Page 272 - First Aid for the USMLE Step 1 2020, Thirtieth edition [MedicalBooksVN.com]_Neat

228 SECtIoN II Pathology ` PATHOLOGY—neOPLASIA

Paraneoplastic syndromes
MAnIfeSTATIOn DeSCrIPTIOn/MeCHAnISM MOST COMMOnLY ASSOCIATeD TuMOr(S)
Musculoskeletal and cutaneous
Dermatomyositis Progressive proximal muscle weakness, Gottron Adenocarcinomas, especially ovarian
papules, heliotrope rash
Acanthosis nigricans Hyperpigmented velvety plaques in axilla and Gastric adenocarcinoma and other visceral
neck malignancies
Sign of Leser-Trélat Sudden onset of multiple seborrheic keratoses GI adenocarcinomas and other visceral
malignancies
Hypertrophic Abnormal proliferation of skin and bone at Adenocarcinoma of the lung
osteoarthropathy distal extremities Ž clubbing, arthralgia, joint
effusions, periostosis of tubular bones
Endocrine
Hypercalcemia PTHrP Squamous cell carcinomas of lung, head, and
neck; renal, bladder, breast, and ovarian
carcinomas
 1,25-(OH) 2 vitamin D 3 (calcitriol) Lymphoma
Cushing syndrome  ACTH
Hyponatremia (SIADH)  ADH Small cell lung cancer
Hematologic
Polycythemia  Erythropoietin Pheochromocytoma, renal cell carcinoma,
Paraneoplastic rise to high hematocrit levels HCC, hemangioblastoma, leiomyoma
Pure red cell aplasia Anemia with low reticulocytes
Thymoma
Good syndrome Hypogammaglobulinemia
Trousseau syndrome Migratory superficial thrombophlebitis
Nonbacterial Deposition of sterile platelet thrombi on heart Adenocarcinomas, especially pancreatic
thrombotic (marantic) valves
endocarditis
Neuromuscular
Anti-NMDA receptor Psychiatric disturbance, memory deficits, Ovarian teratoma
encephalitis seizures, dyskinesias, autonomic instability,
language dysfunction
Opsoclonus- “Dancing eyes, dancing feet” Neuroblastoma (children), small cell lung
myoclonus ataxia cancer (adults)
syndrome
Paraneoplastic Antibodies against antigens in Purkinje cells Small cell lung cancer (anti-Hu), gynecologic
cerebellar and breast cancers (anti-Yo), and Hodgkin
degeneration lymphoma (anti-Tr)
Paraneoplastic Antibodies against Hu antigens in neurons
encephalomyelitis
Small cell lung cancer
Lambert-Eaton Antibodies against presynaptic (P/Q-type) Ca
2+
myasthenic syndrome channels at NMJ
Myasthenia gravis Antibodies against postsynaptic ACh receptors Thymoma
at NMJ

FAS1_2019_04-Pathol.indd 228 11/7/19 4:02 PM