A case of bronchogenic cyst with high production of antigen CA 19–9

Okubo, Akio; Sone, Saburo; Ogushi, Fumitaka; Ogura, Takeshi; Uyama, Tadashi; Monden, Yasumasa; Kunio,

doi:10.1002/1097-0142(19890515)63:10<1994::aid-cncr2820631021>3.0.co;2-#

Cited by 29 publications

(10 citation statements)

References 12 publications

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“…However, the relation between of CA19-9and bronchogenic cyst has been previously reported in only a few cases (8)(9)(10)(11)(12)(13)). …”

Section: Introductionsupporting

confidence: 90%

“…A small amount of to be elevated to more than 100 U/ml in benign digestive tract diseases such as chronic pancreatitis or cholelithiasis (18). Okuboet al first reported a case ofbronchogenic cyst with high level ofCA19-9 inboth serum and cystic fluidin 1989 (8). Since then there have been five reports that indicate the relationship between bronchogenic cysts and increase of the CA19-9 level in the serum or the cyst fluid (9-13).…”

Section: Discussionmentioning

confidence: 99%

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Bronchogenic Cyst with High Carbohydrate Antigen 19-9 in the Cyst Fluid and the Serum.

Tokuchi¹,

Ukita²,

Tsuneta³

et al. 1998

Intern. Med.

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A mass of 8 cm in diameter was revealed in the right upper lung field of a 46-year-old female patient. The chest X-ray film taken one year previously revealed only a linear shadow in the same position, which was thought to be a vacant cyst. The levels of carbohydrate antigen (CA) 19-9 in cyst fluid and serum were elevated, at 410,000 and 130 U/ml, respectively. After surgical resection, serum CA19-9 returned to normal. Pathologically, the cyst wall was lined with bronchial epithelium with no evidence of malignancy. Immunohistochemical study revealed CA19-9 positivity in the bronchial epithelium of the cyst wall. (Internal Medicine 37: 86-90, 1998)

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“…However, the relation between of CA19-9and bronchogenic cyst has been previously reported in only a few cases (8)(9)(10)(11)(12)(13)). …”

Section: Introductionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Bronchogenic Cyst with High Carbohydrate Antigen 19-9 in the Cyst Fluid and the Serum.

Tokuchi¹,

Ukita²,

Tsuneta³

et al. 1998

Intern. Med.

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“…This possibility was supported by the finding that the serum level of CA 19-9 returned to within the normal range after her total thyroidectomy (Table 2). Similar CA 19-9-producing lung cysts have been reported by Okubo et al (Okubo et al, 1989). Routinely this tumor would have been broadly defined as a follicular or papillary carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Tumor Markers and Oncogene Expression in Thyroid Cancer using Biochemical and Immunohistochemical Studies.

Hashimoto¹,

Matsubara²,

Mizukami

et al. 1990

Endocrinol Japon

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In 111 thyroid cancer patients consisting of 89 papillary carcinomas, 17 follicular carcinomas, 2 medullary carcinomas, 1 squamous cell carcinoma and 2 malignant lymphomas, the levels of 12 tumor markers, including thyroglobulin (Tg), were measured in the serum by radioimmunoassay and radioimmunoassay related methods. Serum levels of Tg were elevated in 58.6%, those of CA-M26 in 15.7%, CA 19-9 in 5.3%, CT in 3.6%, NSE in 3.6%, CA 15-3 in 2.6%, CA 125 in 2.6%, CEA in 0.9%, CA-M 29 in 0%, ferritin in 0%, SCC in 0% and AFP in 0% of cases.Among the patients, there was a case of thyroid carcinoma secreting thyroglobulin and CA 19-9, both of whose titer decreased after surgery.Immunohistochemical studies were carried out on 57 of the above mentioned patients plus 6 anaplastic carcinomas, 15 adenomas, 5 adenomatous goiters, 6 Hashimoto's thyroiditis, 15 Graves' disease and 15 normal subjects. CA 19-9 was positive in 58% of the papillary carcinomas, EGF in 73% of papillary carcinomas, 67% of anaplastic carcinomas, and 33% of follicular carcinomas, while EGF-R was found in 73% of the papillary carcinomas, and 33% of the follicular carcinomas. Enhanced expression of ras p 21 oncogene and (c-myc oncogene) was demonstrated in 100% (100%) of anaplastic carcinomas, in 100% (67%) of follicular carcinomas and in 63% (90%) of papillary carcinomas.Our results indicate that a better tumor marker is required and more extensive molecular oncology research should be pursued.

