Tuberc Respir Dis.  2006 Jul;61(1):70-73.

A Case of Alpha-Fetoprotein Producing Adenocarcinoma of the Lung

• No EJ
• Hur JW
• Lee SS
• Lee YM
• Lee HP
• Kim JI
• Choi SJ
• Yum HK
• Choi SJ
• Kim CH
• Lee HK

Abstract

Alpha-fetoprotein(AFP) is a plasma protein produced in the fetal liver, yolk sac and gastrointestinal tract. The plasma level of AFP decreases markedly 1 year after birth. The AFP level is usually increased in hepatocellular carcinoma and yolk sac tumor but is rare in a primary lung cancer. We report a case of primary adenocarcinoma of lung producing high levels of AFP.

Keyword

Alpha-fetoprotein; Lung cancer; Adenocarcinoma

MeSH Terms

Adenocarcinoma*
alpha-Fetoproteins*
Carcinoma, Hepatocellular
Endodermal Sinus Tumor
Gastrointestinal Tract
Liver
Lung Neoplasms
Lung*
Parturition
Plasma
Yolk Sac
alpha-Fetoproteins

Figure

• 

  Figure 1 Lobulated huge mass is in the right upper lobe. Air-fluid level is in the infected bulla.

• 

  Figure 2 The CT scan reveals lobulated mass in posterior segment of right upper lobe. Infected bullae is in superior segment of the right lower lobe.

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  Figure 3 Poorly differentiated cluster showing sinusoidal pattern, gland formation (H & E, × 200)

• 

  Figure 4 Cytoplasm of tumor cell in the lung shows positive cytokeratin staining (H & E, × 200).

• 

  Figure 5 Cytoplasm of tumor cell in the lung shows positive CEA staining (H & E, × 200).

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  Figure 6 Tumor cell in the lung cut shows positive staining for AFP (H & E, × 200).

Reference

1. Gitlin D, Pericelli A, Gitlin GM. Synthesis of alpha-fetoprotein by liver, york sac, and gastrointestinal tract of the human conceptus. Cancer Res. 1972. 32:979–982.

2. Ruoslahti E, Seppala M. Alpha-fetoprotein in cancer and fetal development. Adv Cancer Res. 1979. 29:275–346.

3. Javaspour N. The National Cancer Institute experience with testicular cancer. J Urol. 1978. 120:651–659.

4. Kato K, Akai S, Tobia Y, Tsutsui K, Tsunoda H, Suzuki M. Alpha fetoprotein positive cases in cancer except for hepatoma and malignant teratoma: mainly on the sum up data in Japan. Jpn J Cancer Clin. 1974. 20:376–382.

5. Holyoke ED, Chu TM, Murphy GP. CEA as a monitor of gastrointestinal malignancy. Cancer. 1975. 35:830–836.

6. Spragins J, Hall WH, White HJ. Fetoprotein from esophageal squamous cell carcinoma. Ann Intern Med. 1972. 77:322–323.

7. Mostofi FK. Pathology of germ cell tumors of testis. Cancer. 1980. 45:Suppl. I735–I754.

8. O'concor GT, Tatarinov YS, Abelev GI, Uriel J. A collaborative study for the evaluation of serologic test for primary liver cancer. Cancer. 1970. 25:1091–1098.

9. McIntire KR, Waldmann TA, Moertel CG, Go VL. Serum alpha-fetoprotein in patients with neoplasms of the gastrointestinal tract. Cancer Res. 1975. 35:991–996.

10. Masopust J, Kithier K, Radl J, Kouteeky J, Kotal L. Occurrence of fetoprotein in patients with neoplasm and non-neoplastic disease. Int J Cancer. 1968. 3:364–373.

11. Kozower M, Fawaz KA, Miller HM, Kaplan M. Positive alpha fetoglobulin in a case of gastric carcinoma. N Engl J Med. 1971. 285:1059–1060.

12. Yasunami R, Hashimoto Z, Ogura T, Hirao F, Yamamura Y. Primary lung cancer producing alpha-fetoprotein. Cancer. 1981. 47:926–929.

13. Miyake M, Ito M, Mitsuoka A, Taki T, Wada H, Hitomi S, et al. Alpha-fetoprotein and human chorionic gonadotropin producing lung cancer. Cancer. 1987. 59:227–232.

14. Asamura H, Nakayama H, Kondo H, Tsuchiya R, Ono R, Noguchi M, et al. AFP-producing squamous cell carcinoma of the lung in adolescent. Jpn J Clin Oncol. 1996. 26:103–106.