Epithelioid sarcoma presenting as pulmonary cysts with cancer antigen 125 expression

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概要

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• A 39-year-old Japanese woman presented with a swollen right hand and a right-sided pneumothorax. Chest CT revealed bilateral multiple pulmonary thin-walled cysts measuring ≤1 cm in diameter and small nodules. An initial skin biopsy led to a misdiagnosis of metastatic adenocarcinoma, as tumour cells were positive for cytokeratin, epithelial membrane antigen, carcinoembryonic antigen and cancer antigen 125. However, chemotherapy proved ineffective, and the skin biopsy was repeated. A final diagnosis of epithelioid sarcoma (ES) was made. Open lung biopsy showed that the pulmonary nodules represented metastases of ES. Although the pulmonary cyst walls did not contain tumour cells, bronchiolar wall adjacent to the cysts had been infiltrated by tumour cells. These findings suggested that pulmonary cysts, a rare form of pulmonary metastases from soft tissue sarcomas, had developed through a ball-valve effect of metastatic tumour in small airways. However, presence of cancer antigen 125 hindered obtaining a correct diagnosis of ES.

• Blackwell Publishingの論文

著者

• Nishimura M

  First Department Of Medicine Hokkaido University School Of Medicine

• Nakashima M

  Department Of Molecular Immunology And Clinical Immunology Medical Institute Of Bioregulation Kyushu

• Itoh Tomoo

  School Of Pharmaceutical Sciences Kitasato University

• Nakashima M

  Kyushu Univ. Fukuoka Jpn

• Shimizu Hiroshi

  Department Of Dermatology Hokkaido University Graduate School Of Medicine

• Shimizu Tadamichi

  Department Of Dermatology Toyama University School Of Medicine

• Shinoda Hiroyuki

  Faculty Of Pharmaceutical Sciences University Of Toyama

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