유방암 환자에서 방사선 조사 후 발생한 폐쇄성 세기관지 기질화 폐렴 1예

A Case of Bronchiolitis Obliterans Organizing Pneumonia after Radiation Therapy in Breast Cancer

  • 홍지형 (가톨릭대학교 의과대학 성모병원 내과) ;
  • 강지영 (가톨릭대학교 의과대학 성모병원 내과) ;
  • 김태정 (가톨릭대학교 의과대학 성모병원 병리과) ;
  • 이재호 (가톨릭대학교 의과대학 성모병원 내과) ;
  • 김대원 (가톨릭대학교 의과대학 성모병원 내과) ;
  • 윤형규 (가톨릭대학교 의과대학 성모병원 내과) ;
  • 송정섭 (가톨릭대학교 의과대학 성모병원 내과)
  • Hong, Ji-Hyung (Departments of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Kang, Ji-Young (Departments of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Kim, Tae-Jung (Departments of Pathology, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Lee, Jae-Ho (Departments of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Kim, Dae-Won (Departments of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Yoon, Hyoung-Kyu (Departments of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Song, Jeong-Sup (Departments of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine)
  • 발행 : 2011.04.01

초록

폐쇄성 세기관지 기질화 폐렴은 방사선 치료 후에 드물지만 발생할 수 있는 합병증이다. 종양으로 흉부 방사선 조사의 기왕력이 있는 환자에서 다발성 경결성 폐병변이 있는 경우, 특히 방사선에 노출되지 않은 부위라 하더라도 감염성 폐렴이나 방사선 폐렴, 종양의 재발 뿐만 아니라 본 증례와 같이 방사선 유도 BOOP의 가능성이 발생할 수 있음을 염두에 두고 접근하는 것이 필요하겠다.

Pulmonary toxicity can develop following radiation therapy during breast cancer treatment. Of the pulmonary toxicities that can develop, radiation-induced bronchiolitis obliterans organizing pneumonia (BOOP) is relatively rare. A 43-year-old woman who had previously undergone radiation therapy for right breast cancer presented with fever and cough for 4 days. Chest radiology findings demonstrated consolidations in the right middle and lower lobe. Initially, we assumed that her findings were consistent with pneumonia and started empirical antibiotics. However, even after 10 days of antibiotic treatment, the fever persisted, and the consolidations showed progression. A transbronchial lung biopsy of the right middle lobe via bronchoscopy revealed organizing pneumonia. We strongly suspected radiation-induced BOOP and began steroid treatment. The symptoms and consolidations rapidly disappeared. We tapered the steroids, and no relapse has occurred since then. Considering the clinical, radiological, and pathological findings, we diagnosed the patient with radiation-induced BOOP. To our knowledge, this is the first case of radiation-induced BOOP in Korea.

키워드

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