Paraneoplastic syndromes

Question 1

Acanthosis nigricans

Answer 1

Hyperpigmented velvet plaques in axilla and neck

Gastric adenocarcinoma, other visceral malignancies

Question 2

Sign of Leser Trelat

Answer 2

Sudden onset of multiple seborrheic keratoses

GI adenocarcinoma, other visceral malignancies

Question 3

Hypercalcemia

Answer 3

Due to PTHrP - squamous cell carcinoma of lung, head and neck; renal, bladder, breast and ovarian carcinomas

Due to ↑ Vit D - lymphoma

Question 4

Cushings syndrome

Answer 4

↑ ACTH → Small cell lung cancer

Question 5

Hyponatremia - SIADH

Answer 5

↑ ADH → Small cell lung cancer

Question 6

Polycythemia

Answer 6

↑ EPO → RCC, HCC, pheochromocytoma, hemangioblastoma, leiomyoma

Question 7

Pure red cell aplasia

Answer 7

Anemia w/ no reticulocytes → Thymoma

Question 8

Good syndrome

Answer 8

Hypogammaglobulinemia → Thymoma

Question 9

Trosseau syndrome

Answer 9

Migratory superficial thrombophlebitis → adenocarcinomas, esp pancreatic

Question 10

Marantic (non bacterial) endocarditis

Answer 10

Sterile platelet thrombi on heart valves → adenocarcinomas, esp pancreatic

Question 11

Anti-NMDA receptor encephalitis

Answer 11

Psych disturbance, memory deficits, seizures, dyskinesias, autonomic instability, language dysfunction → ovarian teratomas

Question 12

Opsoclonus-myoclonus ataxia syndrome

Answer 12

Dancing eyes and feet → neuroblastoma in kids, small cell lung cancer in adults

Question 13

Paraneoplastic cerebellar degeneration

Answer 13

Abs against antigens in purkinje cells.
Anti-Hu → small cell lung cancer
Anti-Yo → breast and gyn cancers
Anti-Tr → Hodgkin lymphoma

Question 14

Paraneoplastic encephalomyelitis

Answer 14

Abs against Hu antigens in neurons → small cell lung cancer

Question 15

Lambert Eaton Myasthenic Syndrome

Answer 15

Abs against presynpatic Ca channels → small cell lung cancer

Question 16

Myasthenia gravis

Answer 16

Abs against postsynaptic ACh receptors → thymoma

Question 17

Thymoma

Answer 17

Pure red cell aplasia
Good syndrome
Mysathenia gravis

Question 18

Small cell lung cancer

Answer 18

Paraneoplastic cerebellar degeneration
Paraneoplastic encephalomyelitis
Lambert Eaton Myasthenic Syndrome
Opsoclonus Myoclonus Ataxia syndrome
SIADH