동시 다발성 폐흡충증의 임상적 치험

Paragonimiasis with Simultaneous Multifocal Lesions

  • 신동일 (성균관대학교 의과대학 강북삼성병원 흉부외과학교실) ;
  • 장운하 (성균관대학교 의과대학 강북삼성병원 흉부외과학교실) ;
  • 김정태 (성균관대학교 의과대학 강북삼성병원 흉부외과학교실) ;
  • 손진희 (성균관대학교 의과대학 강북삼성병원 흉부외과학교실) ;
  • 김경민 (성균관대학교 의과대학 강북삼성병원 흉부외과학교실) ;
  • 오태윤 (성균관대학교 의과대학 강북삼성병원 흉부외과학교실)
  • Shin, Dong-Il (Department of Thoracic and Cardiovascular Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Chang, Woon-Ha (Department of Thoracic and Cardiovascular Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Jung-Tae (Department of Thoracic and Cardiovascular Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Sohn, Jin-Hee (Department of Thoracic and Cardiovascular Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Kyoung-Min (Department of Thoracic and Cardiovascular Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Oh, Tae-Yoon (Department of Thoracic and Cardiovascular Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 발행 : 2007.05.05

초록

42세 남자가 객혈을 주소로 본원으로 전원되었다. 흉부 전산 촬영상에서 우상엽 폐첨부에 공동성 병변과 종격동의 종괴가 보였다. 폐첨부의 병변과 종격동 종괴에 대해 쐐기 절제술과 완전 절제술을 시행하였다. 병리학적 판독상 폐흡충증에 의한 염증성 병변이었다. 술 후 복부 전산 촬영상 폐흡충증으로 의심되는 병변이 가로 결장과 하행 결장에 나타났다. 환자는 술 후 2일간 praziquantel을 복용 후 합병증 없이 퇴원하였다. 현재까지 2년 동안 환자는 재발 없이 양호한 상태이다.

A 42-years-old man was referred to our department due to his hemoptysis. Chest CT showed a cavitary lung lesion in the apical segment of the RUL and an anterior mediastinal mass. The patient underwent wedge resection for the cavitary lesion and complete resection for the mediastinal mass. The pathologic finding was Paragonimus Westermani infestation in both the lung and thymus. The abdomen CT taken postoperatively showed an inflammatory mass involving the transverse colon and a small nodular lesion around the descending colon, which strongly suggested paragonimiasis. Postoperatively, the patient took Praziquantel for 2 days and he was discharged without any complications. There was no evidence of recurrence for the last 2 years.

키워드

참고문헌

  1. Song KH, Beak MJ, Sun K, Kim KT, Lee IS, Kim HM. Mediastinal parasitic cyst by paragonimiasis. Korean J Thorac Cardiovas Surg 1993;26:67-9
  2. DeFrain M, Hooker R. North American paragonimiasis. Chest 2002;121:1368-72 https://doi.org/10.1378/chest.121.5_suppl.121S
  3. Sakaki M, Kamiyama T, Yano T, Nakamura F, Nawa Y. Active hepatic capsulitis by paragonimus westermani infection. Intern Med 2002;41:661-3 https://doi.org/10.2169/internalmedicine.41.661
  4. Ashitani J, Kumamoto K, Matsukura S. Paragonimiasis westermani with multifocal lesions in lungs and skin. Intern Med 2000;39:433-6 https://doi.org/10.2169/internalmedicine.39.433
  5. Moon TJ, Yoon BY, Hahn YS. Spinal paragonimiasis. Yonsei Med J 1964;5:55-61 https://doi.org/10.3349/ymj.1964.5.1.55
  6. Jeon KM, Koh WJ, Kim HJ, et al. Clinical features of recently diagnosed pulmonary paragonimiasis in Korea. Chest 2005;128:1423-30 https://doi.org/10.1378/chest.128.4.2005
  7. Ahn WS, Hur Y, Kim BY, et al. Surgical treatment of paragonimiasis. Korean J Thorac Cardiovas Surg 1979;12: 312-7