Shioji Y, Akazai Y, Takahata T, Okamoto Y, Ohara T, Tsutsui N, Hirose S, Kataoka K
Department of Surgery, Okayama Saiseikai General Hospital, Japan.
Nihon Geka Gakkai Zasshi. 1996 Apr;97(4):325-9.
A 75-year-old female had loss of appetite, left hypochondrial and back pain. An X-ray and a computed tomogram of both lungs showed multiple small granular shadows. By Tc-labelled bone scintigram, multiple uptakes were found. Since high serum CA19-9 was obtained, pancreatic or bile duct cancer with multiple lung and bone metastasis was suspected. The autopsy revealed, small nodules in both lungs were well-differentiated adenocarcinoma, bronchiolo-alveolar type, and immunohistologically, tumor cells were stained positively for CA19-9. Since CA19-9 exists in normal bronchial glands and bronchiole, high level of serum CA19-9 in our patient may be derived from the neoplastic bronchiolar epithelium.
一名75岁女性出现食欲不振、左季肋部及背部疼痛。双肺X线及计算机断层扫描显示多个小颗粒状阴影。通过锝标记骨闪烁造影，发现多处放射性摄取。由于血清CA19-9水平升高，怀疑为伴有双肺及骨转移的胰腺癌或胆管癌。尸检显示，双肺小结节为高分化腺癌，细支气管肺泡型，免疫组织化学检查显示肿瘤细胞CA19-9染色呈阳性。由于正常支气管腺体和细支气管中存在CA19-9，该患者血清CA19-9水平升高可能源于肿瘤性细支气管上皮。
