Wataya H, Ogata K, Morooka M, Nakahashi H, Hara N
Department of Pulmonary Disease, Matsuyama Red Cross Hospital, Ehime, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 Apr;36(4):389-93.
We report an unusual case of T 0 N 2 M 0 small cell lung cancer in a patient with Lambert-Eaton myasthenic syndrome (LEMS). A 52-year-old man began to notice muscle weakness in a left limb in January 1996, which was followed by muscle weakness in his left arm and fingers, appetite loss, and general fatigue. An electromyogram (EMG) showed the waxing phenomenon in response to high-frequency repetitive stimulation. Lambest-Eaton myasthenic syndrome was diagnosed, based on his symptoms and EMG findings. Chest computed tomography (CT) was done, and left paratracheal, tracheobronchial, subaortic, and hilar lymphadenopathy were found. No mass was seen in either lung field. Cytologic examination of the sputum and bronchial lavage fluid were done, but no malignant cells were found Small cell lung cancer was diagnosed after thoracoscopic resection of the subaortic lymph nodes. No metastases were detected by bone scintigraphy, abdominal CT, or magnetic resonance imaging of the brain. Complete response and resolution of symptoms were obtained by chemotherapy and irradiation.
我们报告了一例罕见的T0N2M0小细胞肺癌患者,该患者同时患有兰伯特-伊顿肌无力综合征(LEMS)。一名52岁男性于1996年1月开始注意到左下肢肌肉无力,随后出现左臂和手指肌肉无力、食欲减退和全身疲劳。肌电图(EMG)显示对高频重复刺激有波幅递增现象。根据其症状和肌电图检查结果,诊断为兰伯特-伊顿肌无力综合征。进行了胸部计算机断层扫描(CT),发现气管旁、气管支气管、主动脉弓下和肺门淋巴结肿大。两肺野均未见肿块。对痰液和支气管灌洗液进行了细胞学检查,但未发现恶性细胞。在胸腔镜下切除主动脉弓下淋巴结后诊断为小细胞肺癌。骨闪烁显像、腹部CT或脑部磁共振成像均未检测到转移。通过化疗和放疗,症状完全缓解。