이소성 간으로 오진된 좌폐 하엽의 결핵종

A Tuberculoma in the Left Lower Lobe of Lung That Was Erroneously Diagnosed as Ectopic Liver

  • 송동섭 (원광대학교 산본병원 흉부외과) ;
  • 한원철 (원광대학교 산본병원 병리학과)
  • Song, Dong-Seop (Department Thoracic and Cardivascular Surgery, Sanbon Medical Center, Wonkwang University) ;
  • Han, Weon-Cheol (Department Pathology, Sanbon Medical Center, Wonkwang University)
  • 발행 : 2009.12.05

초록

폐의 결핵종은 드물지 않게 관찰되는 소견이다. 그러나, 폐의 이소성 간은 매우 드물다. 결핵종으로 보여지는 폐결핵은 방사선적 소견으로 진단이 가능하지만 확진은 항산균을 확인하거나 조직학적 소견으로 한다. 초음파하 세침 흡인 조직 검사로 이소성간으로 잘못 진단된 좌하엽의 결핵종 증례를 보고한다. 간의 정상적 변이에 대한 이해가 불필요한 침습적 시술을 예방할 수 있으리라 생각된다.

Tuberculoma of the lungs is not an uncommon finding, but an ectopic liver in the lung is extremely rare. Pulmonary tuberculosis presenting as tuberculoma can be diagnosed radiologically, but its definite diagnosis is established by confirmation of the acid-fast bacillus or the unique histology. We report here on a case of tuberculoma of the left lower lobe that was erroneously diagnosed as ectopic liver by ultrasono-guided fine needle aspiration biopsy. An understanding of the normal variants of the liver can prevent a patient from undergoing an unnecessary invasive procedure.

키워드

참고문헌

  1. Andreu J, Caceres J, Pallisa E, Martinez-Rodriquez M. Radiologic manifestations of pulmonary tuberculosis. Eur J Radiol 2004;51:139-49 https://doi.org/10.1016/j.ejrad.2004.03.009
  2. Kasales CJ, Patel SP, Hopper KD, et al. Imaging variants of the liver, pancreas, and spleen. Crit Rev Diagn Imaging 1994;35:485-543
  3. Seo CH, Cha SS, Lee BJ, Choe JY, Choe SJ, Eun CG. Evaluation of lateral margin of left lobe of the liver on CT scan: focus on perisplenic extension. J Korean Radiol Soc 1996;35:511-6 https://doi.org/10.3348/jkrs.1996.35.4.511
  4. Chen F, Heller DS, Bethel C, Faye-Petersen O. Intrathoracic ectopic lobe of liver presenting as pulmonary sequestration. Fetal Pediatr Pathol 2005;24:155-9 https://doi.org/10.1080/15227950500305520
  5. Slone T, Emil S, Meissner N, Behjatnia B, Fairbanks T, Romansky S. Sternal cleft, morgagni hernia, and ectopic liver: a unique chest wall anomaly. J Pediatr Surg 2007;42: 2132-5 https://doi.org/10.1016/j.jpedsurg.2007.08.053
  6. Chalak LF, Parham DM. A newborn with poland anomaly and liver ectopy: an unusual association with important prognostic implications. Pediatr Dev Pathol 2007;10:134-7 https://doi.org/10.2350/06-04-00801.1
  7. Khalbuss WE, Bajestani S, D’Agostino HJ. Cytomorphology of a solitary left chest wall mass: an unusual presentation from unknown primary hepatocellular carcinoma. Diagn Cytopathol 2007;35:586-9 https://doi.org/10.1002/dc.20459
  8. Leone N, De Paolis P, Carrera M, et al. Ectopic liver and hepatocarcinogenesis: report of three cases with four years’ follow up. Eur J Gastroenterol Hepatol 2004;16:731-5 https://doi.org/10.1097/01.meg.0000131044.05434.f7