ABSTRACT
The patient was a 79-year-old woman who had received enucleation of right pulmonary papilloma 7 years earlier. She experienced bloody sputum and was therefore referred to our hospital. Chest computed tomography revealed a mass shadow(21 mm) in the right upper lobe (S2). By bronchoscopy, there was no bulging lesion in the visible range. SCC and CEA increased to 6.4 ng/ml and 6.42 ng/ml, respectively. Whole-body 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) showed increased FDG uptake in the region of the right-lung mass shadow (maximum standardized uptake value 12.95). Since malignancy could not be ruled out, a wedge resection was performed. The post-operative histopathologic diagnosis was squamous cell papilloma. Our literature review showed 12 out of 14 cases with solitary papilloma of the peripheral lung to have increased FDG uptake. Ki-67 positive cells were confirmed in the basal layers of the epithelium, and active cell proliferation of the papilloma is likely to be a cause of increased FDG uptake.
Subject(s)
Fluorodeoxyglucose F18 , Lung Neoplasms/diagnostic imaging , Papilloma/diagnostic imaging , Positron-Emission Tomography , Aged , Female , HumansABSTRACT
A 64-year-old man was found to have serum carcinoembryonic antigen(CEA) elevation while undergoing an examination for recurrent gastroenteritis. His past medical history included gastroenteritis, rheumatoid arthritis, and diabetes. Blood testing revealed an increased CEA level of 153.00 ng/ml( normal ≤ 5.00 ng/ml). Chest computed tomography scan revealed an abnormal soft tissue shadow measuring 5.7 × 1.2 × 7 cm in the anterior mediastinum. The soft tissue shadow in the anterior mediastinum was the only abnormality found by whole-body examination. The possibility of a malignant tumor could not be ruled out, and the surgery was performed. Histopathological examination of the specimen confirmed thymic hyperplasia, and immunohistochemical staining detected CEA-positive cells. Serum CEA level normalized at three months after surgery and also 2 years postoperatively.
Subject(s)
Carcinoembryonic Antigen/blood , Thymus Hyperplasia/blood , Humans , Male , Middle AgedABSTRACT
The patient was a 36-year-old woman. She had previously undergone surgery for hysteromyoma and endometriosis. At 8 week of pregnancy, the fetus's heart stopped beating, and the woman underwent abortion. On the same day, she began experiencing difficulty in breathing in the evening. After 4 days, she was referred to our hospital with dyspnea. Chest X-ray finding showed a right pneumothorax. Tube toracotomy was performed, and the right lung re-expanded immediately. Two months later, pneumothorax recurred without any association with the menstruation cycle. Thoracoscopic surgery was performed. No lesion was detected in the lung or visceral pleura, but a small hole and some thinned areas were noted in the diaphragm. Partial resection of the diaphragm was performed. Microscopic examination revealed endometriosis and localized lymphocyte infiltration in the resected diaphragm. It was suggested that the recurrence of pneumothorax without menstruation was caused by the thinning of the diaphragm due to endometriosis.
