Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Mixed Herbal Medicine Induced Diffuse Infiltrative Lung Disease: The HRCT and Histopathologic Findings

혼합성분의 한약복용 후 발생된 미만성침윤성폐질환: 고해상CT 및 조직병리학적 소견

  • Kim, Tae-Gyu (Department of Radiology, Sanggye Paik Hospital, Inje University) ;
  • Kim, Joung-Sook (Department of Health Promotion Medicine, Mokdong Hospital, Ewha Womans University) ;
  • Shin, Eun-A (Department of Pathology, Sanggye Paik Hospital, Inje University)
  • 김태규 (인제대학교 상계백병원 영상의학과) ;
  • 김정숙 (이화여자대학교 목동병원 건진의학과) ;
  • 신은아 (인제대학교 상계백병원 진단병리과)
  • Received : 2010.08.30
  • Accepted : 2010.10.09
  • Published : 2010.12.01
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Abstract

Purpose: The purpose of this study was to evaluate the high-resolution CT (HRCT) and pathologic findings of mixed herbal medicine-induced diffuse interstitial lung disease. Materials and Methods: Eight patients (6 women and 2 men, age range: 31 to 81 years, mean age: 51.4 years) who presented with cough or dyspnea after taking mixed herbal medicine were included in this study. All the patients underwent plain chest radiography and HRCT. We obtained pathologic specimens from 7 patients via fluoroscopy guided large bore cutting needle biopsy and transbronchial lung biopsy. All the patients were treated with steroid therapy. Results: The most common HRCT finding was bilateral diffuse ground glass opacity (n=7), followed by peribronchial consolidation (n=5) and inter- or intralobular septal thickening (n=2). For the disease distribution, the lower lung zone was dominantly involved. The pathologic results of 7 patients were nonspecific interstitial pneumonia (n=3), bronchiolitis obliterans organizing pneumonia (n=2), hypersensitivity pneumonitis (n=1) and eosinophilic pneumonia (n=1). Irrespective of the pathologic results, all 8 patients improved clinically and radiologically after steroid treatment. Conclusion: The HRCT findings of mixed herbal medicine-induced diffuse infiltrative lung disease were mainly bilateral diffuse ground glass opacity, peribronchial consolidation and dominant involvement of the lower lung zone. Those pathologic findings were nonspecific and the differential diagnosis could include interstitial pneumonia, bronchiolitis obliterans organizing pneumonia, hypersensitivity pneumonitis and eosinophilic pneumonia.

목적: 혼합성분의 한약 복용 후 발생한 미만성침윤성폐질환의 고해상 CT소견 및 병리학적 소견을 알아보고자 하였다. 대상과 방법: 혼합 성분의 한약을 복용한 이후 기침, 호흡곤란이 발생하였거나 기존의 기침, 호흡곤란이 더 심해진 8명(여자 6명, 남자 2명, 31~81세)을 대상으로 하였다. 모든 환자에게 흉부 X선촬영 및 흉부 고해상 CT를 시행하였고, 7명에서는 방사선투시 하 대침절제생검 및 경기관지폐생검으로 폐병변 부위의 병리 조직을 얻었다. 결과: 가장 흔한 고해상CT 소견으로는 양측성 미만성 간유리 음영(n=7)이었고, 다음으로 기관지주위 경화(n=5), 소엽간 중격 비후(n=2)였다. 병변은 폐 상부보다는 폐 하부, 폐 주변부보다는 폐 중심부에 주로 분포하였다. 조직검사를 시행한 7예의 병리학적 소견으로는 비특이적 간질성폐렴이 3명, 폐쇄성세기관지기질화폐렴이 2명, 그리고 과민성폐렴, 호산구성폐렴이 각각 1명이었다. 조직병리학적 소견과 관계없이 모든 환자는 스테로이드 치료 이후 임상적, 영상학적으로 호전되었다. 결론: 혼합 성분의 한약 복용 후 발생한 미만성침윤성폐질환의 고해상CT 소견은 주로 양측성 미만성 간유리 음영, 기관지주위 경화로 나타났으며 폐 하부를 주로 침범하는 경향이 있었다. 병리학적 소견으로는 비특이적간질성폐렴, 폐쇄성세기관지기질화폐렴, 과민성폐렴, 호산구성 폐렴 등 다양하였다.

Keywords

References

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