Multiple Cavitary Pulmonary Metastases from Cholangiocarcinoma

담관암의 다발성 공동성 폐전이

  • Do, Mi Young (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Chung, Jae Ho (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Hee Man (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Han, Seung Jin (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Shim, Jae Min (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Hwang, Sang Yon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Park, Moo Suk (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Young Sam (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Chang, Joon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Sung Kyu (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Park, Seung Woo (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Choe, Kyu Ok (Department of Diagnostic Radiology, Yonsei University College of Medicine) ;
  • Shin, Dong Hwan (Department of Pathology, Yonsei University College of Medicine) ;
  • Kim, Se Kyu (Department of Internal Medicine, Yonsei University College of Medicine)
  • 도미영 (연세대학교 의과대학 내과학교실) ;
  • 정재호 (연세대학교 의과대학 내과학교실) ;
  • 김희만 (연세대학교 의과대학 내과학교실) ;
  • 한승진 (연세대학교 의과대학 내과학교실) ;
  • 심재민 (연세대학교 의과대학 내과학교실) ;
  • 황상연 (연세대학교 의과대학 내과학교실) ;
  • 박무석 (연세대학교 의과대학 내과학교실) ;
  • 김영삼 (연세대학교 의과대학 내과학교실) ;
  • 장준 (연세대학교 의과대학 내과학교실) ;
  • 김성규 (연세대학교 의과대학 내과학교실) ;
  • 박승우 (연세대학교 의과대학 내과학교실) ;
  • 최규옥 (연세대학교 의과대학 진단방사선과학교실) ;
  • 신동환 (연세대학교 의과대학 병리학교실) ;
  • 김세규 (연세대학교 의과대학 내과학교실)
  • Published : 2004.02.28

Abstract

Because a cavitary pulmonary metastasis is rare, it may not be readily identified. However, various types of cancers can metastasize to the lung in the form of cavities. We report a case of a multiple cavitary metastases to the lung from a cholangiocarcinoma in a 60-year-old man. He complained of generalized weakness and a poor oral intake for 2 months. The plain chest radiography and the chest computed tomography showed multiple small thick-walled cavities and nodules the both lungs. A bronchoscopic examination revealed a focal irregularly elevated surface of the mucosa at the orifice of the superior segment of the right lower lobe and the biopsy demonstrated an infiltrative metastatic adenocarcinoma. The abdomen-pelvis computed tomography showed an ill-marginated and irregularly low-dense area in the right lobe of the liver and a diffuse dilatation of the peripheral intrahepatic bile ducts. The esophagogastroscopy and colonoscopy showed no abnormal findings. It was concluded that the cholangiocarcinoma of the liver metastasized to the lung in the form of cavities. Thereafter, the patient underwent six cycles of the systemic chemotherapy with gemcitabine and cisplatin, and the follow-up imaging studies showed a partial response.

폐전이에서 공동성 폐병변이 관찰되는 경우가 흔하지 않으며, 다른 양성 폐병변과 감별이 필요하다. 저자들은 다발성 공동성 폐병변을 주소로 내원한 환자에서 굴곡성 기관지내시경 검사를 통한 조직검사상 전이성 폐암을 진단하였고 원발성 병변인 담관암을 진단하여 전신적인 항암약물을 시행한 경험이 있어 이에 보고하는 바이다.

Keywords

References

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