The Journal of the Japanese Respiratory Society ONLINE JOURNAL
ABSTRACT
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Article in Japanese
Case Report
CA19-9-producing Idiopathic Pulmonary Fibrosis with Diffuse Alveolar Damage and a High Titer of KL-6 -An autopsy case
Yuji Shimizu1) *, Yoshiki Tanaka2) , Atsushi Sasaki3) and Toshikazu Nemoto1)
1)Department of Internal Medicine, Nanokaichi Municipal Hospital, Gunma, Japan, 2)First Department of Internal Medicine, and 3)First Department of Pathology, Gunma University School of Medicine, Gunma, Japan,
*Nanokaichi Municipal Hospital, 643 Nanokaichi, Tomioka, Gunma 370-2343 Japan
ABSTRACT
A 73-year-old woman with CA19-9-producing idiopathic interstitial pneumonia was admitted to the hospital when her condition was exacerbated. Chest radiography and computed tomography showed an additional patchy shadow. The serum CA19-9 level remained high during the clinical course, whereas KL-6 increased only at exacerbation. No therapy was effective, and the patient died 5 days later. The lung obtained at autopsy showed hyaline membrane formation, hemorrhage, and squamous metaplasia, suggesting that acute exacerbation had resulted in diffuse alveolar damage. Immunohistochemical staining using either anti-CA19-9 mAb or anti-KL-6 mAb showed the localization of CA19-9 and KL-6 antigen in the dilated bronchiolar epithelial cells. In conclusion, although CA19-9 can be an indicator for the degree of fibrotic and destructive change of lung structure, KL-6 seemed more sensitively to reflect the disease state of the diffuse alveolar damage.
KEYWORDS: Idiopathic interstitial pneumonia (IIP), CA19-9, KL-6, Immunohistochemical stain, Diffuse alveolar damage (DAD)
RECEIVED: 2000.7.14
JJRS, 39(5): 351-356, 2001