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“…As bronchogenic cysts are derived from the foregut, it is likely that the epithelial cells of the bronchial glands located in the wall of the cyst secreted CA 19‐9, and without clearance by the bronchial mucus into normal bronchial spaces, it resulted in a gradual accumulation of CA 19‐9 in the cyst. Although bronchogenic cysts are uncommonly associated with a raised CA 19‐9 level, there were several case reports to show that bronchogenic cysts can present similarly with an elevated serum and cystic fluid CA 19‐9 2 . All these reported cases were intrathoracic or of non‐gastric origins.…”

mentioning

confidence: 99%

“…Although bronchogenic cysts are uncommonly associated with a raised CA 19-9 level, there were several case reports to show that bronchogenic cysts can present similarly with an elevated serum and cystic fluid CA 19-9. 2 All these reported cases were intrathoracic or of non-gastric origins. Ours is perhaps the first gastric bronchogenic cyst to present as such.…”

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confidence: 99%

A case of gastric bronchogenic cyst in Singapore with multiple intrigues

Tan

Nandini

2010

ANZ Journal of Surgery

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A 30-year-old lady was referred for the evaluation of a cystic pancreatic mass. The initial ultrasound scan showed a cystic mass measuring 6 ¥ 3 ¥ 3 cm adjacent to the tail of the pancreas. Clinical examination was unremarkable. Subsequently, a computed tomography (CT) scan was performed and showed a 5.1 ¥ 3.6 ¥ 4.6 cm well-circumscribed cystic lesion arising from the body of the pancreas (Fig. 1). The lesion was exophytic in nature and extended superiorly to just below the left hemidiaphragm. No calcification or septation was seen. Her serum carbohydrate antigen 19-9 (CA 19-9) was also found to be elevated at 86 U/mL (0-35 U/mL).An endoscopic ultrasound (EUS), together with fine needle aspiration (FNA) of the cyst, was performed. It showed that the cyst was arising from the body/tail region of the pancreas, and it was also thin-walled and septated. The rest of the pancreas appeared normal. FNA of the pancreatic cyst yielded only a minimal amount of thick mucoid fluid and was sent for both cytological examination and analysed for tumour markers. Cytological examination revealed ciliated columnar epithelial cells with mucoid material and no malignant cells. Unfortunately, our laboratory rejected the specimen for analysis of tumour markers as the contents were deemed too gelatinous and unsuitable.In view of the size and the predisposition for malignant change, she agreed for a laparoscopic spleen preserving distal pancreatectomy. During the diagnostic laparoscopy, the cyst was actually found to be an exophytic mass arising from the posterior wall of the stomach that was resting on the anterior surface of the pancreas (Fig. 2). An on-table gastroscopy was performed to exclude any mucosal involvement and to ensure an adequate gastric capacity after laparoscopic wedge resection.Post-operatively, she recovered well and was discharged on the third post-operative day. A repeat CA 19-9 performed several months later showed that it had normalized to 32 U/mL (0-35 U/mL).Final histology found the lesion to be arising from the posterior aspect of the stomach with the cyst confined in the serosa layer of the stomach and extending into the muscularis propria. It was lined by pseudostratified ciliated columnar epithelium, consistent with respiratory epithelium and surrounded by smooth muscle, reminiscent of a respiratory bronchiole. Scattered seromucinous glands were also seen. There was also focal ulceration of the lining epithelium with Fig. 1. CT scan showing the lesion, which seemed to be arising from the pancreas.Fig. 2. Gross pathological picture showing the cyst arising from the stomach. The cyst lies inferior to the resected stomach in this picture.

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A case of bronchogenic cyst with high production of antigen CA 19–9

Cited by 29 publications

References 12 publications

Bronchogenic Cyst with High Carbohydrate Antigen 19-9 in the Cyst Fluid and the Serum.

Bronchogenic Cyst with High Carbohydrate Antigen 19-9 in the Cyst Fluid and the Serum.

Tumor Markers and Oncogene Expression in Thyroid Cancer using Biochemical and Immunohistochemical Studies.

A case of gastric bronchogenic cyst in Singapore with multiple intrigues

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