Fukumoto H, Nishimoto T, Morita H
Department of Thoracic and Cardiovascular Surgery, Osakafu Mishima Critical Care Medical Center, Osaka, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Jul;40(7):1161-5.
A 58 year old housewife with tumor shadow in the right upper lung field on the chest X-ray was admitted. Marked swelling and severe arthralgia of both extremities and soft tissue clubbing of the fingers had been presented for two years prior to admission. The radiographs and bone scintigrams indicated proliferating periostitis along the long bones. Bronchofiberscope showed the obstruction of B2a of the right bronchus but the histological diagnosis was not established. Serum level of CEA and IAP were found to be high. Soon after the right upper lobectomy, arthralgia was significantly improved. The histological evaluation revealed a well differentiated adenocarcinoma of a primary lung cancer without mediastinal lymph node metastasis. Within 4 months the serum level of CEA and IAP normalized, the clubbing and the periosteal changes of the bones regressed.
一名58岁的家庭主妇因胸部X光显示右上肺野有肿瘤阴影而入院。入院前两年出现双下肢明显肿胀和严重关节痛，手指软组织杵状指。X线片和骨闪烁显像显示长骨有骨膜增生。纤维支气管镜检查显示右支气管B2a阻塞，但未确立组织学诊断。发现血清癌胚抗原（CEA）和胰岛自身抗体（IAP）水平升高。右上肺叶切除术后不久，关节痛明显改善。组织学评估显示为原发性肺癌高分化腺癌，无纵隔淋巴结转移。4个月内，血清CEA和IAP水平恢复正常，杵状指和骨膜改变消退。
