Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
권호 표지

Multilple Pulmonary Nodules in A Patient with Sinusitis, Proteinuria and Hematuria

부비동염 환자에 병발한 다발성 폐결절

  • Yu, Su-Eun (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Joo, Kang (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Noh, Chee-Ho (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Song, So-Hyang (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Chi-Hong (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Park, Yong-Jin (Department of Otolaryngology, College of Medicine, The Catholic University of Korea) ;
  • Kang, Seok-Jin (Department of Clinical Pathology, College of Medicine, The Catholic University of Korea)
  • 유수은 (가톨릭대학교 의과대학 내과학교실) ;
  • 주강 (가톨릭대학교 의과대학 내과학교실) ;
  • 노치호 (가톨릭대학교 의과대학 내과학교실) ;
  • 송소향 (가톨릭대학교 의과대학 내과학교실) ;
  • 김치홍 (가톨릭대학교 의과대학 내과학교실) ;
  • 박용진 (가톨릭대학교 의과대학 이비인후과학교실) ;
  • 강석진 (가톨릭대학교 임상병리학교실)
  • Published : 2002.10.30
Download PDF
⟨ Previous Next ⟩

Abstract

A 49-year old man who had been treated for five months at a private clinic due to chronic paranasal sinusitis was admitted to our hospital because of recently aggravated nasal stuffiness, headache, and cough. The X-ray film of paranasal sinuses and facial CT scan showed marked mucosal thickening of the nasal cavity and paranasal sinuses. The plain chest film and chest CT scan showed multiple, vatiable sized, pulmonary nodules in both lungs. The level of c-ANCA was elevated and urinalysis revealed proteinuria and hematuria. Percutaneous lung and kidney biopsies were performed for confirmative diagnosis. Histologic examination of the lung nodule demonstrated extensive necrosis and poorly-formed granulomatous inflammation. The histologic finding of the kidney showed focal necrotizing glomerulonephritis. A diagnosis of Wegener's granulomatosis involving the paranasal sinuses, lung and kidney was made, and treatment was successfully performed with cyclophosphamide and prednisone.

저자들은 비폐색과 두통을 주소로 내원한 49세 남자에서 단백뇨 및 혈뇨와 병발된 다발성 폐결절을 발견하였고, c-ANCA와 조직검사를 통해 부비동, 폐, 신장을 침범한 Wegener씨 육아종증을 진단하고, cyclophosphamide와 스테로이드 병합투여로 증세가 호전되고, 흉부 방사선 사진에서도 호전된 소견을 보이는 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords