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Normal Tumor Markers and Increased Adenosine Deaminase in Pericardial Effusion Misdiagnosed as Tuberculous Pericarditis Ultimately Proven as Lung Adenocarcinoma with Pericardial Metastasis: a Case Report and Literature Review by Yan L. Ge, Cong H. Liu, Qian Zhang, Hai S. Gao, Ying M. Wang, Yi Chen, Wen Q. Li, Qian C. Chen, Xiao Y. Zhu, Jing J. Jin, Tian T. Xu, Ai S. Fu

Background: Elevated adenosine deaminase (ADA) and normal tumor markers in pericardial or pleural effusion are usually considered to be a specific manifestation of benign pericardial or pleural effusion. Here we report a case of lung adenocarcinoma with pericardial metastasis with elevated ADA and normal tumor markers in pericardial effusion.
Methods: Pericardiocentesis and lung puncture combined laboratory indexes and pathology were performed for diagnosis.
Results: Analysis of pericardial fluid revealed a white blood cell (WBC) count of 2,000 x 106/L (70% for lymphocytes) with an ADA level of 72.8 U/mL. Pathology of pericardial effusion found no malignant cells. Histopathology of percutaneous lung puncture showed adenocarcinoma.
Conclusions: ADA and tumor markers were not a specific index in differential diagnosis between tuberculosis and metastasis in pericardial effusion.

DOI: 10.7754/Clin.Lab.2018.181036