양성 전이성 폐 평활근종 1예

A Case of Benign Metastasizing Leiomyoma in the Lung

  • 황재경 (가천의대 중앙길병원 호흡기내과) ;
  • 박계영 (가천의대 중앙길병원 호흡기내과) ;
  • 박정웅 (가천의대 중앙길병원 호흡기내과) ;
  • 박재경 (가천의대 중앙길병원 호흡기내과) ;
  • 정성환 (가천의대 중앙길병원 호흡기내과) ;
  • 서준범 (가천의대 중앙길병원 방사선과) ;
  • 이한경 (가천의대 중앙길병원 방사선과) ;
  • 이재웅 (가천의대 중앙길병원 흉부외과) ;
  • 오영하 (가천의대 중앙길병원 해부병리과) ;
  • 남귀현 (가천의대 중앙길병원 호흡기내과)
  • Hwang, Jae-Kyung (Department of Internal Medicine, Gacheon Medical School, Gil Medical Center) ;
  • Park, Kae-Young (Department of Internal Medicine, Gacheon Medical School, Gil Medical Center) ;
  • Park, Jeong-Woong (Department of Internal Medicine, Gacheon Medical School, Gil Medical Center) ;
  • Park, Jae-Kyung (Department of Internal Medicine, Gacheon Medical School, Gil Medical Center) ;
  • Jeong, Seong-Hwan (Department of Internal Medicine, Gacheon Medical School, Gil Medical Center) ;
  • Suh, Jun-Bum (Department of Radiology, Gacheon Medical School, Gil Medical Center) ;
  • Lee, Han-Kyung (Department of Radiology, Gacheon Medical School, Gil Medical Center) ;
  • Lee, Jae-Woong (Department of Chest surgery, Gacheon Medical School, Gil Medical Center) ;
  • Oh, Young-Ha (Department of Anatomical Pathology, Gacheon Medical School, Gil Medical Center) ;
  • Nam, Gui-Hyun (Department of Internal Medicine, Gacheon Medical School, Gil Medical Center)
  • 발행 : 2000.08.30

초록

10년전 자궁근종으로 자궁전절제술을 시행받은 39세 여자환자로 기침을 주소로 내원하여 흉부 단순촬영, 흉부 전산화 단층촬영상 좌측상엽기관지에 연하여 3$\times$4cm크기 종괴 및 우하부 기저부에 5mm크기의 소결절이 관찰되어, 좌측 상엽 절제술을 시행받았다. 종괴의 병리조직소견상 유사분열을 보이는 세포가 50개의 고배율시야당 2-3개 정도이었으며 세포의 이형성은 관찰할 수 없었고 면역조직화학염색상 Smooth muscle actin, Vimentin, Desmin에 양성반응을 보여 평활근종임을 확인하였다. 수술 후 별다른 증상의 호소는 없었고, 경과 추적 관찰중 우측 폐에 새로운 결절이 발견되어 양성 전이성 평활근종으로 확진하였으며, 이에 문헌고찰과 함께 보고하는 바이다.

Benign metastasizing leiomyoma usually occurs in women and is associated with a past hysterectomy in 80% of the cases, which is a rare entity. The patient was a 39-year-old woman who complained of cough and sputum. She underwent hysterectomy because of benign leiomyoma ten years ago. Chest X-ray showed nodular lesion in the left lung field. Chest CT showed a 3cm sized round well defined mass at left hilum with mild indentation of segmental bronchi of left upper lobe and a small tiny nodule in right lower lung field. Nodular lesion of left upper 1000 was resected by thoracotomy. Pathological evaluation showed benign spindle-like cells having nuclei without cytotic atypia similar to those of benign leiomyoma. Immunohistochernical stainings for desmin and smooth muscle actin were positive. Therefore these nodules are considered as benign metastasizing leiomyoma from a uterine leiomyoma. We report this case with the review of literature.

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