Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Diffuse Pulmonary Nodular Lesions Persisting for 5 Years

5년간 지속된 미만성 폐결절

  • Kim, Kyung-Kyu (Department of Internal Medicine, Korea University, College of Medicine) ;
  • Kim, Byung-Kyu (Department of Internal Medicine, Korea University, College of Medicine) ;
  • Jeong, Ki-Hwan (Department of Internal Medicine, Korea University, College of Medicine) ;
  • Jeong, Hye-Cheol (Department of Internal Medicine, Korea University, College of Medicine) ;
  • Kim, Je-Hyeong (Department of Internal Medicine, Korea University, College of Medicine) ;
  • Park, Sang-Myen (Department of Internal Medicine, Korea University, College of Medicine) ;
  • Lee, Sin-Hyung (Department of Internal Medicine, Korea University, College of Medicine) ;
  • Shin, Chol (Department of Internal Medicine, Korea University, College of Medicine) ;
  • Cho, Jae-Youn (Department of Internal Medicine, Korea University, College of Medicine) ;
  • Shim, Jae-Jeong (Department of Internal Medicine, Korea University, College of Medicine) ;
  • In, Kwang-Ho (Department of Internal Medicine, Korea University, College of Medicine) ;
  • Kang, Kyung-Ho (Department of Internal Medicine, Korea University, College of Medicine) ;
  • Yoo, Se-Hwa (Department of Internal Medicine, Korea University, College of Medicine) ;
  • Oh, Yu-Whan (Department of radiology, Korea University, College of Medicine)
  • 김경규 (고려대학교 의과대학 내과학교실) ;
  • 김병규 (고려대학교 의과대학 내과학교실) ;
  • 정기환 (고려대학교 의과대학 내과학교실) ;
  • 정혜철 (고려대학교 의과대학 내과학교실) ;
  • 김제형 (고려대학교 의과대학 내과학교실) ;
  • 박상면 (고려대학교 의과대학 내과학교실) ;
  • 이신형 (고려대학교 의과대학 내과학교실) ;
  • 신철 (고려대학교 의과대학 내과학교실) ;
  • 조재연 (고려대학교 의과대학 내과학교실) ;
  • 심재정 (고려대학교 의과대학 내과학교실) ;
  • 인광호 (고려대학교 의과대학 내과학교실) ;
  • 강경호 (고려대학교 의과대학 내과학교실) ;
  • 유세화 (고려대학교 의과대학 내과학교실) ;
  • 오유환 (고려대학교 의과대학 방사선과학교실)
  • Published : 2000.05.30
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Abstract

Diffuse pulmonary nodular lesions have many causes. When they are caused by infection, the likely organisms are M. tuberculosis and various fungi. Silicosis, eosinophilic granuloma and pulmonary metastasis should be considered for differential diagnosis. Differential diagnosis needs detailed clinical history, physical examination and various laboratory tests. A case of persistent diffuse pulmonary nodular lesions which had persisted 5 years is reported. The patient was a 25 years old man with minimal pulmonary symptoms. Detailed past history and physical examination suggested thyroid tumor. Chest radiography showed numerous evenly sized well-defined nodules scattered in entire lung fields. Previous chest X-rays showed similar nodular lesions, which had lasted for 5 years. The number of nodules was slightly increased. Neck CT showed heterogenous mass in left lobe of thyroid gland and multiple lymphadenopathies along both internal jugular chains. Total thyroidectomy was performed. A case of lung metastasis which progressed slowly in papillary thyroid cancer is reported.

본 증례는 갑상선암이 폐전이를 일으킨 예로 처음에 목에 작은 림프절이 있었으나 속립성 결핵으로 진단 후 치료한 경우로 갑상선암보다 먼저 폐전이 양상이 뚜렷하게 나타났고 폐결절이 매우 천천히 진행하는 형태를 보여 더욱 진단이 늦어졌다.

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