Miyamoto T, Oda N, Mokuno T, Sawai Y, Nishida Y, Mano T, Kotake M, Masunaga R, Ito Y, Asano K
Department of Internal Medicine, Fujita Health University School of Medicine, Aichi.
Nihon Naibunpi Gakkai Zasshi. 1995 Mar 20;71(2):167-72. doi: 10.1507/endocrine1927.71.2_167.
A rare case of a patient with non-insulin-dependent diabetes mellitus (NIDDM) with small cell lung cancer, initially diagnosed as pyogenic vertebral osteomyelitis, was reported. A 40-year-old male patient was diagnosed with NIDDM about 3 years earlier, but he did not receive any treatment. Then, a two-month history of high fever, persistent cough and back pain developed. Chest X-ray film showed a lung infiltrate with a small cavity in the upper portion of the left lung. Computed tomography and magnetic resonance imaging of the chest revealed a tumor mass shadow with osteoclasia along the bodies of the 6th and 7th thoracic vertebral bone. Staphylococcus aureus infection was confirmed by arterial blood culture. Administration of antibiotics resulted in the disappearance of the left lung infiltrate and a slight reduction of the tumor mass in the thoracic vertebral bone, suggesting pyogenic vertebral osteomyelitis as an unusual complication of NIDDM. However, as the tumor mass still remained, needle biopsy for the mass lesion was performed, resulting in the diagnosis of metastasis of small cell carcinoma from the left lung. Gene aberration in this lung disease has been reported recently, and its correlation with NIDDM which may also be induced by genetic abnormality is an interesting question that remains to be resolved.
报告了一例非胰岛素依赖型糖尿病（NIDDM）患者合并小细胞肺癌的罕见病例，该患者最初被诊断为化脓性脊椎骨髓炎。一名40岁男性患者约3年前被诊断为NIDDM，但未接受任何治疗。随后，出现了两个月的高热、持续咳嗽和背痛病史。胸部X线片显示左肺上部有肺浸润伴小空洞。胸部计算机断层扫描和磁共振成像显示第6和第7胸椎椎体有肿瘤肿块阴影伴骨质破坏。动脉血培养证实为金黄色葡萄球菌感染。抗生素治疗后左肺浸润消失，胸椎骨肿瘤肿块略有缩小，提示化脓性脊椎骨髓炎是NIDDM的一种罕见并发症。然而，由于肿瘤肿块仍然存在，对肿块病变进行了针吸活检，结果诊断为左肺小细胞癌转移。最近报道了这种肺部疾病的基因异常，其与也可能由基因异常引起的NIDDM的相关性是一个有待解决的有趣问题。
