title: Chronic bronchitis with fungal infection presenting with marked elevation of serum carbohydrate antigen 19-9: a case report.
abstract: Carbohydrate antigen 19-9 (CA19-9) is the most frequently applied serum tumor marker for diagnosis of cancers in the digestive organs. However, some patients with benign diseases can have elevated serum levels of CA19-9 as well. The current study presents a 55-year-old female who was admitted to our hospital for further evaluation of a nodular cavity shadow in the right lower lobe and clarification of the cause of the marked elevation of serum CA19-9 levels. Abdominal MRI and gastrointestinal endoscopy did not find any malignancy. As lung cancer cannot be excluded in this patient, a video-assisted thoracoscopic surgery was carried, intraoperative and postoperative biopsy analysis both suggested chronic bronchitis with fungal infection (due to Histoplasma capsulatum or Penicillium marneffei) and organization. Immunohistochemistry showed marked positive staining for CA19-9 in the damaged lung tissue. The CA19-9 levels quickly returned to the normal range following lobe resection. Therefore, the marked elevation of serum CA19-9 levels, in this case, may have resulted from the chronic bronchitis with fungal infection.
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Han
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Yan
authors.affiliation: Tuberculosis Prevention Institution of Wuhan Wuhan 430030, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Tu
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, China.
authors.forename: Jia-Yi
authors.initials: JY
authors.lastname: He
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, China.
authors.forename: Jing-Mei
authors.initials: JM
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Gong
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, China.
authors.forename: Yun-Wu
authors.initials: YW
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, China.
authors.forename: Meng-Ke
authors.initials: MK
authors.lastname: Li
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, China.
authors.forename: De-An
authors.initials: DA
authors.lastname: Tian
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, China.
authors.forename: Huan-Jun
authors.initials: HJ
authors.lastname: Huang
mesh_terms: D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D029481:Bronchitis, Chronic / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D018395:CA-19-9 Antigen / Q000097:blood*; D005260:Female; D006658:Histoplasma / Q000472:pathogenicity; D006660:Histoplasmosis / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008172:Lung Diseases, Fungal / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D008875:Middle Aged; D010407:Penicillium / Q000472:pathogenicity; D011013:Pneumonectomy / Q000379:methods; D011237:Predictive Value of Tests; D020775:Thoracic Surgery, Video-Assisted; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D018395:CA-19-9 Antigen
keywords: Carbohydrate antigen 19-9; chronic bronchitis; fungal infection; immunohistochemistry