Clubbing Fingers in a Patient as an Initial Presenting Symptom of Lung Adenocarcinoma-A Case Report

肺腺細胞癌病人以杵狀指為初始表現－個案報告

林祐賢(Hugo You-Hsien Lin) ； 鍾飲文(Inn-Wen Chong) ； 王東衡(Tung-Heng Wang) ； 蔡米山(Mee-Sun Tsai) ； 黃明賢(Ming-Shyan Huang) ； 黃吉志(Jhi-Jhu Hwang)

《胸腔醫學》 22卷3期 (2007/06) Pp. 187-192

https://doi.org/10.29806/TM.200706.0006

摘要

杵狀指在許多疾病中是個極有特色的理學徵像，它的病理生理學機轉依然未獲定論，但這個極富特色的症狀提供臨床醫師一個重要的線索來做鑑別診斷。我們報告一位57歲女性因為杵狀指，合併骨頭疼痛而住院。經詳細檢查，發現骨骼掃描呈現兩邊骨盆以及下肢長骨骨增生性病變，並且在胸部X光以及斷層掃描發現右上胸肺葉有一小葉狀腫瘤與數個小結節遍布兩邊肺葉。病理檢查報告為腺細胞癌，由於肺癌後期，經過了化學治療，杵狀指獲得了改善，因此我們認為造成此病患處狀指的病因是肺癌。

關鍵字

杵狀指 ； 增生性肺性骨關節病 ； 腺癌

並列摘要

Clubbing finger is a characterized physical finding in many diseases. Its pathophysiology is still uncertain. But this striking symptom and sign gives the physician an important clue to make the differential diagnosis. We report the case of a 57-year-old female who was admitted to our hospital with chief complaint of clubbing fingers and bone pain. The serial examinations showed possible hypertrophic pulmonary osteoarthropathy (HPOA) throughout the bilateral pelvic bones and the long bones of both lower limbs, with a lobulated nodule in the right middle lung and multiple small nodules in both lung fields. The CT-guided biopsy pathologic study of this pulmonary nodule was adenocarcinoma. Due to the advanced stage of the lung cancer, she received chemotherapy, after which, the clubbing fingers improved. We conclude that the HPOA of this patient was probably caused by the lung cancer.

並列關鍵字

clubbing finger ； hypertrophic pulmonary osteoarthropathy HPOA ； adenocarcinoma