Seike M, Usuki J, Uematsu K, Enomoto T, Shinoda K, Yoshimori K, Fukuda Y, Kudoh S, Niitani H
Fourth Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1995 Aug;33(8):894-9.
Interstitial pneumonia and recurrent pneumothorax developed in a 48-year-old man who had worked as a metal grinder. He died of respiratory failure despite having received antibiotics and steroids, and despite having undergone pleural sclerosis therapy. Giant cell interstitial pneumonia was diagnosed; innumerable bizarre giant cells engulfing black granules were found within the alveoli. The results of high-energy dispersion X-ray microanalysis indicated that the patient had hard metal pneumoconiosis associated with tungsten in the black granules. When he was admitted to the hospital, his serum CA19-9 and SLEX concentrations were abnormally high (2600 and 200 ng/ml, respectively). Immunohistochemical analysis of lung tissue was done with anti-CA19-9 and SLEX antibodies. CA19-9 staining revealed strong bronchialization and squamous metaplasia in contrast to type II hyperplasia. SLEX staining showed strong type II hyperplasia. Further investigations will be needed to determine the mechanism of elevated tumor-associated carbohydrate antigens in serum.
一名48岁曾从事金属研磨工作的男性患上了间质性肺炎和复发性气胸。尽管接受了抗生素和类固醇治疗，也接受了胸膜硬化治疗，但他最终死于呼吸衰竭。诊断为巨细胞间质性肺炎；在肺泡内发现了无数吞噬黑色颗粒的奇异巨细胞。高能色散X射线微量分析结果表明，该患者患有与黑色颗粒中钨相关的硬金属尘肺。他入院时，血清CA19-9和SLEX浓度异常高（分别为2600和200 ng/ml）。用抗CA19-9和SLEX抗体对肺组织进行免疫组织化学分析。CA19-9染色显示与II型增生相比有强烈的支气管化生和鳞状化生。SLEX染色显示强烈的II型增生。需要进一步研究以确定血清中肿瘤相关碳水化合物抗原升高的机制。
