• Tuberculosis and Respiratory Diseases
• /
• 제45권1호
• /
• pp.191-196
• /
• 1998

Follicular bronchitis/bronchiolitis is pathologically characterized by peribronchiolar lymphoid follicles, which is one of reactive pulmonary lymphoid disorders. It is associated with 1) the result of infections such as mycoplasma, chlamydia etc., 2) immunodeficiency syndromes, 3) connective tissue diseases such as rheumatoid arthritis and Sjogren's syndrome and 4) local or systemic hypersensitivity reaction. And it can be also developed without obvious causes and associated diseases(idiopathic). Radiologically it represents as bilateral interstitial patterns of pulmonary infiltrates. In this case, a 49 year-old woman was presented with intermittent cough and sputum. On chest X-ray and CT, $5\times4$ cm sized mass in right upper lobe and paratracheal lymphadenopathies were detected, by which lung malignancy was suspected. Bronchoscopy, trans bronchial lung biopsy and transthoracic needle aspiration showed non-specific findings only. After right upper lobectomy, we could confirm a case of follicular bronchiolitis which presented as an unusual mass-like radiologic finding.

• 대한수의학회지
• /
• 제44권3호
• /
• pp.449-454
• /
• 2004

Ninety pigs under the age of 120-day-old requested at the diagnostic laboratory of animal diseases in Cheju National University were evaluated for the prevalence of tissue antigen and serum antibody to swine influenza virus (SIV). For histopathologic examination there was sampled at the consolidated area in cranioventral or dorsocaudal lobes of lungs. Lung tissues from all pigs were tested for the antigen of SIV type A by immunohistochemistry (IHC). Sera from 56 pigs were used for the antibody detection to SIV type A (subtype H1N1 and H3N2) by haemagglutinin inhibition test. Pneumonic lesions were observed in 72 cases (80%) of 90 pigs. Broncho-interstitial or interstitial pneumonia were more prevalent than suppurative or fibrinous bronchopneumonia. According to HI test, 46.4% of the tested sera showed seropositive. Positive sera were consisted with 5.3% for SIV H1N1, 28.6% for SIV H3N2, and 12.5% for both subtype to be tested, respectively. SIV antigens were detected in 51 cases(56.6%) of 90 pigs. Most SIV antigens were presented in the epithelium of the bronchi and bronchiole. Necrotizing bronchitis or bronchiolitis were observed in 28(31.1%) cases of all inspected pigs. These results suggested that SIV might be an important role to induce swine pneumonia in Jeju. Also IHC was very useful for the detection of SIV in the lung.

• 대한한방소아과학회지
• /
• 제22권2호
• /
• pp.37-49
• /
• 2008

Objectives : Idiopathic pulmonary fibrosis (IPF) is chronic fibrotic interstitial pneumonia and the pathogenesis is unknown. Peucedani Radix is well-known for the treatment of respiratory diseases and pulmonary hypertension. This study was to evaluate the effectiveness of Peucedani Radix on the bleomycin-induced lung fibrosis model (BLFM) in mouse. Methods : We induced lung fibrosis by intratracheal instillation of bleomycin in C57BL/6J. We compared two groups BLFM without Peucedani Radix (group I) and BLFM with Peucedani Radix (group II). We performed bronchoalveolar lavages (BAL) and obtained lung specimens from both group I and II on the 7th (A) and 21st (B) day, and also for the normal group. We compared with group I and II to find BAL by using ANOVA test and to find pathologic symptoms by using semiquantitative histological index (SHI). Results : In BAL, total cell counts, lymphocytes, and neutrophils was increased in both group I and II comparing with normal group. However, lymphocyte level was decreased more in group IIB than group IB. It was statistically significant. In microscopic findings, scores of SHI in normal group, group IB and IIB were 0.33, 4.47, and 1.96 each. Conclusions : Peucedani Radix might have inhibitory effect on lung fibrosis by reducing inflammatory cells in bleomycin-induced lung fibrosis model in mouse.

