Asymmetrical diffuse Interstitial Lung Lesions with Multiple Lymphadenopathy

다발성 임파절 이상증을 동반한 비대칭적 폐 간질성 병변

We have experienced a case of sarcoidosis appearing asymmetrical diffuse interstitial lung lesions with multiple lymphadenopathy. This patient was a 57 year-old female who had been in good health until 2 months ago. At that time she noted the onset of an exertional dyspnea and weakness. Pulmonary function tests showed moderate obstructive pattern with mild decreased DLco. In the chest CT, multiple lymphadenopathy with small nodular lesions are scattered, and the impression was a metastatic lymph nodes with lymphangitic carcinomatosis. In bronchofiberscopy, we noted luminal narrowing by extrinsic compression in the right middle and lower lobe bronchi. And microscopic examination of by bronchofiberscopic biopsy showed chronic inflammation. Thus we performed subcarinal and tight supraclaviclar lymph nodes aspiration biopsy cytology, and that revealed class 0 and class 1, respectively. Finally, we performed an excisional biopsy for the right scalene lymph node, which revealed the specimen as a noncaseating granuloma. The angiotensin convecting enzyme level was overt two folds compared to normal value. And the patient had negative PPD skin test and hyperglobulinemia. After 18 weeks treatment with prednisone, the signs and symptoms which the patient clad suffered from, disappeared.

저자 등은 입원 당시 전이성 암 또는 원발성 폐암의 방사선학적 소견을 보인 환자의 진단과정 중에 우리가 흔히 보는 형태가 아닌 유육종증 1예를 경험하여 문헌 고찰과 함께 보고하는 바이다.