Tuberculosis and Respiratory Diseases

  • 제63권4호
  • /
  • Pages.382-386
  • /
  • 2007
  • /
  • 1738-3536(pISSN)
  • /
  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
권호 표지

비소세포 폐암과 동반된 부수종양성 변연계뇌염 1예

A Case of Paraneoplastic Limbic Encephalitis Associated with Primary Adenocarcinoma of Lung

  • 신현종 (한양대학교 구리병원 혈액종양내과) ;
  • 김현수 (한양대학교 구리병원 혈액종양내과) ;
  • 임금남 (한양대학교 구리병원 혈액종양내과) ;
  • 노유석 (한양대학교 구리병원 혈액종양내과) ;
  • 최정혜 (한양대학교 구리병원 혈액종양내과) ;
  • 김인순 (한양대학교 구리병원 혈액종양내과) ;
  • 이영열 (한양대학교 구리병원 혈액종양내과) ;
  • 박병배 (한양대학교 구리병원 혈액종양내과) ;
  • 박동우 (한양대학교 구리병원 진단방사선과)
  • Shin, Hyun Jong (Department of Internal Medicine, Hanyang University Guri Hospital) ;
  • Kim, Hyun Soo (Department of Internal Medicine, Hanyang University Guri Hospital) ;
  • Lim, Keum Nam (Department of Internal Medicine, Hanyang University Guri Hospital) ;
  • Noh, U Seok (Department of Internal Medicine, Hanyang University Guri Hospital) ;
  • Choi, Jung Hye (Department of Internal Medicine, Hanyang University Guri Hospital) ;
  • Kim, In Soon (Department of Internal Medicine, Hanyang University Guri Hospital) ;
  • Lee, Young Yeul (Department of Internal Medicine, Hanyang University Guri Hospital) ;
  • Park, Byeong Bae (Department of Internal Medicine, Hanyang University Guri Hospital) ;
  • Park, Dong Woo (Department of Radiology, Hanyang University Guri Hospital)
  • 투고 : 2007.08.31
  • 심사 : 2007.09.28
  • 발행 : 2007.10.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

저자들은 이미 비소세포 폐암(선암)을 진단받고 Gefitinib으로 치료중인 여자 환자에서 기억장애, 행동 및 인지기능 장애 등의 증상으로 내원하여 뇌자기공명 소견과 혈청학적 검사로 부수종양성 변연계 뇌염을 진단하였으며 스테로이드 치료에 호전이 없었던 증례를 처음 경험하였기에 보고하는 바이다.

Paraneoplastic limbic encephalitis is a rare disorder that is characterized by personality changes, irritability, depression, seizures, memory loss and dementia, and is commonly associated with small cell lung cancer. The cause is unknown but it is believed to be an autoimmune disorder that develops secondary to a carcinomatous process. We report a patient with the clinical feature consistent with limbic encephalitis. A 64-year-old women developed disorientation, memory loss and general weakness. She was diagnosed with NSCLC (adenocarcinoma) with a brain metastasis 1 year earlier and was treated with radiation and chemotherapy. Although the lung mass and brain metastatic lesions had improved, the brain T2-weighted MRI showed high signal intensity in the right temporal region. This lesion consisted of with limbic encephalitis and was negative to the other viral and immune markers. The patient's symptoms did not improve after steroid treatment. Our case demonstrated that a NSCLC (adenocarcinoma) also can be associated with paraneoplastic limbic encephalitis.

키워드

참고문헌

  1. Corsellis JA, Goldberg GJ, Norwn AR. 'Limbic encephalitis' and its association with carcinoma. Brain 1968;91:481-96 https://doi.org/10.1093/brain/91.3.481
  2. Cakirer S. Paraneoplastic limbic encephalitis: case report. Comput Med Imaging Graph 2002;26:55-8 https://doi.org/10.1016/S0895-6111(01)00025-8
  3. Gultekin SH, Rosenfeld MR, Voltz R, Eichen J, Posner JB, Dalmau J. Paraneoplastic limbic encephalitis: neurological symptoms, immunologic findings and tumor association in 50 patients. Brain 2000;123:1481-94 https://doi.org/10.1093/brain/123.7.1481
  4. Dalmau J, Bataller L. Clinical and immunological diversity of limbic encephalitis: a model for paraneo-plastic neurologic disorders. Hematol Oneal Clin North Am 2006;20:1319-35 https://doi.org/10.1016/j.hoc.2006.09.011
  5. Vedeler CA, Antoine JC, Gometto D, Graus F, Grisold W, Hart IK, et al. Management of paraneo-plastic neurological synd개mes. Eur J Neurol 2006;13:682-90 https://doi.org/10.1111/j.1468-1331.2006.01266.x
  6. Cho TY, Kim YJ, Lee BI, Huh K A case of limbic encephalitis associated with small cell lung cancer about diagnostic MRl findings. J Korean Neural Assoc 1994;12:338-42
  7. Cho HJ, Jo JW. A case of paraneoplastic limbic encephalitis associated with immature teratoma. J Korean Neurol Assoc 2003;21:647-50
  8. Seo KY, Hur SY, Kim SJ, Park TC, Bae SN, Han GT, et al. A Clinicopathologic study of immature teratoma of the ovary. Korean J Obstet Gynecol 2004;47: 2389-96
  9. Hiasa Y, Kunishige M, Mitsui T, Kondo S, Kuriwaka R, Shigekiyo S, et al. Complicated paran대plastic neurological syndromes: a report of two patients with small cell or non-small cell lung cancer. Clin Neurol Neurosurg 2003;106:47-9 https://doi.org/10.1016/S0303-8467(03)00059-3
  10. Darnell RB, Fbsner JB. Paraneoplastic syndromes involving the Nervous system. N Engl J Med 2003;349: 1543-64 https://doi.org/10.1056/NEJMra023009
  11. Kim KK. Paraneoplastic syndrome. J Korean Neurol Assoc 2002;20:216-22
  12. Aydiner A, Curvit H, Baral I. Paraneoplastic limbic encephalitis with immature ovarian teratoma. J Neurooncol 1998;37:63-6 https://doi.org/10.1023/A:1005875822605
  13. Messori A, Lanza C, Serio A, Salvolini U. Resolution of limbic encephalitis with detection and treatment of lung cancer clinicalmdiological correlation. Eur J Radiol 2003;45:78-80 https://doi.org/10.1016/S0720-048X(02)00290-5
  14. Voltz R. Paraneoplastic neurological syndromes: an update on diagnosis, pathogenesis, and therapy. Lencet Neurol 2002;1:294-305 https://doi.org/10.1016/S1474-4422(02)00135-7
  15. Pittock S, Kryzer TJ, Lennon VA. Pamneoplastic antibodies coexist and predict cancer, not neurological syndrome. Ann Neurol 2004;56:716-9
  16. Vernino S, Lennon VA. New Putkinje cell antibody(FCA-2): marker of lung cancer-related neurological autoimmunity. Ann Neurol 2000;47:297-305 https://doi.org/10.1002/1531-8249(200003)47:3<297::AID-ANA4>3.0.CO;2-4