Elevated serum CA19-9 level and regional lymphadenopathy in a young man with allergic bronchopulmonary aspergillosis

A 21-year-old man with bronchial asthma who suffered from productive cough; his chest X-rays and computed tomographic (CT) scans revealed central atelectasis and pulmonary infiltrates with paratracheal and hilar lymphadenopathy. The serum CA19-9 level was elevated. He was suspected to have malignant neoplasms on admission, but he was diagnosed with allergic bronchopulmonary aspergillosis (ABPA) by Rosenberg's criteria. After steroid therapy, his symptoms and radiographic findings improved and the serum CA19-9 level decreased. ABPA should be considered in the differential diagnosis of asthmatic patients with or without lymphadenopathy and an elevated serum CA19-9 level.