膜性肾病作为不明原发肿瘤癌的副肿瘤综合征。
Membranous Nephropathy as a Paraneoplastic Syndrome in Cancer of Unknown Primary.
机构信息
Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Hidaka, Japan;
Department of Nephrology, Faculty of Medicine, Saitama Medical University, Moroyama, Japan.
出版信息
In Vivo. 2024 May-Jun;38(3):1503-1508. doi: 10.21873/invivo.13598.
BACKGROUND/AIM: Membranous nephropathy (MN) is a nephrotic syndrome with both idiopathic and secondary etiologies. The mechanism of cancer-associated MN is presumed to involve the immunological production of antibodies against a tumor antigen, although little is known about the detailed mechanism. Lung cancer is a major neoplasm associated with cancer-associated MN. However, the simultaneous occurrence of secondary MN in patients with cancer of unknown primary (CUP) remains unclear.
CASE REPORT
Here, we present a case of secondary MN in a 72-year-old female as a paraneoplastic syndrome in CUP. Thoracic radiotherapy up to a total of 60 Gy was initially performed on the right subclavian and mediastinal lymph nodes. Computed tomography revealed marked shrinking of these lymph nodes, and the secondary MN also improved without any symptoms.
CONCLUSION
The presence of proteinuria in patients with CUP suggests the possibility of secondary MN as a rare differential diagnosis.
背景/目的：膜性肾病（MN）是一种具有特发性和继发性病因的肾病综合征。癌症相关 MN 的发病机制被认为涉及针对肿瘤抗原的免疫抗体产生，尽管对其详细机制知之甚少。肺癌是与癌症相关 MN 相关的主要恶性肿瘤。然而，癌症来源不明（CUP）患者同时发生继发性 MN 的情况尚不清楚。
病例报告
在这里，我们报告了一例 72 岁女性作为 CUP 副肿瘤综合征的继发性 MN 病例。最初对右锁骨下和纵隔淋巴结进行了总计 60 Gy 的胸部放射治疗。计算机断层扫描显示这些淋巴结明显缩小，继发性 MN 也在没有任何症状的情况下得到改善。
结论
CUP 患者出现蛋白尿提示可能存在继发性 MN 作为罕见的鉴别诊断。
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