Hypertrophic Pulmonary Osteoarthropathy as a Paraneoplastic Manifestation of Lung Cancer Takeo Ito, MD, Koichi Goto, MD, Kiyotaka Yoh, MD, Seiji Niho,

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Hypertrophic Pulmonary Osteoarthropathy as a Paraneoplastic Manifestation of Lung Cancer Takeo Ito, MD, Koichi Goto, MD, Kiyotaka Yoh, MD, Seiji Niho, MD, Hironobu Ohmatsu, MD, Kaoru Kubota, MD, Kanji Nagai, MD, Eishi Miyazaki, MD, Toshihide Kumamoto, MD, Yutaka Nishiwaki, MD Journal of Thoracic Oncology Volume 5, Issue 7, Pages 976-980 (July 2010) DOI: 10.1097/JTO.0b013e3181dc1f3c Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Bone scan of a lung cancer patient with HPO who underwent complete surgical resection of the lung cancer. The pathologic stage of the resected tumor was T2aN0M0, stage IB. A, Scan before the operation, performed on August 27, 2002. Note the bilateral localized uptake of the radionuclide at the wrist, femur, tibia, fibula, knee, and ankle. Abnormal uptake is observed along the cortical margins of the femur or tibia. B, Scan after surgery, performed on February 2, 2004. The abnormal uptake decreased, compared with the preoperative scan. The operation was performed on November 11, 2002. Journal of Thoracic Oncology 2010 5, 976-980DOI: (10.1097/JTO.0b013e3181dc1f3c) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Bone scan of a lung cancer patient with HPO who underwent chemotherapy. The clinical stage was T2bN2M1b, stage IV. The clinical response to treatment with chemotherapy was stable disease. A, Scan before chemotherapy, performed on January 5, 2006. Marked abnormal diffuse, strong uptake is seen in the lower extremities. Abnormal uptake is seen in both elbows and wrists. B, Scan after the second course of chemotherapy, performed on May 24, 2006. The abnormal uptake decreased. Journal of Thoracic Oncology 2010 5, 976-980DOI: (10.1097/JTO.0b013e3181dc1f3c) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions