BOF: 48
A 63-year-old female presents with dizziness, slurring of
speech and incoordination of movement of 4-6 weeks duration.
She was admitted numerous investigations were performed and
she was discharged.
Results were as follows:
Routine haematology and biochemistry were normal.
Antibody screen had shown her to be positive for anti Yo
antibody
MRI scan of her head had been normal.
EEG showed no abnormality
CSF examination following lumbar puncture normal
Your colleague rings you up to ask you about these tests
and your advise would be that this lady is likely to have:
a)
Small cell carcinoma of the lung
b)
Ovarian carcinoma
c)
Hodgkin’s lymphoma
d)
Non-Hodgkin’s lymphoma
e)
Pancreatic cancer
Answer:
b)
The patient presented with a cerebellar syndrome. The
normal MRI excludes a structural lesion of the cerebellum; normal CSF makes a
demyelinating lesion unlikely.
The chances of this being a paraneoplastic syndrome are
high.
Anti Yo antibodies occur in paraneoplastic cerebellar
syndromes and suggest cancers of the breast or ovary as the underlying lesion.
In males anti Yo antibodies occur in patients having cancers of the parotids,
oesophagus or stomach.
Anti Hu antibodies occur in small cell carcinoma of the
lung
Last Updated: 1/05/06
