The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

A case of lung metastasis of papillary thyroid carcinoma presenting with tuberculous pleurisy

결핵성 흉막염을 동반한 갑상선 유두암의 폐전이 1예

  • Ahn, Byung-Kyu (Department of Internal Medicine, Gumi Hospital, Soonchunhyang University College of Medicine) ;
  • Park, Se-Yun (Department of Internal Medicine, Gumi Hospital, Soonchunhyang University College of Medicine) ;
  • Hwang, Hun-Gyu (Department of Internal Medicine, Gumi Hospital, Soonchunhyang University College of Medicine) ;
  • Lim, Gun-Il (Department of Internal Medicine, Gumi Hospital, Soonchunhyang University College of Medicine) ;
  • Kim, Sook (Department of Diagnostic Pathology, Gumi Hospital, Soonchunhyang University College of Medicine) ;
  • Yang, Seung-Boo (Department of Radiology, Gumi Hospital, Soonchunhyang University College of Medicine) ;
  • Im, Han-Hyeok (Department of Radiology, Gumi Hospital, Soonchunhyang University College of Medicine)
  • 안병규 (순천향대학교 구미병원 내과) ;
  • 박세윤 (순천향대학교 구미병원 내과) ;
  • 황헌규 (순천향대학교 구미병원 내과) ;
  • 임건일 (순천향대학교 구미병원 내과) ;
  • 김숙 (순천향대학교 구미병원 병리과) ;
  • 양승부 (순천향대학교 구미병원 영상의학과) ;
  • 임한혁 (순천향대학교 구미병원 영상의학과)
  • Received : 2009.08.04
  • Accepted : 2009.11.16
  • Published : 2010.09.01
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Abstract

Papillary thyroid carcinoma is the most prevalent type of thyroid cancer. Metastasis of this carcinoma commonly occurs in the lung and has been reported to present 5 to 30 years after the initial diagnosis of thyroid cancer. Pleural effusion can mask this metastatic spread. In patients with pleural effusion, laboratory measurement of the adenosine deaminase (ADA) level in the pleural fluid can be effective in identifying and ranking pulmonary metastasis in the differential diagnosis. A 70-year-old female patient visited our hospital with dyspnea. She presented with a considerable amount of pleural effusion. A pleural biopsy was performed and the Ziehl-Neelsen stains revealed a few acid-fast bacilli, but the ADA level in the pleural fluid was 2.4 IU/L. After drainage of the pleural effusions, we discovered pulmonary nodules by computed tomography (CT), which were later diagnosed through histologic examination as pulmonary metastasis from papillary thyroid carcinoma. We report this case.

저자들은 70세 여자 환자가 흉수소견으로 내원하여 흉수천자 및 늑막 조직검사를 시행하여 결핵성 흉막염이 진단되었으나, 아데노신 탈아미노효소가 2.4 IU/L로 낮았고, 흉부전산화단층촬영상 우하엽에 폐종괴 소견과 양측 미세결절이 관찰되었다. 경흉 세침흡입 세포검사에서 5년 전 전절제술을 받았던 갑상선 유두암의 폐전이가 진단되어, 결핵성 흉막염을 동반한 갑상선 유두암의 폐전이 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

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