High Amylase Levels in Neoplasm-Related Pleural Effusion
Authors: Mordechai R. Kramer
Journal: Annals of Internal Medicine (1989)

Brief Reports1 April 1989High Amylase Levels in Neoplasm-Related Pleural EffusionMordechai R. Kramer, MD, Mario J. Saldana, MD, Rodolfo J. Cepero, MD, Arthur E. Pitchenik, MDMordechai R. Kramer, MDSearch for more papers by this author, Mario J. Saldana, MDSearch for more papers by this author, Rodolfo J. Cepero, MDSearch for more papers by this author, Arthur E. Pitchenik, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-110-7-567 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAmylase levels elevated in pleural effusions are found in three categories. First, the commonest category is pancreatitis with or without pseudocyst formation or a direct pancreatic-pleural fistula. Second, and uncommonly, is rupture of the esophagus, usually recognized by a distinct clinical picture. Third, malignant effusion may have elevated amylase levels (1-13). We report the case of a patient in whom extremely high amylase levels in pleural effusion contributed to diagnosis of a lung neoplasm. We also review 33 additional reports in the literature.Case ReportA 67-year-old previously healthy man was hospitalized because of left chest pain and increasing dyspnea...References1. LightBall RW. Glucose and amylase in pleural effusions. JAMA. 1973;225:257-9. CrossrefMedlineGoogle Scholar2. CramerBruns SD. Amylase-producing ovarian neoplasm with pseudo-Meigs' syndrome and elevated pleural fluid amylase: case report and ultrastructure. Cancer. 1979;44:1715-21. CrossrefMedlineGoogle Scholar3. CorletteDratchSorger MMK. Amylase elevation attributable to ovarian neoplasm. Gastroenterology. 1978;74:907-9. CrossrefMedlineGoogle Scholar4. O'FlanaganTigheEganDelaney SBTP. Meigs' syndrome and pseudo-Meigs' syndrome. J R Soc Med. 1987;80:252-3. CrossrefMedlineGoogle Scholar5. ShapiroDropkinFinkelsteinAledortGreenstein RRJDA. Ovarian carcinomatosis presenting with hyperamylasemia and pleural effusion. Am J Gastroenterol. 1981;76:365-8. MedlineGoogle Scholar6. Ende N. Studies of amylase activity in pleural effusion and ascites. Cancer. 1960;13:283-7. CrossrefMedlineGoogle Scholar7. BraganzaButlerFox JEH. Ectopic production of salivary type amylase by a pseudomesotheliomatous carcinoma of the lung. Cancer. 1978;41:1522-5. CrossrefMedlineGoogle Scholar8. BucklerHoneybourne HD. Raised pleural effusion amylase level as an aid in the diagnosis of adenocarcinoma of the lung. Br J Clin Pract. 1984;38:359-61, 71. MedlineGoogle Scholar9. OtsukiYuuMaedaSaekiYamasaki MHMST. Amylase in the lung. Cancer. 1977;39:1956-63. CrossrefGoogle Scholar10. Ende N. Amylase activity in body fluids. Cancer. 1961;44:1109-14. CrossrefGoogle Scholar11. SatzMünchKuhlmann NRU. High amylase content of neoplastic pleural and pericardial effusion probably secondary to amylase producing tumor cells: report of 2 cases. Klin Wochenschr. 1983;61:91-4. CrossrefMedlineGoogle Scholar12. SanKaranKuttyBairdDowseMorris MJJJ. Adenocarcinoma of the pancreas with massive pleural effusion. Br J Clin Pract. 1978;32:294-7. MedlineGoogle Scholar13. ZimmermanBankBuchKatzkaLendvai HSPIS. Macroamylase in the pleural effusion of a patient with lymphoma. Gastroenterology. 1983;85:190-3. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From the Veterans Administration Hospital, Jackson Memorial Hospital, and University of Miami School of Medicine, Miami, Florida. For current author addresses, see end of text. 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