1995 Volume 35 Issue 2 Pages 209-214
A 74-year-old male with idiopathic pulmonary fibrosis was admitted to our hospital on suspicion of acute exacerbation.Chest CT on admission demonstrated a solid mass about 5 cm in diameter located in front of the left main pulmonary artery. Because of the location corresponding to the region of #10 lymph node and the high serum levels of CEA and CA 19-9 (15.5ng/ml and 429U/ml respectively), the mass was suspected to be a metastatic hilar lymph node from a primary lung cancer. Neither a primary nor a metastatic lesion were detected, however, in the lung or in other organs of the body. As the mass grew, with gradual increases in the serum levels of tumor markers, resection was performed. This case was classified as a T0N1M0 adenocarcinoma of the lung because of the histological findings, which demonstrated adenocarcinoma proliferating in a lymph node. On special and immunohistochemical stainings, Al-PAS and CEA showed positive findings but stainings were negative for CA19-9, SP-A, SP-D and CC10. The serum levels of CEA and CA19-9 continuously increased, even after the operation, and reached respective levels of 104ng/ml and 1020U/ml at the time of discharge, seven months after admission.
