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간문 주위 림프절병증으로 발현된 아밀로이드증 1예

A Case of Amyloidosis Presenting as Lymphadenopathy at the Porta Hepatis

  • 이자인 (가톨릭대학교 의과대학 인천성모병원 내과학교실 소화기내과) ;
  • 김준성 (가톨릭대학교 의과대학 인천성모병원 내과학교실 소화기내과) ;
  • 김병욱 (가톨릭대학교 의과대학 인천성모병원 내과학교실 소화기내과)
  • Lee, Ja In (Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Joon Sung (Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Byung Wook (Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 투고 : 2018.04.18
  • 심사 : 2018.06.10
  • 발행 : 2018.09.30

초록

We report a rare case of systemic amyloidosis with gastrointestinal and lymph node involvement. A 64-year-old woman was admitted to our hospital with dyspepsia and weight loss. Initial esophagogastroduodenoscopy (EGD) revealed nonspecific findings, and abdominal computed tomography showed necrotizing lymphadenopathy at the porta hepatis. Laparoscopic lymph node biopsy was performed under suspicion of tuberculous lymphadenopathy, but a definite diagnosis was not established. Follow-up EGD performed 6 months later revealed multiple telangiectasia-like lesions at the gastric body, and endoscopic biopsy revealed amyloid deposition. Through additional blood and urine protein electrophoresis, the patient was finally diagnosed with systemic amyloidosis associated with multiple myeloma. She was treated with dexamethasone, thalidomide, and bortezomib; however, she died 3 months after diagnosis because of pneumonia and multiple organ failure.

키워드

참고문헌

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