Ectopic Adrenocorticotropic Hormone-Secreting Bronchial Carcinoid Diagnosed by Balloon-Occluded Pulmonary Arterial Sampling.
We present the case of a 50-year-old man with Cushing syndrome caused by an ectopic adrenocorticotropic hormone (ACTH)-secreting tumor. A small nodule was located in close association with the lateral segmental branch of the pulmonary artery in the left upper lobe. Blood samples were obtained from various branches of the pulmonary artery by balloon-occluded retrograde sampling for the measurement of location-specific serum ACTH levels. After confirmation that the pulmonary nodule was responsible for the increased ACTH secretion, lobectomy was performed. This report demonstrates the usefulness of balloon-occluded retrograde pulmonary arterial sampling for the preoperative diagnosis of an ACTH-producing tumor whose diagnosis is difficult to confirm.
Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan.
Masaya
M
Yotsukura
Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan.
Mitsutomo
M
Kohno
Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan.
Keisuke
K
Asakura
Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan.
Ikuo
I
Kamiyama
Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan.
Takashi
T
Ohtsuka
Department of Pathology, Keio University School of Medicine, Tokyo, Japan.
Yuichiro
Y
Hayashi
Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Isao
I
Kurihara
Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan.
Seishi
S
Nakatsuka
Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan. Electronic address: hasamura@a3.keio.jp.
Hisao
H
Asamura
D000182:ACTH Syndrome, Ectopic / Q000175:diagnosis*; D000324:Adrenocorticotropic Hormone / Q000097:blood*; D001984:Bronchial Neoplasms / Q000175:diagnosis*; D002276:Carcinoid Tumor / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery; D013048:Specimen Handling / Q000379:methods*
D000324:Adrenocorticotropic Hormone