두피 혈관육종의 낭성 폐 전이: 증례 보고

Cystic Pulmonary Metastasis in a Patient with Scalp Angiosarcoma: A Case Report

  • 김아영 (성균관대학교 의과대학 삼성서울병원 영상의학과학교실) ;
  • 이경수 (성균관대학교 의과대학 삼성서울병원 영상의학과학교실) ;
  • 한정호 (성균관대학교 의과대학 삼성서울병원 병리과학교실) ;
  • 김호중 (성균관대학교 의과대학 삼성서울병원 호흡기내과분과) ;
  • 김관민 (성균관대학교 의과대학 삼성서울병원 흉부외과학교실) ;
  • 백정환 (성균관대학교 의과대학 삼성서울병원 이비인후과학교실)
  • Kim, Ah-Yeong (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Kyung-Soo (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Han, Joung-Ho (Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Ho-Joong (Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Kwhan-Mien (Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Baek, Chung-Hwan (Department of Otorhinolaryngology, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 발행 : 2011.08.01

초록

혈관육종, 특히 두피의 혈관육종은 흉부 컴퓨터단층촬영에서 다수의 낭성 형태를 띠며 폐 전이를 하는 것으로 알려져 있다. 또한, 전이성 기낭은 종종 흉강 내로 파열되어 폐기종을 유발할 수 있다. 그러나 현재까지는, 얼마나 빨리 폐 전이가 일어날 수 있는지, 그리고 기낭성 전이의 정확한 기전은 무엇인지에 대해 알려진 바가 제한적이다. 우리의 경험에 따르면, 폐 전이의 진행 속도는 상대적으로 빠르며, 전체 폐에 2~3개월 이내에 전이가 퍼질 수 있다는 것을 알 수 있었다. 그리고 폐포 벽을 따라서 침습적으로 자라는 방추형 전이 세포들이 주변의 폐포 강에 연결됨으로써, 확장된 기낭을 형성하게 된다는 것도 알 수 있었다.

It has been well known that angiosarcoma (AS), particularly scalp AS, metastasizes to the lungs with multiple air-filled cystic lesions on chest computed tomography scans. Pneumothorax, due to cystic lesion rupture into the pleural space, is frequent; however, we do not exactly know how rapidly the metastatic lesions spread to the lungs or what the exact pathogenetic mechanism for cystic metastasis is. According to our experience, the speed of disease progression in pulmonary metastasis is relatively fast and the entire lungs may be involved within two or three months. The infiltrating spindle cell tumors in the alveolar walls are tethering the adjacent alveolar spaces in order to form a dilated air-filled cystic lesion.

키워드

참고문헌

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