• Tuberculosis and Respiratory Diseases
• /
• 제70권3호
• /
• pp.257-260
• /
• 2011

A 65-year-old woman was admitted due to poor oral intake and a dry cough over the previous 3 months. The physical examination was remarkable for bibasilar crackles, and plain chest radiography showed reticulation in both lower lung fields. A pulmonary function test demonstrated a restrictive pattern with a reduced diffusing capacity of the lung for carbon monoxide. High resolution computed tomography showed reticulation and honey-combing in both peripheral lung zones, which was consistent with usual interstitial pneumonia pattern. Her skin showed livedo reticularis. The erythrocyte sedimentation rate and C-reactive protein level were elevated, and hematuria was noted on urinary analysis. A serologic test for auto-antibodies showed seropositivity for Myeloperoxidase-Anti-neutrophil cytoplasmic antibody (MPO-ANCA). A kidney biopsy was performed and showed focal segmental glomerulosclerosis. She was diagnosed as having pulmonary fibrosis with microscopic polyangiitis (MPA) and treated with high dose steroids. Here we report a case of pulmonary fibrosis coexistent with microscopic polyangiitis.

• Tuberculosis and Respiratory Diseases
• /
• 제67권2호
• /
• pp.127-130
• /
• 2009

Bilateral interstitial infiltration in chest radiography, which may be fine granular, reticular or of ground glass opacity, is the typical radiographic findings of Pneumocystis jiroveci pneumonia. Recently, atypical radiographic features, including cystic lung disease, spontaneous pneumothorax or nodular opacity, have been reported intermittently in patients with P. jiroveci pneumonia. We report the case of a 29-year-old woman with a transplanted kidney whose simple chest radiography and HRCT scan showed numerous miliary nodules in both lungs, mimicking miliary tuberculosis (TB). Under the presumptive diagnosis of miliary TB, empirical anti-TB medication was started. However, Grocott methenamine silver nitrate staining of a transbronchial lung biopsy tissue revealed P. jiroveci infection without evidence of TB. These findings suggest that even in TB-endemic area other etiology such as P. jiroveci as well as M. tuberculosis should be considered as an etiology of miliary lung nodules in mmunocompromised patients.

• Tuberculosis and Respiratory Diseases
• /
• 제46권5호
• /
• pp.735-740
• /
• 1999

평소 건강하던 19세 여자 환자가 호흡곤란을 보이며 급속히 진행하는 양상의 폐렴으로 입원, 혈청학적 검사에서 마이코플라스마 폐렴으로 진단되었으며, 초기 스테로이드 투여와 항생제 치료로 증상 호전되어 퇴원하였다. 호흡부전을 동반하면서 광범위한 양측성 폐경변과 흉수 소견을 보이는 중증의 전격성 마이코플라스마 폐렴은 비교적 드물기에 문헌고찰과 함께 바이다.

• Tuberculosis and Respiratory Diseases
• /
• 제46권1호
• /
• pp.82-88
• /
• 1999

Herpes simplex virus pneumonia in immunocompromised host is difficult to diagnose with non-invasive method, and has high mortality rate. Because early diagnosis and early treatment can significantly decrease the mortality rate, the enthusiastic efforts for the early diagnosis should be done. A 41-year-old woman who took prednisolone due to mixed connective tissue disease developed gradually increasing dyspnea with radiological features of interstitial lung disease. Initially, we treated her with empirical antibiotics, but failed to improve her dyspnea. So we performed bronchoalveolar lavage and open lung biopsy. Open lung biopsy specimen showed herpes simplex virus pneumonia. Herpes simplex virus was also isolated from bronchoalveolar lavage fluid. There was both clinical and radiological improvement after treatment with acyclovir for 14 days.

• Tuberculosis and Respiratory Diseases
• /
• 제50권2호
• /
• pp.245-251
• /
• 2001

저자들은 신장의 혈관근지방종을 동반한 폐임파관평활근종증 1예를 경험하였기에 폐임파관평활근종증에 대한 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
• /
• 제44권3호
• /
• pp.669-676
• /
• 1997

Castleman's disease is uncommon lymphoproliferative disorder as giant lymph node hyperplasia and angiofollicular lymph node hyperplasia. Multicentric variant of Castleman's disease, plasma cell type has been described that has more generalized lymph node involvement as well as involvement of other organ systems than localized type. Multicentric plasma cell type is frequently accompanied by systemic manifestations, such as weight loss, lowgrade fever and weakness. But the reported cases of pulmonary parenchymal involvement are rare and have almost consisted of hyalinized granuloma adjacent to a bronchus. We report a patient with Castleman's disease of the lung, pathologically proven interstitial pulmonary involvement.

