A Case of X-ray Negative Lung Cancer with Elevated Serum Carcinoembryonic Antigen for Seven Years

概要

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A 56-year-old man, whose serum carcinoembryonic antigen (CEA) Ievel had been 7.3ng/ml (normal<5.0) seven years earlier and increased as high as 237.9ng/ml, was referred to our hospi.tal to investigate the causative malignancy. Chest roentgenography on admission showed no abnormal opacities. Chest computed tomography (CT) revealed a small irregular opacity 1 cm in diameter in right S3, and pretracheal ( #3) Iymphadenopathy. This micronodule could be recognized on chest CT taken two years earlier, but could not be confirmed as a lung cancer. Exploratory thoracotomy was performed and the pretracheal lymph nodes were extirpated for frozen sectioning. The diagnosis of lymph node metastases of adenocarcinoma was obtained and subsequently right upper lobectomy and mediastinal lymph node dissection were performed. Immunohistochemical examination showed that the tumor cells stained positively with anti-CEA antibodies. Serum CEA declined remarkably after the operation. We reviewed the diagnostic significance of serum CEA with regard to unknown primary malignancies and evaluated pre-and postoperative levels of CEA as a prognostic indicator.
日本肺癌学会の論文
1999-04-20