Bone scan characteric findings for hypertrophic pulmonary osteoarthropathy (HPO) in patients with pulmonary diseases
- VernacularTitle:肥大性肺性骨关节病的骨显像特征及临床意义
- Author:
Xinghao AI
- Publication Type:Journal Article
- Keywords:
lung carcinoma;
secondary hypertrophic osteoarth ropathy;
radionuclide imaging
- From:
China Oncology
1998;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Purpose:To investigate the characteristic findi ngs for HPO in bone scintigraphy and evaluate the clinical significance of HPO i n lung diseases. Methods:~99mTc-MDP bone scintigram of 11 025 patients in Shanghai Chest Hospital were reviewed. Among them 75 HPO cases were confirmed by ~99mTc-MDP bone scan. The scintigrams and clinical evidences of these pat ients were retrospectively analyzed. Results:①In our study, bone scan disclosed two patterns: doubl e-stripe sign and symmetrically increased uptake in juxta-articular bone. The incidence were 96% and 2.6% respectively. Increased uptake along the cortical ma rgins of the long bone were more obvious in the lower than upper extremities.②H PO occurred principally in man more than 45 years old with smoking history excee ding 400 pack years. ③Digital clubbing and arthralgia were presented in 25(33.3 %) of the 75 patients with HPO. They may be the first sign of the intrathoracic tumors especially of bronchogenic carcinoma. ④We observed 72 HPO cases(96%) sec ondary to intrathoracic tumors including solitary pleural tumor, pulmonary metas tatic tumor, thymic carcinoma and bronchogenic carcinoma. The most common diseas e associated with HPO was bronchogenic carcinoma, which occurred in 90.7% of pat ients. The inflammatory pulmonary disease associated with HPO was unusual(4%), i ncluding bacterial pneumonia and tubclosis. ⑤The incidence of HPO in patients w ith bronchogenic carcinoma was 2.3%. The tumor was predominantly located in the periphery. HPO was more common in patients with adenocarcinoma(51.4%) and almost occurred in middle or low differentiated lung cancer(91.2%). There was no relat ionship between HPO and staging of tumor. Conclusions:Double-stripe sign was a main characteristic findi ng for HPO. The presence of HPO may predict the involvement of lung disease. HPO was mainly associated with intrathoracic tumors especially with lung cancer. Th e physicians should pay much attention to the syndrome.
