Nishi K, Matsumura M, Myou S, Ooka T, Ohta Y, Satoh H, Fujimura M, Matsuda T
Division of Pulmonary Medicine, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Mar;32(3):271-6.
Pulmonary hypertrophic osteoarthropathy (PHO) is a syndrome of unknown etiology, presenting with osteitis of the long bones, arthritis, and clubbing of digits, associated with lung cancer or other chronic pulmonary or pleural diseases. Although about 3-10 percent of cases of lung cancer were reported to be associated with PHO in USA or Europe, reports of these cases are relatively rare in Japan. We report two cases of PHO associated with primary lung cancer, in which symptoms were rapidly improved by resection of the primary lesions. Both cases were poorly differentiated adenocarcinoma of the lung (pT2N0M0, Stage I). The bone and joint pain rapidly improved soon after the resection of the primary lesions. The abnormal findings of bone scan and bone X-ray film subsequently improved. In the 2nd case, radionuclide imaging more clearly revealed the presence and extent of subperiosteal activity than radiography. Radionuclide disclosure of PHO was considerably more sensitive than radiography.
肺性肥大性骨关节病（PHO）是一种病因不明的综合征，表现为长骨骨炎、关节炎和手指杵状指，与肺癌或其他慢性肺部或胸膜疾病相关。在美国或欧洲，虽然约3%-10%的肺癌病例据报道与PHO有关，但在日本这些病例的报告相对较少。我们报告两例与原发性肺癌相关的PHO病例，其中通过切除原发性病变症状迅速改善。两例均为肺低分化腺癌（pT2N0M0，Ⅰ期）。切除原发性病变后，骨和关节疼痛很快迅速改善。随后骨扫描和骨X线片的异常表现也有所改善。在第2例中，放射性核素成像比X线摄影更清楚地显示了骨膜下活动的存在和范围。PHO的放射性核素显示比X线摄影敏感得多。
