대한흉부영상의학회 Korean Society of Thoracic Radiology

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Weekly Chest CasesCases by Disease Category

Case No : 1364 Date 2023-12-12

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  • Courtesy of Sung Shine Shim, Woocheol Kwon / Ewha Womans University Seoul Hospital
  • Age/Sex 81 / F
  • Chief ComplaintBoth lower extremities (proximal limb) weakness for 3 months
  • Figure 1
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  • Figure 6
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Diagnosis With Brief Discussion

Diagnosis
small cell cancer associated with Lambert-Eaton myasthenic syndrome
Radiologic Findings
Histological examination of bronchoscopic-guided biopsy disclosed small cell lung cancer. Following a diagnosis of LEMS, the patient underwent one course of cisplatin + etoposide chemotherapy.

Fig 1-3. Chest CT images show an enhancing mass in subcarina and enlarged LNs in paratracheal area.
Fig 4-5. On the fused PET/CT images, the mass and LNs show focal hypermetabolic uptake.
Fig 6-7. Lung window setting of CT images show multifocal bronchiectasis with bronchiolitis. Decreased volume of left lung combined with effusion is noted.
Brief Review
The Lambert
References
1. ONeill JH, Murray NMF, Newsom-Davis J. The Lambert-Eaton myasthenic syndrome
Keywords

No. of Applicants : 70

▶ Correct Answer : 22/70,  31.4%
  • - Oita University, Faculty of Medicine , Japan FUMITO OKADA
  • - Jiangsu province hospital , China WANGJIAN ZHA
  • - Healthy Longevity Medical Center , Japan SHIN-ICHI CHO
  • - Fukuoka university , Japan KEISUKE SATO
  • - Osaka metropolitan university Hospital , Japan TATSUSHI OURA
  • - GHICL , France MANUEL TOLEDANO
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - , Japan KENTARO KOTANI
  • - , Japan SHUNJIRO NOGUCHI
  • - Qatif Central Hospital , Saudi Arabia HANI MAKKY ALSALAM
  • - Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
  • - , China LI GUO
  • - , Japan YUMI MAEHARA
  • - Ishikawa Matto Central Hospital , Japan MANABU AKIMOTO
  • - , Japan SUZUNE TSUKAMOTO
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Toyota Kosei Hospital , Japan YUKI HAYASHI
  • - Hyogo Prefectural Kobe Children , Japan SHUHEI NORIMOTO
  • - Tokyo Medical and Dental University , Japan MIKIYA FUJII
  • - , Japan HIROAKI ARAKAWA
  • - Yokkaichi municipal hospital , Japan HIKARI FUKUI
  • - Nerimahikarigaoka hospital , Japan TAKANA HAYASHI
▶ Correct Answer as Differential Diagnosis : 5/70,  7.1%
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
  • - The Catholic University of Korea Yoeuido St. Mary , Korea (South) CHAWOONG JEON
  • - , Japan KYOKO NAGAI
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
▶ Semi-Correct Answer : 2/70,  2.9%
  • - Others , India PURUSHOTHAMA RAO TUMMALA
  • - Matsunami General Hospital , Japan TARO TAKEDA
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