• Tuberculosis and Respiratory Diseases
• /
• 제48권4호
• /
• pp.530-542
• /
• 2000

연구배경 : 특발성 폐섬유화증은 병리조직학 소견이 usual interstitial pneumonia(UIP)이면서 치료반응과 예후가 좋지 않은 질환이지만 1994년 처음 보고된 nonspecific interstitial pneumonia(NSIP)는 UIP와는 달리 치료반응 및 예후가 매우 좋아 정확한 감별 진단 및 적극적인 치료가 필요하지만 아직 특발성 NSIP의 임상적 특징 및 치료경과에 대한 보고가 별로 없어 UIP와의 감별이 쉽지 않은 실정이다. 방 법 : 1996년 7월부터 2000년 3월까지 성균관의대 삼성서울병원에서 외과적 폐생검을 통해 미만성 간질성 폐질환으로 확진된 120명 중 총 18례의 특발성 NSIP에 대한 임상적 특징 및 치료 경과를 의무기록 조사 및 방사선학적 분석을 통해 후향적으로 평가하였다. 결 과 : 1) 진단당시의 임상적 특징 18명의 환자중 17명이 여자였고 평균 연령은 $55.2{\pm}8.4$세(44~73세)였으며 호흡곤란 및 기침 이외에 발열이 6명의 환자에서 판정되었다. 이학적검사상 곤봉지는 1명에서만 관찰되었고 증상 발현후 병원을 찾기까지의 기간은 $7.3{\pm}16.9$개월, 외과적 폐생검까지의 기간은 $9.9{\pm}17.1$개월이었다. BAL 검사상 림프구가 $23.0{\pm}13.1%$로 증가되어 있었고 흉부 HRCT 소견상 봉와양 음영은 전혀 관찰되지 않으면서 간유리 음영 및 불규칙 선상 음영이 주로 관찰되었다. 2) 치료약제 및 부작용 13명이 스테로이드로 먼저 치료를 시작하였고 5명은 경구 cyclophosphamide 단독으로 치료를 시작하였다. 스테로이드로 치료를 시작한 13명 종 3명은 치료개시 1달 이내에 심각한 부작용으로 스테로이드 복용을 중단하여 2명은 경구 cyclophosphamide로 전환하여 치료를 계속할 수 있었으나 스테로이드 유발성 정신병이 유발된 1명은 향후 모든 치료를 포기하였다. 스테로이드로 치료를 계속 받은 10명에서는 대상포진 3례, 백내장 2례, 결핵 1례, 대퇴골 허혈 괴사 1례, 당뇨 1례 등이 유발되었고 7명의 경구 cyclophosphamide 복용 환자에서는 출혈성 방광염 1례, 대상포진 1례, 반복성 질염 1례 등이 부작용으로 나타났다. 3) 약물 치료후 반응 치료 시작후 $24.1{\pm}11.2$개월간 추적 관찰한 결과, 스테로이드를 복용한 10명 중 9명이 호전, 1명이 안정 상태를 보였고 경구 cyclophosphamide를 복용한 7명에서는 5명이 호전, 2명이 안전 상태를 보였다. 폐기능검사상 FVC(n=15)는 예측치 절대값으로 $20.2{\pm}11.2%$가 증가하였고 흉부 HRCT 소견상 간유리 음영의 면적(n=15)은 절대값으로 $15.7{\pm}14.7%$가 감소하였으며 추적검사상 봉와양 음영이 나타난 환자는 전혀 없었다. 4) 약물 치료 중단후 재발 호전후 약물 치료를 중단하였던 14명 중 5명이 재발하였고 2명은 스테로이드 감량중 악화되었다. 재발한 4명은 치료 중단 6개월 이내에, 1명은 10개월째에 재발하였고 치료 중단 1년내에 재발이 없었던 4명의 환자는 이후에도 재발의 증거가 전혀 없었다. 추적 관찰 기간($24.1{\pm}11.2$개월)중에 사망한 환자는 1명도 없었다. 결 론 : NSIP는 뚜렷한 임상적 특징과 좋은 치료 반응을 보이므로 예후가 좋지 않은 UIP와 적극적으로 감별하여 치료를 시행해야 할 것으로 사료된다.