Path-Paraneoplastic Syndromes

Question 1

Describe acanthosis nigricans

Answer 1

Hyperpigmented velvety plaques in axilla and neck

Question 2

What cancers is acanthosis nigricans most commonly associated with?
-Acanthosis nigricans is also associated with what other diseases?

Answer 2

• Gastric adenocarcinomas and other visceral malignancies

- More commonly associated with obesity and insulin resistance

Question 3

Describe the sign of Leser-Trelat

Answer 3

Sudden onset of multiple seborrheic keratoses

Question 4

The Leser-Trelat sign is most commonly associated with what cancers?

Answer 4

Gastric adenocarcinomas and other visceral malignancies

Question 5

What are the 2 possible mechanisms that lead to hypercalcemia?
-What cancer(s) is each mechanism associated with?

Answer 5

• PTHrP -> Squamous cell carcinomas of the lung, head, and neck, renal, bladder, breast, and ovarian carcinomas
• Excess vitamin D3 (active form/calcitriol) -> Lymphomas

Question 6

What is Cushing syndrome?

Answer 6

Increased ACTH

Question 7

Cushing syndrome is most commonly associated with what cancer?

Answer 7

Small cell lung cancer

Question 8

Hyponatriemia (SIADH) is most commonly associated with what cancer?

Answer 8

Small cell lung cancer

Question 9

What is polycythemia?

Answer 9

Increased EPO -> increased RBCs

Question 10

Polycythemia is most commonly associated with what cancers?

Answer 10

Renal cell carcinoma, hepatocellular carcinoma, hemangioblastoma, pheochromocytoma, leiomyoma

Question 11

What is pure red cell aplasia?

Answer 11

Anemia with low reticulocyte count

Question 12

Pure red cell aplasia is most commonly associated with what cancer?

Answer 12

Thymoma

Question 13

What is Good syndrome?

Answer 13

Hypogammaglobulinemia

Question 14

Good syndrome is most commonly associated with what cancer?

Answer 14

Thymoma

Question 15

What is Trousseau syndrome?

Answer 15

Migratory superficial thrombophlebitis

Question 16

Trousseau syndrome is most commonly associated with what cancers?

Answer 16

Adenocarcinoma, especially pancreatic

Question 17

What is nonbacterial thrombotic (marantic) endocarditis?

Answer 17

Deposition of sterile platelet thrombi on heart valves

Question 18

Nonbacterial thrombotic (marantic) endocarditis is most commonly associated with what cancers?

Answer 18

Adenocarcinomas, especially pancreatic

Question 19

What are the symptoms of anti-NMDA receptor encephalitis?

Answer 19

Psychiatric disturbance, memory deficits, seizures, dyskinesias, autonomic instability, language dysfx

Question 20

Anti-NMDA receptor encephalitis is most commonly associated with what cancer?

Answer 20

Ovarian teratoma

Question 21

What are the symptoms of opsoclonus-myoclonus ataxia syndrome?

Answer 21

“Dancing eyes, dancing feet”

Question 22

Opsoclonus-myoclonus ataxia syndrome is most commonly associated with what cancer in ADULTS?

Answer 22

Small cell lung cancer

Question 23

Opsoclonus-myoclonus ataxia syndrome is most commonly associated with what cancer in CHILDREN?

Answer 23

Neuroblastoma

Question 24

What is the mechanism of paraneoplastic cerebellar degeneration?

Answer 24

Abs against Ags in Purkinje cells

Question 25

Paraneoplastic cerebellar degeneration is most commonly associated with what cancers -What are the Abs associated with each?

Answer 25

- Small cell lung cancer (anti-Hu) - Gynecologic and breast cancers (anti-Yo) - Hodgkin lymphoma (anti-Tr)

Question 26

What is the mechanism of paraneoplastic encephalomyelitis?

Answer 26

Abs against Hu Ags in neurons

Question 27

Paraneoplastic encephalomyelitis is most commonly associated with what cancer?

Answer 27

Small cell lung cancer

Question 28

What is the mechanism of Lambert-Eaton myasthenic syndrome?

Answer 28

Abs against PRE-synaptic (P/Q-type) Ca channels at NMJ

Question 29

Lambert-Eaton myasthenic syndrome is most commonly associated with what cancer?

Answer 29

Small cell lung cancer

Question 30

What is the mechanism of myasthenia gravis?

Answer 30

Abs against POST-synaptic Ach receptors at NMJ

Question 31

Myasthenia gravis is most commonly associated with what cancer?

Answer 31

Thymoma