title: Sarcoidosis presenting with massive pleural effusion and elevated serum and pleural fluid carbohydrate antigen-125 levels.
abstract: A 55-year-old woman was admitted for an elevated serum carbohydrate antigen-125 (CA-125) level, and a left pleural effusion, which were detected at a routine health examination. Computed tomography of the chest was performed upon admission, revealing extensive bilateral paratracheal and mediastinal lymph node enlargement with a massive left-sided pleural effusion. Subsequent analysis of the pleural fluid demonstrated consistency with an exudate, no evidence of malignant cells, and a normal adenosine deaminase. However, the pleural fluid and serum CA-125 levels were 2,846.8 U/mL and 229.5 U/mL, respectively. A positron emission tomography did not reveal any primary focus of malignancy. Finally, a surgical mediastinoscopic biopsy of several mediastinal lymph nodes was performed, revealing non-necrotizing granulomas, consistent with sarcoidosis. After a month of treatment of prednisolone, the left pleural effusion had resolved, and after 2 months the serum CA-125 level was normalized.
authors: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.
authors: In Seon
authors: IS
authors: Lee
authors: Sae Byul
authors: SB
authors: Kim
authors: Chan Soo
authors: CS
authors: Moon
authors: Sung Mo
authors: SM
authors: Jung
authors: Song Yee
authors: SY
authors: Kim
authors: Eun Young
authors: EY
authors: Kim
authors: Ji Ye
authors: JY
authors: Jung
authors: Young Ae
authors: YA
authors: Kang
authors: Young Sam
authors: YS
authors: Kim
authors: Se Kyu
authors: SK
authors: Kim
authors: Joon
authors: J
authors: Chang
authors: Moo Suk
authors: MS
authors: Park
keywords: CA-125 Antigen; Pleural Effusion; Sarcoidosis