A case of allergic bronchopulmonary mycosis with elevated serum CEA levels and false-positive FDG-PET/CT in the hilar and mediastinal lymph nodes
Kenji Kawatoko Atsushi Moriwaki Makoto Yoshida
Department of Respiratory Medicine, National Hospital Organization Fukuoka National Hospital
A 47-year-old woman presented to our hospital with a fever. Chest computed tomography (CT) showed infiltrative shadows, central bronchiectasis, and a mucus plug in the lingula and lower lobes of the left lung, suggesting allergic bronchopulmonary mycosis (ABPM). However, lung cancer first had to be ruled out based on the following findings: enlarged hilar and mediastinal lymph nodes; an elevated serum carcinoembryonic antigen (CEA) level, and high 18F-fluorodeoxyglucose (FDG) uptake in the hilar and mediastinal lymph nodes in positron emission tomography (PET)/CT. Bronchoscopy showed no malignant findings, and a final diagnosis of ABPM was made. After corticosteroid treatment, the hilar and mediastinal lymph nodes shrank, and the serum CEA level decreased. We present a case of ABPM with hilar and mediastinal lymphadenopathy, false-positive accumulation in FDG-PET/CT, and elevated serum CEA, which made it necessary to differentiate it from lung cancer.
18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) Allergic bronchopulmonary mycosis (ABPM) Carcinoembryonic antigen (CEA) Hilar and mediastinal lymph nodes
Received 16 Jul 2022 / Accepted 19 Dec 2022
AJRS, 12(2): 84-87, 2023