title: Elevated CA 19-9 levels observed in association with a pulmonary neuroendocrine tumour and amyloid.
abstract: Investigations completed in a 77-year-old ex-smoker presenting with weight loss showed raised CA 19-9 levels. The findings of chest radiograph, abdominal computed tomography (CT) and gastrointestinal endoscopic examinations were all normal. On follow-up, the patient developed left upper lobe collapse on chest radiograph with increasing CA 19-9 levels. Chest CT findings suggested the presence of a left upper lobe tumour. The results of a biopsy of the left upper lobe nodule seen on bronchoscopy suggested a diagnosis of amyloidosis; however, this was not the only diagnosis. The left upper lobe mass comprised a neuroendocrine tumour with amyloid deposition just beneath the bronchial epithelium and focally between the nests of the tumour cells. We report and discuss this uncommon association and presentation.
authors.affiliation: Department of Respiratory Medicine, Castle Hill Hospital, UK. sfaruqi@doctors.net.uk
authors.forename: Shoaib
authors.initials: S
authors.lastname: Faruqi
authors.forename: Krishna
authors.initials: K
authors.lastname: Gumparthy
authors.forename: Zaroug
authors.initials: Z
authors.lastname: Wahbi
mesh_terms: D000368:Aged; D000682:Amyloid / Q000378:metabolism; D000686:Amyloidosis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D001344:Autopsy; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001707:Biopsy, Needle; D001999:Bronchoscopy / Q000379:methods; D018395:CA-19-9 Antigen / Q000235:genetics / Q000378:metabolism*; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D018358:Neuroendocrine Tumors / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D000682:Amyloid; D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen