Allergic Bronchopulmonary Mycosis Complicated with Lung Adenocarcinoma

Abstract

Chest computed tomography (CT) of a 76-year-old woman with bronchial asthma showed multiple lung nodules with high CT densities that were compatible with high-attenuation mucoid (HAM) impactions characteristic of allergic bronchopulmonary mycosis (ABPM). Follow-up chest CT revealed increased sizes of multiple lung nodules. However, a left upper lobe nodule showed lower CT density than the other HAM impactions. A transbronchial lung biopsy of that upper lobe nodule revealed lung adenocarcinoma. Measuring the CT density is important for the differential diagnosis of lung nodules when following ABPM patients. Our patient's increased serum carcinoembryonic antigen levels were associated with peripheral blood eosinophilia. Mucoid impaction in the lung was positively stained with carcinoembryonic antigen and showed the distribution of eosinophilic granules.

Allergic hyper-carcinoembryonic antigen syndrome: A syndrome summarized by case series

“… 20 , 21 Serum CEA levels have long been recognized as potential biomarkers for diagnosing tumors, monitoring tumor progression, and post-surgical surveillance in various cancer types, such as breast cancer and gastrointestinal tumors. 5 – 7 Ohnishi et al 22 reported a patient exhibited elevated CEA and EOS levels, which led to the detection of malignancy, and was subsequently diagnosed as allergic bronchopulmonary mycosis complicated with lung adenocarcinoma. However, elevated CEA levels have also been reported in benign conditions.…”

Two Different Tumors and Lung Aspergilloma: An Uncommon Etiopathogenic Association

“…The most important particularity of our case is the association between colonization with Aspergillus and two synchronous tumors. After reviewing the scientific literature, we found several cases of associations between pulmonary aspergillosis and carcinoid tumors, as well as pulmonary aspergillosis and pulmonary adenocarcinoma [ 27 , 28 , 29 , 30 , 31 ]. However, we have not discovered any cases that linked all three diseases.…”