Chartrand-Lefebvre C, Howarth N, Grenier P, Keime F, Orcel B, Beigelman C
Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France.
AJR Am J Roentgenol. 1998 Jun;170(6):1513-7. doi: 10.2214/ajr.170.6.9609164.
The anti-Hu syndrome (bearing the name of the patient in whom the antibody was first discovered) is characterized by a paraneoplastic encephalomyelitis or sensory neuronopathy and the presence of a specific antibody in the serum or CSF and is associated with lung cancer in most patients who have the syndrome. The objective of this study was to determine the relative merits of chest radiography and CT in the imaging of patients with the anti-Hu syndrome.
Chest radiographic and CT findings of 11 patients with anti-Hu syndrome were reviewed and correlated with results of bronchoscopy, surgery, or autopsy.
Ten of the 11 patients had small cell lung cancer; in the remaining patient, no cancer was found. Small cell lung cancer was first revealed on radiographs in one patient and solely on CT in the remaining nine patients with small cell lung cancer. In six of these nine patients, the initial CT findings were positive for lung cancer. Tumor was found on follow-up CT in 4-8 months when initial CT findings were negative. Mediastinal adenopathy was present in all 10 cancer patients. Hilar adenopathy was present in four. Parenchymal involvement was seen in three of the 10 patients with cancer. In two patients, the only CT finding of small cell lung cancer was one mediastinal lymph node of 10 mm in each patient.
Chest CT should be recommended for patients with anti-Hu syndrome, even when chest radiographic findings are interpreted as normal.
抗Hu综合征（以首次发现该抗体的患者名字命名）的特征为副肿瘤性脑脊髓炎或感觉神经元病，血清或脑脊液中存在特异性抗体，且大多数患有该综合征的患者与肺癌相关。本研究的目的是确定胸部X线摄影和CT在抗Hu综合征患者成像中的相对优势。
回顾了11例抗Hu综合征患者的胸部X线摄影和CT表现，并与支气管镜检查、手术或尸检结果进行了对比。
11例患者中有10例患有小细胞肺癌；其余1例未发现癌症。1例患者的小细胞肺癌首先在X线片上显示，其余9例小细胞肺癌患者仅在CT上显示。在这9例患者中的6例中，最初的CT表现为肺癌阳性。当初始CT表现为阴性时，在4 - 8个月的随访CT中发现了肿瘤。所有10例癌症患者均有纵隔淋巴结肿大。4例有肺门淋巴结肿大。10例癌症患者中有3例出现实质受累。在2例患者中，小细胞肺癌的唯一CT表现是每位患者各有一个10毫米的纵隔淋巴结。
对于抗Hu综合征患者，即使胸部X线摄影结果被解释为正常，也应推荐进行胸部CT检查。
