Ansari J, Nagabhushan N, Syed R, Bomanji J, Bacon C M, Lee S M
Meyerstein Institute of Oncology, Middlesex, UK.
Clin Oncol (R Coll Radiol). 2004 Feb;16(1):71-6. doi: 10.1016/j.clon.2003.09.008.
A 53-year-old man presented with an 8-week history of upper and lower limb paraesthesia. Neurological examination revealed a glove and stocking distribution of sensory loss. Sural nerve biopsy showed severe axonal neuropathy associated with microvasculitis. Positron-emission tomography and thoracic computed tomography helped in localising the underlying malignancy. A transbronchial biopsy confirmed the diagnosis of small cell lung carcinoma (SCLC). Neuroimmunological studies identified anti-Hu antibodies and confirmed a paraneoplastic aetiology for his neuropathy. Treatment of small cell lung cancer with carboplatin and etoposide resulted in significant improvement of neurological symptoms. We report a case of a patient with SCLC and anti-Hu paraneoplastic sensory neuropathy with microvasculitis, and discuss the literature on prognosis of patients with SCLC with paraneoplastic neurological syndromes compared with patients with SCLC only.
一名53岁男性,有8周的上下肢感觉异常病史。神经系统检查发现感觉丧失呈手套和袜套样分布。腓肠神经活检显示严重的轴索性神经病伴微血管炎。正电子发射断层扫描和胸部计算机断层扫描有助于定位潜在的恶性肿瘤。经支气管活检确诊为小细胞肺癌(SCLC)。神经免疫学研究发现抗Hu抗体,证实其神经病的副肿瘤病因。用卡铂和依托泊苷治疗小细胞肺癌使神经症状显著改善。我们报告一例患有小细胞肺癌和抗Hu副肿瘤性感觉神经病伴微血管炎的患者,并讨论与仅患有小细胞肺癌的患者相比,患有小细胞肺癌伴副肿瘤性神经综合征患者的预后相关文献。