Allergic bronchopulmonary mycosis with elevated levels of tumor markers in a nonasthmatic patient
Makiko Takeyasua Hisashi Takayaa Hironori Urugaa Takeshi Fujiib Atsuko Kurosakic Kazuma Kishia
aDepartment of Respiratory Medicine, Respiratory Center, Toranomon Hospital
bDepartment of Pathology, Toranomon Hospital
cDepartment of Diagnostic Radiology, Fukujuji Hospital
A 36-year-old never-smoking female without history of asthma was admitted to our hospital in June 2012 for diagnostic evaluation of a right-lung tumor. Since April 2012 she had been complaining of chest pain. Chest computed tomography (CT) scan revealed a mass in the right-middle lobe. Serum levels of carcinogenic embryonic antigen (CEA), sialyl Lewis X (SLX), and squamous cell carcinoma antigen (SCC) were elevated. CT-guided needle biopsy of the mass revealed epitheloid cell granulomas, Charcot-Leyden crystals, and mucus infiltrated by eosinophils and fungi. A diagnosis of allergic bronchopulmonary mycosis was made, and treatment with 20 mg/day oral prednisolone and 200 mg/day itraconazole was commenced, leading to clinical, radiological, and serological improvement (serum IgE and tumor markers decreased to normal range). To the best of our knowledge, this is the first reported case of allergic bronchopulmonary mycosis with elevated levels of several tumor markers in a nonasthmatic patient.
Allergic bronchopulmonary mycosis (ABPM) Mucoid impaction of bronchi (MIB) Tumor marker Carcinogenic embryonic antigen (CEA)
Received 27 Mar 2014 / Accepted 1 Jul 2014
AJRS, 3(5): 723-726, 2014