SEROPOSITIVE, SYMMETRICAL POLYARTHRITIS IN A PATIENT WITH POORLY DIFFERENTIATED LUNG-CARCINOMA - CARCINOMATOUS POLYARTHRITIS, HYPERTROPHIC OSTEOARTHROPATHY OR RHEUMATOID-ARTHRITIS

Polyarthritis resembling rheumatoid arthritis (RA) may be the presenti ng manifestation of occult malignancy. Hypertrophic osteoarthropathy ( HOA) may also develop in association with pulmonary neoplasia and cons ists of clubbing, periostitis, and arthropathy. We describe a patient who presented with a seropositive, symmetric, inflammatory polyarthrit is only 4 weeks before a lung tumor became clinically and radiographic ally apparent. After initiation of chemotherapy, she developed feature s characteristic of HOA. It appears that the patient had both RA and H OA. We discuss the different diagnosis and review the relationship of RA, HOA, carcinomatous polyarthritis, and malignancy.