased slowly along with the gradual disappearance of the mucus plugs. ABPA with mucus plugs in the bronchi may present with elevated levels of serum tumour markers as well as nodular shadows on chest x-rays, requiring differentiation from malignancy.
我们报告一例56岁女性,诊断为变应性支气管肺曲霉病(ABPA),胸部X线显示多个结节状阴影。患者血液嗜酸性粒细胞计数增加,血清肿瘤标志物水平升高,包括癌胚抗原(CEA)、鳞状细胞癌(SCC)抗原和唾液酸化路易斯X(SLX)。计算机断层扫描显示,这些异常阴影反映了伴有黏液栓的中央型支气管扩张。患者开始使用泼尼松龙治疗,外周血嗜酸性粒细胞立即恢复正常。相比之下,随着黏液栓逐渐消失,血清CEA、SCC抗原和SLX水平缓慢下降。伴有支气管黏液栓的ABPA可能表现为血清肿瘤标志物水平升高以及胸部X线结节状阴影,需要与恶性肿瘤相鉴别。