ASSOCIATION OF SMALL-CELL LUNG-CANCER AND THE ANTI-HU PARANEOPLASTIC-SYNDROME - RADIOGRAPHIC AND CT FINDINGS

OBJECTIVE. The anti-Hu syndrome (bearing the name of the patient in wh om the antibody was first discovered) is characterized by a paraneopla stic encephalomyelitis or sensory neuronopathy and the presence of a s pecific antibody in the serum or CSF and is associated with lung cance r in most patients who have the syndrome. The objective of this study was to determine the relative merits of chest radiography and CT in th e imaging of patints with the anti-Hu syndrome. MATERIALS AND METHODS. Chest radiographic and CT findings of Il patients with anti-Hu syndro me were reviewed and correlated with results of bronchoscopy, surgery, or autopsy. RESULTS. Ten of the 11 patients had small cell lung cance r; in the remaining patient, no cancer was found. Small cell lung canc er was first revealed on radiographs in one patient and solely on CT i n the remaining nine patients with small cell lung cancer. In six of t hese nine pa tients, the initial CT findings were positive for lung ca ncer. Tumor was found on follow-up CT in 4-8 months when initial CT fi ndings were negative. Mediastinal adenopathy was present in all 10 can cer patients. Hilar adenopathy was present in four. Parenchymal involv ement was seen in three of the 10 patients with cancer, In two patient s, the only CT finding of small cell lung cancer was one mediastinal l ymph node of 10 mm in each patient. CONCLUSION. Chest CT should be rec ommended for patients with anti-Hu syndrome, even when chest radiograp hic findings are interpreted as normal.