jkra The Journal of the Korean Rheumatism Association J Korean Rheum Assoc 1226-8070 2233-4718 The Korean Rheumatism Association 10.4078/jkra.2008.15.1.70 jkra-15-70 Original Article A Case of Bronchioloalveolar Carcinoma Presenting Adult-onset Still's Disease-like Manifestations due to Paraneoplastic Syndrome KimHyun-JinM.D. KwokSeung-KiM.D. ShinJung HaM.D. ∗ ChoChul-SooM.D. Division of Rheumatology, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea 03 2008 20 03 2008 15 1 70 75 12092007 28122007 Copyright © 2008 The Korean Rheumatism Association 2008 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract

Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder with the characteristics of high spiking fever, evanescent salmon-colored skin rash, arthralgia or arthritis, lymphadenopathy, hepato-splenomegaly, sore throat, leukocytosis, negative autoantibody and hyperferriti-nemia. There are reports that rheumatic diseases such as dermatomyositis, polymyositis, hypertrophic osteoarthropathy, and polymyalgia rheumatica are associated with neoplasms. And small cell lung cancer, thymoma, lymphoma, leukemia, and breast cancer are known to be more associated with paraneoplastic syndromes mimicking rheumatic diseases. We experienced a case with bronchioloalveolar carcinoma who developed clinical manifestations of AOSD. Although there are several reports that AOSD is associated with paraneoplastic syndrome, to our knowledge, this is the first case of bronchioloalveolar carcinoma mimicking AOSD reported in the world.

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Chest PA and Chest CT on admission (A) and 2 months later (B) show 2.8 cm sized, spiculated GGO nodule with air-bronchogram in lateral basal segment of RLL. GGO: ground glass opacity, RLL: right lower lobe of lung.

Bronchioloalveolar carcinoma characterized by tumor cell growing along preexisting alveolar structure (H&E, A: ×100, B: ×400).