Madabhavi Irappa, Revannasiddaiah Swaroop, Rastogi Madhup, Gupta Manoj Kumar
Department of Internal Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
BMJ Case Rep. 2012 Jul 3;2012:bcr0320125985. doi: 10.1136/bcr.03.2012.5985.
This description pertains to a previously healthy gentleman aged 54 years who developed symptoms coherent with Raynaud's phenomenon. The patient never had any prior episodes of peripheral cyanosis. The patient's first presentation was in summer and the paroxysms of peripheral cyanosis were not associated with any specific aggravating factor. The paroxysms went on to become more severe and painful across a span of 6 months, when he also developed non-radiating pain in the right lateral chest-wall, which would aggravate after episodes of cough. A chest roentgenogram then demonstrated the presence of a mass lesion in the right lung and a fine-needle-aspiration cytology confirmed malignancy- an adenocarcinoma. There was a dramatic relief in pain and a reduction in the intensity and duration of paroxysms of peripheral cyanosis within 2-weeks of initiation of chemotherapy for lung cancer.
该描述涉及一位54岁的既往健康男性,他出现了与雷诺现象相符的症状。该患者既往从未有过外周发绀发作。患者首次就诊于夏季,外周发绀发作与任何特定加重因素无关。在6个月的时间里,发作变得更加严重且疼痛,此时他还出现了右侧胸壁非放射性疼痛,咳嗽发作后疼痛会加重。胸部X线片随后显示右肺存在肿块病变,细针穿刺细胞学检查确诊为恶性肿瘤——腺癌。在开始肺癌化疗的2周内,疼痛显著缓解,外周发绀发作的强度和持续时间也有所减轻。