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Query: UMLS:C0684249 (lung carcinoma)
 23,830 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of paraneoplastic retinopathy in a patient who was found to have small cell carcinoma of the lung and was shown to have serum antibody against retinal soluble 70 kDa protein. A 71-year-old woman visited her ophthalmologist for gradual visual loss in both eyes. Although she underwent uncomplicated cataract surgery in her left eye, she was referred to our hospital because of progressive visual deterioration in November 1994. On admission, her corrected visual acuity was 0.3 OD and hand motion OS. Funduscopic examination showed narrowing retinal arteries, pigment epithelial mottling in the posterior retina bilaterally, and optic disc pallor in the left eye. An electroretinogram demonstrated marked reduction in the a and b waves. Bilateral central scotomas were detected by kinetic perimetry. We pursued further examination for systemic disease, and identified increased serum level of neuron specific enolase and radiographically abnormal shadow in the chest. Transcutaneous needle biopsy of the mediastinum confirmed small cell carcinoma. In western blot analysis the patient's serum reacted strongly with soluble retinal proteins of 70 kDa molecular weight, although the 26 kDa CAR antigen was not labeled. This patient was diagnosed as having paraneoplastic retinopathy due to small cell carcinoma and unusual serum protein which responded to an antigen with a molecular weight of 70 kilodaltons.
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PMID:[A case of paraneoplastic retinopathy with serum antibody against retinal soluble 70 kDa protein]. 902 14

We present the case of a 74-year-old man with rapidly progressive bilateral visual loss, optic disc pallor, retinal arteriolar attenuation, and an abnormal electroretinogram with a 90% reduction in cone function and a 50% reduction in rod function. He was examined for a suspected cancer-associated retinopathy (CAR). Although he was found not to have expressed the previously reported 23-kd CAR antibody, high titers were found of an antibody to a 60-kd retinal protein, which as yet remains unidentified. An initial clinical search for an underlying cancer was unsuccessful, but 2 months later a mediastinal mass was found on chest x-rays, and biopsy confirmed a diagnosis of small-cell lung carcinoma. Combined therapy with oral corticosteroids and plasmapheresis resulted in a recovery of vision from counting fingers to 20/200 in the right eye and 20/40 to 20/25 in the left eye. Conventional chemotherapeutic management of the small-cell lung carcinoma was instituted, and the modest visual recovery was maintained. The visual improvement as well as lung tumor regression were accompanied by a decline in antibody titers from 1:2,000 pretreatment to 1:200 during the course of therapy. The absence of reactivity with the previously described 23-kd retinal antigen of the CAR syndrome does not exclude the diagnosis of paraneoplastic retinopathy in patients fitting the clinical profile of this disease.
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PMID:Paraneoplastic retinopathy: a novel autoantibody reaction associated with small-cell lung carcinoma. 917 75

We describe distinctive necrosis in the brainstem of two adult patients of anoxic encephalopathy. The patients were a 75-year-old man and an 82-year-old woman, who were resuscitated after cardiac arrest that lasted about 20 minutes and artificially ventilated. The first patient remained comatose without recovery of brainstem reflexes and had persistent hypotension requiring continuous infusion of catecholamine until death that occurred two weeks after the onset of illness. In the second patient, her general circulation recovered on the next day resuscitation, and traces of brainstem reflexes reappeared thereafter, while her consciousness was severely disturbed throughout the three weeks' clinical course. Both of the patients failed to regain spontaneous respiration and required the ventilatory support. On general autopsy, the first patient had small cell carcinoma of the lung with metastasis to the pleura, hilar lymph nodes and liver. In the second patient, an old myocardial infarction and pneumothorax were found. The neuropathological findings in the two patients were similar, varying only in their severity, except for the presence of the degenerative changes compatible with those of progressive supranuclear palsy in the second patient. There were laminar necrosis in the cerebral cortex and severe ischemic changes in the basal ganglia, thalamus and cerebellum. The cerebral white matter, however, exhibited only myelin pallor without apparent destruction. There was no herniation in the brain. In the first patient, fresh hemorrhages were noted in the bilateral globus pallidus. In the brainstem, symmetrical necrosis was present exclusively in the gray matter: the superior and inferior colliculi, periaqueductal gray matter, substantia nigra and the several cranial nuclei including the spinal nucleus of the trigeminal nerve, solitary and vestibular nuclei. In the second patient the symmetrical necrotic foci were also found in the substantia gelatinosa of the lower lumbar and sacral cords which were available for examination. Around these sharply demarcated necrotic lesions of the brainstem and spinal cord were there rarefaction and pronounced astrogliosis. Unlike the cases of neonates or infants, symmetrical necrosis in the brainstem has been reported to be exceptional in adult patients of anoxic encephalopathy. Now that the medical technology of resuscitation is well advanced, the adult patients exhibiting the pathology presented here may be encountered more frequently than previously thought.
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PMID:[Symmetrical necrosis in the gray matter of the brainstem and spinal cord. Two adult cases of anoxic encephalopathy]. 1282 May 60