A 55-year-old woman was admitted for an elevated serum carbohydrate antigen-125 (CA-125) level, and a left pleural effusion, which were detected at a routine health examination. Computed tomography of the chest was performed upon admission, revealing extensive bilateral paratracheal and mediastinal lymph node enlargement with a massive left-sided pleural effusion. Subsequent analysis of the pleural fluid demonstrated consistency with an exudate, no evidence of malignant cells, and a normal adenosine deaminase. However, the pleural fluid and serum CA-125 levels were 2,846.8 U/mL and 229.5 U/mL, respectively. A positron emission tomography did not reveal any primary focus of malignancy. Finally, a surgical mediastinoscopic biopsy of several mediastinal lymph nodes was performed, revealing non-necrotizing granulomas, consistent with sarcoidosis. After a month of treatment of prednisolone, the left pleural effusion had resolved, and after 2 months the serum CA-125 level was normalized. Copyright
Bibliographical noteFunding Information:
Acknowledgements. This work was supported in part by the Neuro-Oncology Research Fund, the Royal Marsden NHS Trust and the Cancer Research Campaign. We are grateful to our neurosurgical colleagues for their continued collaboration. This work was undertaken by the Royal Marsden NHS Trust, who received a proportion of its funding from the NHS Executive. The views expressed are those of the authors and not necessarily those of the NHS Executive.
All Science Journal Classification (ASJC) codes
- Pulmonary and Respiratory Medicine
- Infectious Diseases