A Resected Case of Creatine Kinase Producing Adenocarcinoma of the Lung With Elevated Levels of Serum Macro-CK.

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• <B>Background</B>: We report a case of adenocarcinoma of the lung producing creatine kinase (CK) with elevated levels of serum macro-CK.<BR><B>Case</B>: A 56-year-old man was referred to our hospital because of a mass in the right lower lung field. Cells of squamous cell carcinoma were detected in smears obtained by bronchoscopy from the mass located in Sw. A diagnosis of primary lung cancer with a clinical stage of IIIB, (T2N3M0), was given after serial examinations with CT and scintigraphy. The serum CK level elevated to 423IU/l with a regular pattern in the electrophoretic mobility of its isoenzymes. Further studies revealed that the native CK was a macromolecule consisting of a CK-immunoglobulin complex and that the binding protein was IgA of which the light chain linking to CK was γ type. Clinical or neurophysiological examinations did not show any finding of either polymyositis (PM) or dermatomyositis (DM), suggesting that CK may be produced by lung cancer. After induction chemotherapy consisting of carboplatin (CBDCA) and etoposide (VP-16), right lower extended segmentectomy S10 with lymph node sampling was performed. The histologic type of the neoplasm was shown to be moderately differentiated papillary adenocarcinoma with foci of squamous cell carcinoma. Immunohistochemically, adenocarcinoma cells were stained focally with both anti-CK-MM and anti-CK-BB antibodies. Although both the chomotherapy and the surgical resection resulted in a transient decline of the serum CK level, it rapidly elevated with tumor relapse and metastasis. The patient died of disseminated intravascular coagulation (DIC) 9 months after surgery.<BR><B>Conclusion</B>: We concluded that adenocarcinoma cells of the lung in this case produce CK, resulting in the formation of macromolecules consisting of CK-immunoglobulin complexes, and demonstrate that non-small cell lung cancer may produce not only CK-BB but CK-MM.

• 特定非営利活動法人 日本肺癌学会の論文

特定非営利活動法人 日本肺癌学会 | 論文

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