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폐경 후 여성의 양측성 난소 섬유종증: MRI 소견과 감별진단 중점의 증례 보고

Bilateral Ovarian Fibromatosis in a Postmenopausal Female: A Case Report with Emphasis on MRI Findings and Differential Diagnosis

  • 홍성철 (인하대학교 의과대학 영상의학교실) ;
  • 김미영 (인하대학교 의과대학 영상의학교실) ;
  • 김준미 (인하대학교 의과대학 병리학교실) ;
  • 황성욱 (인하대학교 의과대학 산부인과학교실)
  • Sung Cheol Hong (Department of Radiology, College of Medicine, Inha University) ;
  • Mi Young Kim (Department of Radiology, College of Medicine, Inha University) ;
  • Joon Mee Kim (Department of Pathology, College of Medicine, Inha University) ;
  • Sung Ook Hwang (Department of Obstetrics and Gynecology, College of Medicine, Inha University)
  • 투고 : 2024.01.08
  • 심사 : 2024.06.12
  • 발행 : 2024.10.01

초록

난소 섬유종증(ovarian fibromatosis)은 콜라젠을 형성하는 난소의 버팀질의 증식으로 인해 난소의 비대를 유발하는 희귀한 비신생물성 상태로 25세 전후의 여성에게서 발생한다. 난소 섬유종증의 주요한 진단적 소견은 MRI의 T2 강조영상에서 난소의 표층을 따라 특징적인 다소엽 형태의 매우 저신호 강도를 보이는 '검은 화환 징후'(black garland sign)이다. 내부에 정상 난소 버팀질과 난포가 보존되는 소견 역시 특징적이다. 저자들은 65세의 폐경 후 여성에게서 병리적으로 난소 섬유종(ovarian fibroma)으로 오인되었으나 특징적인 MRI 소견에 기반하여 난소 섬유종증으로 진단이 수정되었던 증례를 보고한다. 난소 섬유종증과 관련된 감별진단에 관한 논의와 병리적 소견을 함께 기술하였다.

Ovarian fibromatosis is a rare non-neoplastic condition that causes ovarian enlargement in women, typically around the age of 25. This enlargement is due to the proliferation of the collagen-producing ovarian stroma. On T2-weighted MRI, a key diagnostic feature of ovarian fibromatosis is the 'black garland sign,' characterized by multilobulated very low signal intensity along the ovarian surface. This condition also features the preservation of normal ovarian stroma or follicles internally. We present a case involving a 65-year-old postmenopausal female who was pathologically misdiagnosed with ovarian fibroma. However, the diagnosis was later revised to ovarian fibromatosis based on characteristic MRI findings. The case report discusses the differential diagnosis and pathologic findings associated with ovarian fibromatosis.

키워드

참고문헌

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