Brooks P M
St. Vincent's Hospital, Darlinghurst, Australia.
Curr Opin Rheumatol. 1992 Feb;4(1):90-3.
Neoplasia can be associated with a wide range of rheumatologic manifestations. Literature over the last 12 months has reviewed metastasis of solid tumors to the joint and hypertrophic pulmonary osteoarthropathy. Vasculitis has been reported as a paraneoplastic syndrome associated with both hematologic and solid malignancies. Paraproteinemia occurs in association with rheumatoid arthritis and may progress to lymphoproliferative malignancy. A careful review of 23 rheumatoid arthritis patients with a serum paraprotein has attempted to study the predictive value of monoclonal gammopathy in rheumatoid arthritis for the later development of lymphoproliferative malignancy. Rheumatic manifestations, including cutaneous vasculitis and lupuslike syndromes, are seen in up to 10% of patients with myelodysplastic syndromes. Leukemias sometimes present as synovitis, and immunocytologic analysis of joint fluids can help to establish the diagnosis of leukemic arthritis at an early stage. Several other cases reports of arthritis associated either directly or indirectly with neoplasia are presented.
肿瘤形成可伴有多种风湿性表现。过去12个月的文献综述了实体瘤向关节的转移及肥厚性肺骨关节病。血管炎已被报道为一种与血液系统恶性肿瘤和实体恶性肿瘤相关的副肿瘤综合征。副蛋白血症与类风湿关节炎相关，且可能进展为淋巴增殖性恶性肿瘤。一项对23例伴有血清副蛋白的类风湿关节炎患者的仔细研究，试图探讨类风湿关节炎中单克隆丙种球蛋白病对淋巴增殖性恶性肿瘤后期发生的预测价值。高达10%的骨髓增生异常综合征患者会出现包括皮肤血管炎和狼疮样综合征在内的风湿性表现。白血病有时表现为滑膜炎，关节液的免疫细胞分析有助于早期诊断白血病性关节炎。本文还介绍了其他几例直接或间接与肿瘤形成相关的关节炎病例报告。
