Mediastinal lymph node metastasis of lung cancer with an unknown primary lesion having concurrent endocrine abnormality and acanthosis nigricans: report of a case.
Mediastinal lymph node metastasis of lung cancer with an unknown primary lesion having concurrent endocrine abnormality and acanthosis nigricans: report of a case.
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发表时间：
2009-12
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通讯作者：
N. Yoshino;S. Yamagishi;H. Kubokura;I. Mikami;T. Hirata;K. Koizumi;T. Okano;A. Futagami;M. Kawamoto;K. Shimizu
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作者：
N. Yoshino;S. Yamagishi;H. Kubokura;I. Mikami;T. Hirata;K. Koizumi;T. Okano;A. Futagami;M. Kawamoto;K. Shimizu
我们在此描述一位原发病灶不明的肺癌纵隔淋巴结转移合并内分泌异常及黑棘皮症的病例。一名66岁的男性到当地医院就诊，被诊断为黑棘皮病。患者被转诊至我院做进一步检查。胸部和腹部的计算机断层扫描显示，除了纵隔淋巴结肿大外，没有其他不良结果。上消化道检查未发现恶性病变。基于上述发现，认为病变可能是不明原发肿瘤或恶性淋巴瘤的纵隔淋巴结转移。对纵隔淋巴结进行胸腔镜活检。患者被诊断为肺癌纵隔淋巴结转移，原发灶不明，副肿瘤综合征导致内分泌异常。开始姑息性放射治疗以预防上级腔静脉综合征和食管通道衰竭或吞咽困难。此后皮肤病变明显改善。血清促肾上腺皮质激素水平降低。
We herein describe a patient we encountered in whom mediastinal lymph node metastasis of lung cancer with an unknown primary lesion was complicated by both an endocrine abnormality and acanthosis nigricans. A 66-year-old male visited a local hospital and was diagnosed as having acanthosis nigricans. The patient was referred to our hospital for further examination. Computed tomography scans of the chest and the abdomen showed no adverse findings except for an enlargement of the mediastinal lymph node. No malignant lesions were detected in examinations of the upper gastrointestinal tract. Based on the above findings, the lesion was thus considered to possibly be mediastinal lymph node metastasis of an unknown primary tumor or malignant lymphoma. A thoracoscopic biopsy of the mediastinal lymph node was performed. The patient was diagnosed to have mediastinal lymph node metastasis of lung cancer with an unknown primary lesion and endocrine abnormality resulting from paraneoplastic syndrome. Palliative radiation therapy was initiated to prevent superior vena cava syndrome and esophageal passage failure or dysphagia. The cutaneous lesions markedly improved thereafter. The serum levels of adrenocorticotropic hormone decreased.