Pulmonary inverted Schneiderian papilloma causing high serum levels of carcinoembryonic antigen and squamous cell carcinoma-associated antigen: report of a case.
We report a rare case of inverted Schneiderian papilloma causing exceedingly high serum levels of carcinoembryonic antigen (CEA) and squamous cell carcinoma-associated antigen (SCC). A 74-year-old man presented with a 6-month history of a productive cough, bloody sputa, and dyspnea. Chest computed tomography showed massive infiltration in the lower lobe with multiple focal soft tissue densities. Blood biochemical analysis revealed a serum CEA level of 107.0 ng/ml (normal <5.0 ng/ml), and an SCC level of 373.0 ng/ml (normal <1.5 ng/ml). Squamous papilloma was diagnosed by histological examination of a bronchoscopic biopsy specimen. To alleviate the patient's symptoms and refine the diagnosis, we performed a right lower lobectomy. The lower lobe of the lung was filled with mucinous sputa and very fragile papillary tumors of various sizes. Microscopic examination revealed papillary growth of stratified epithelial cells with massive mucin production. No nuclear abnormality or invasion of the basal membrane of the tumor cells was observed. Postoperatively, the patient's symptoms resolved quickly, and the serum levels of CEA and SCC decreased to 6.4 ng/ml and 1.7 ng/ml, respectively, within 3 months.
Iwata
Takashi
T
Department of Thoracic Surgery, Osaka City University Hospital, 1-4-3 Asahi-machi, Osaka 545-8585, Japan.
Inoue
Kiyotoshi
K
Nishiyama
Noritoshi
N
Izumi
Nobuhiro
N
Mizuguchi
Shinjiro
S
Morita
Ryuhei
R
Tsukioka
Takuma
T
Suehiro
Shigefumi
S
Obatake
Naoko
N
Wakasa
Kenichi
K
D000368:Aged; D000951:Antigens, Neoplasm / Q000276:immunology*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D018308:Papilloma, Inverted / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D015843:Serpins / Q000276:immunology*
D000951:Antigens, Neoplasm; D002272:Carcinoembryonic Antigen; D015843:Serpins; C051072:squamous cell carcinoma-related antigen
Head Neck. 2005 Jan;27(1):44-8
15459916
Pathol Int. 2000 May;50(5):431-9
10849335
Ann Thorac Surg. 2004 May;77(5):1845-6
15111209
Int J Gynecol Pathol. 1999 Jan;18(1):94-5
9891250
Am J Surg Pathol. 1998 Nov;22(11):1328-42
9808125
Otolaryngol Head Neck Surg. 1995 Nov;113(5):558-63
7478645
J Surg Oncol. 2006 Jan 1;93(1):80-5
16353190
Rhinology. 2000 Sep;38(3):97-101
11072653
Cancer. 2002 Jan 1;94(1):152-8
11815971
Cancer. 1989 Sep 15;64(6):1329-35
2548703