Katayama M, Tanaka I, Hosako Y, Hama N, Yamada T, Inada S, Goto M
Division of Rheumatic Diseases, Tokyo Metropolitan Otsuka Hospital.
Ryumachi. 1995 Feb;35(1):85-9.
We report here a very rare case of MCTD complicating double cancer. A 43-year-old woman with suspected MCTD was admitted because of high fever and lymphadenopathy. The laboratory findings indicated high titers of speckled ANA, anti-RNP, DNA and Scl-70, but anti-Sm. SS-A and SS-B was not detected. Chest CT and Spirogram revealed lung fibrosis, restrictive ventilatory impairment, and decreased diffusion capacity. Biopsy specimen by gastric fiberscope s screening indicated II c advanced type of poorly differentiated adenocarcinoma. After subtotal gastrectomy, she had high fever, pleuritis, leukopenia, butterfly erythema and hypoxemia, which were improved by 30 mg/day of oral prednisolone. One year after from the last operation, she had contact bleeding, and squamous cell carcinoma of the uterine cervix was diagnosed. She had Raynaud's phenomenon 6 months after from hysterectomy.
我们在此报告一例非常罕见的混合性结缔组织病（MCTD）合并双癌病例。一名疑似患有MCTD的43岁女性因高热和淋巴结病入院。实验室检查结果显示斑点型抗核抗体（ANA）、抗核糖核蛋白（RNP）、抗DNA和抗Scl - 70抗体滴度高，但未检测到抗Sm、抗SS - A和抗SS - B抗体。胸部CT和肺功能检查显示肺纤维化、限制性通气功能障碍和弥散功能下降。经胃纤维镜筛查活检标本显示为Ⅱc期进展型低分化腺癌。胃次全切除术后，她出现高热、胸膜炎、白细胞减少、蝶形红斑和低氧血症，口服泼尼松龙30毫克/天可使其病情改善。最后一次手术后一年，她出现接触性出血，被诊断为子宫颈鳞状细胞癌。子宫切除术后6个月，她出现雷诺现象。
