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与抗Jo1合成酶综合征相关的肺鳞状细胞癌:一例报告并文献复习

Squamous cell carcinoma of the lung associated with anti-Jo1 antisynthetase syndrome: a case report and review of the literature.

作者信息

Boleto G, Perotin J-M, Eschard J-P, Salmon J-H

机构信息

Department of Rheumatology, Reims University Hospitals, 45 rue Cognacq-Jay, 51092, Reims cedex, France.

Department of Respiratory Medicine, Reims University Hospitals, INSERM 903, 45 rue Cognacq-Jay, 51092, Reims cedex, France.

出版信息

Rheumatol Int. 2017 Jul;37(7):1203-1206. doi: 10.1007/s00296-017-3728-z. Epub 2017 Apr 26.

Abstract

Antisynthetase syndrome is a heterogeneous idiopathic inflammatory myopathy. Anti-Jo1 is the most common antibody found in this condition. Dermatomyositis is known to be associated with malignancy, but the association between antisynthetase syndrome and malignancy is not clearly established. We report a case of an association of squamous cell carcinoma of the lung and anti-Jo1 antisynthetase syndrome. A 67-year-old man presented with polyarthritis, muscle weakness of the pelvic girdle, "mechanic's hands," and weight loss. A diagnosis of antisynthetase syndrome was considered based on the clinical features and the presence of anti-Jo1 antibodies. Positron emission tomography was performed because of weight loss and revealed a pulmonary hypermetabolic lesion. Histological findings revealed squamous cell carcinoma. The patient underwent lobectomy and is currently free of symptoms with regular monitoring. This unusual presentation of squamous cell carcinoma of the lung illustrates the need of a systematic approach to the diagnosis of antisynthetase syndrome. Positron emission tomography can be a useful imaging modality in the diagnosis of paraneoplastic syndromes associated with antisynthetase syndrome especially in the presence of warning signs/symptoms.

摘要

抗合成酶综合征是一种异质性特发性炎性肌病。抗Jo1是该病症中最常见的抗体。已知皮肌炎与恶性肿瘤有关,但抗合成酶综合征与恶性肿瘤之间的关联尚未明确确立。我们报告一例肺鳞状细胞癌与抗Jo1抗合成酶综合征相关的病例。一名67岁男性出现多关节炎、骨盆带肌肉无力、“技工手”和体重减轻。根据临床特征及抗Jo1抗体的存在,考虑诊断为抗合成酶综合征。因体重减轻进行了正电子发射断层扫描,结果显示肺部有高代谢病灶。组织学检查结果显示为鳞状细胞癌。患者接受了肺叶切除术,目前通过定期监测无症状。肺鳞状细胞癌的这种不寻常表现说明对抗合成酶综合征的诊断需要采用系统方法。正电子发射断层扫描在诊断与抗合成酶综合征相关的副肿瘤综合征时可能是一种有用的成像方式,尤其是在存在警示体征/症状的情况下。

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