Tuberculosis and Respiratory Diseases
- 제48권6호
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- Pages.980-985
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- 2000
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- 1738-3536(pISSN)
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- 2005-6184(eISSN)
간질성 음영의 급격한 악화를 보인 림프관성 폐암종증 1예
A Case of Lymphangitic Carcinomatosis of Lung Presented as Rapidly Exacerbating Reticulonodular Infiltrates
- 정정 (가톨릭대학교 의과대학 내과학교실) ;
- 장재순 (가톨릭대학교 의과대학 내과학교실) ;
- 주현중 (가톨릭대학교 의과대학 내과학교실) ;
-
이상학
(가톨릭대학교 의과대학 내과학교실) ;
- 여동승 (가톨릭대학교 의과대학 내과학교실) ;
-
현대성
(가톨릭대학교 의과대학 내과학교실) ;
- 최영미 (가톨릭대학교 의과대학 내과학교실) ;
- 김석찬 (가톨릭대학교 의과대학 내과학교실) ;
- 이숙영 (가톨릭대학교 의과대학 내과학교실) ;
- 문화식 (가톨릭대학교 의과대학 내과학교실) ;
- 송정섭 (가톨릭대학교 의과대학 내과학교실) ;
- 박성학 (가톨릭대학교 의과대학 내과학교실)
- Jung, Jung (Department of Internal Medicine The Catholic University of Korea, College of Medicine) ;
- Jang, Jae-Soon (Department of Internal Medicine The Catholic University of Korea, College of Medicine) ;
- Joo, Hyun-Jung (Department of Internal Medicine The Catholic University of Korea, College of Medicine) ;
-
Lee, Sang-Haak
(Department of Internal Medicine The Catholic University of Korea, College of Medicine) ;
- Yeo, Dong-Seung (Department of Internal Medicine The Catholic University of Korea, College of Medicine) ;
-
Hyun, Dae-Seong
(Department of Internal Medicine The Catholic University of Korea, College of Medicine) ;
- Choi, Young-Mee (Department of Internal Medicine The Catholic University of Korea, College of Medicine) ;
- Kim, Seok-Chan (Department of Internal Medicine The Catholic University of Korea, College of Medicine) ;
- Lee, Sook-Young (Department of Internal Medicine The Catholic University of Korea, College of Medicine) ;
- Moon, Hwa-Sik (Department of Internal Medicine The Catholic University of Korea, College of Medicine) ;
- Song, Jeong-Sup (Department of Internal Medicine The Catholic University of Korea, College of Medicine) ;
- Park, Sung-Hak (Department of Internal Medicine The Catholic University of Korea, College of Medicine)
- 발행 : 2000.06.30
초록
호흡곤란과 마른 기침을 주소로 내원한 52세 여자 환자가 미만성 간질성 폐음영의 급속한 악화소견을 보이며 급성호흡부전으로 진행하여 입원 11일째 사망하였다. 입원 초기에 임상적 진단용 내리는데 어려움이 있었으나 기관지경을 통한 경기관지 폐생검상 선암의 림프관성 폐전이를 확진할 수 있었다. 저자들은 암을 아직 진단받지 않은 상태의 환자에서도 미만성 간질성 폐음영이 진행하는 경우 림프관성 폐암종을 감별진단으로 고려하여야 하며 경기관지 폐생검이 진단에 유용할 수 있을 것으로 생각한다.
A 52-year-old woman was presented with 2-week history of increasing dyspnea and dry cough. The chest radiograph revealed bilateral reticular infiltrates. Radiographic infiltrates were rapidly progressed and symptoms from hypoxemia were aggravated. The patient was intubated and bronchoscopy with transbronchial lung biopsies was performed. Biopsies revealed lymphatic vessels plugged by nests of metastatic adenocarcinoma. She died 11 days after admission despite of intensive ventilatory support. We had difficulties in the diagnosis of lymphangitic lung carcinomatosis at initial presentation of her illness because the progression was unusually rapid. Lymphangitic lung carcinomatosis shoud should be included in the differential diagnosis of patients showing rapidly progressive interstitial radiographic findings. Also, transbronchial biopsy may be a useful tool to confirm the diagnosis.