Tuberculosis and Respiratory Diseases

  • 제61권1호
  • /
  • Pages.74-79
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  • 2006
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  • 1738-3536(pISSN)
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  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
권호 표지

스테로이드 치료로 호전을 보인 폐동맥 고혈압을 유발한 특발성 섬유화성 종격동염 1예

Idiopathic Fibrosing Mediastinitis Causing Pulmonary Hypertension with Improvement by Steroid Treatment

  • 정보용 (순천향대학교 의과대학 내과학교실) ;
  • 어성준 (순천향대학교 의과대학 내과학교실) ;
  • 박은서 (순천향대학교 의과대학 내과학교실) ;
  • 김영통 (순천향대학교 의과대학 영상의학교실) ;
  • 최재성 (순천향대학교 의과대학 내과학교실) ;
  • 오미혜 (순천향대학교 의과대학 진단병리교실) ;
  • 서기현 (순천향대학교 의과대학 내과학교실) ;
  • 나주옥 (순천향대학교 의과대학 내과학교실) ;
  • 이상도 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 어수택 (순천향대학교 의과대학 내과학교실) ;
  • 김용훈 (순천향대학교 의과대학 내과학교실) ;
  • 박춘식 (순천향대학교 의과대학 내과학교실)
  • Jung, Bo Yong (Department of Internal Medicine, University of Soonchunhyang College of Medicine) ;
  • Eo, Sung Jun (Department of Internal Medicine, University of Soonchunhyang College of Medicine) ;
  • Park, Eun Seo (Department of Internal Medicine, University of Soonchunhyang College of Medicine) ;
  • Kim, Young Tong (Department of Radiology, University of Soonchunhyang College of Medicine) ;
  • Cho, Jae Sung (Department of Internal Medicine, University of Soonchunhyang College of Medicine) ;
  • Oh, Mi Hye (Department of Diagnostic Pathology, University of Soonchunhyang College of Medicine) ;
  • Seo, Gi Hyun (Department of Internal Medicine, University of Soonchunhyang College of Medicine) ;
  • Na, Joo Ock (Department of Internal Medicine, University of Soonchunhyang College of Medicine) ;
  • Lee, Sang Do (Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Uh, Soo Taek (Department of Internal Medicine, University of Soonchunhyang College of Medicine) ;
  • Kim, Yong Hoon (Department of Internal Medicine, University of Soonchunhyang College of Medicine) ;
  • Park, Choon Sik (Department of Internal Medicine, University of Soonchunhyang College of Medicine)
  • 투고 : 2006.04.18
  • 심사 : 2006.06.16
  • 발행 : 2006.07.30
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초록

저자들은 종격동에 전반적인 섬유화성 연부조직 침윤으로 인해 폐동맥 협착을 일으켜 호흡곤란과 폐동맥 고혈압이 발생한 특발성 섬유화성 종격동염을 진단하고, 경구 부신피질 호르몬 투여 후 호전을 보인 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Idiopathic fibrosing mediastinitis is, an uncommon cause of pulmonary hypertension this is characterized by excessive fibrosis of the mediastinum with an unknown etiology. Steroid therapy has been suggested for individuals with progressive symptoms, bu there is littlet data demonstrating the efficacy of such therapy are lacking. We present a case of pulmonary hypertension secondary to a compression of a main pulmonary artery by fibrosing mediastinitis which was confirmed by a biopsy with a thoracotomy. The chest CT scan and 2D echocardiography performed before and after a trial of steroid therapy demonstrated improvement after steroid therapy.

키워드

참고문헌

  1. Goodwin RA, Nickell JA, des Perez RM. Mediastinal fibrosis complicating healed primary histoplasmosis and tuberculosis. Medicine 1972;51:227-46 https://doi.org/10.1097/00005792-197205000-00008
  2. Ernest NA, Bacos JM, Macher AM, Marsh HB, Savage DD, Fulmer JD, et al. Fibrosing mediastinitis causing pulmonary arterial hypertension without pulmonary venous hypertension. Am J Med 1977;63: 634-43 https://doi.org/10.1016/0002-9343(77)90209-1
  3. Kittredge RD, Nash AD. The many facets of sclerosing fibrosis. Am J Roentgenol Radium Ther Nucl Med 1974;122:288-98 https://doi.org/10.2214/ajr.122.2.288
  4. Sherrick AD, Brown LR, Harms GF, Myers JL. The radiographic findings of fibrosing mediastinitis. Chest 1994;106:484-9 https://doi.org/10.1378/chest.106.2.484
  5. Levine M R, Kaye L, Mair S, Bates J. Multifocal fibrosclerosis: report of a case of bilateral idiopathic sclerosing pseudotumor and retroperitoneal fibrosis. Arch Ophthalmol 1993;111:841-3 https://doi.org/10.1001/archopht.1993.01090060129037
  6. Kim KH, Kim HC, Chung MP, Kim HJ, Lee KS, Han JH, et al. Two cases of fibrosing mediastinitis caused by tuberculosis. Tuberc Respir Dis 1997;44:1146-57 https://doi.org/10.4046/trd.1997.44.5.1146
  7. Park KS, Jee HO, Park YK, Kim KH. Superior vena caval syndrome: report of a case. Korean J Thorac Cardiovasc Surg 1979;12:140-50
  8. Ko WO, Kim GH, Kim YS, Kim SW, Park SK, Lee DP, et al. A case of chronic sclerosing mediastinitis. Tuberc Respir Dis 1995;42:231-7 https://doi.org/10.4046/trd.1995.42.2.231
  9. Sim JJ, In GH, Kim HG, Kang GH, Yu SH, Chul S, et al. Idiopathic fibrosing mediastinitis causing extensive fibrotic veno-occlusion with minimal mediastinal involvement. Tuberc Respir Dis 2002;52: 278-82 https://doi.org/10.4046/trd.2002.52.3.278
  10. Berry DF, Buccigrossi D, Peabody J, Peterson KL, Moser KM. Pulmonary vascular occlusion and fibrosing mediastinitis. Chest 1986;89:296-301 https://doi.org/10.1378/chest.89.2.296
  11. Loyd JE, Tillman BF, Atkinson JB, des Prez RM. Mediastinal fibrosis complicating histoplasmosis. Medicine 1988;67:295-310 https://doi.org/10.1097/00005792-198809000-00002
  12. Weinstein JB, Aronberg DJ, Sagel SS. CT of fibrosing mediastinitis: findings and their utility. AJR Am J Roentgenol 1983;141:247-51 https://doi.org/10.2214/ajr.141.2.247
  13. Light AM. Idiopathic fibrosis of mediastinum: a discussion of three cases and review of the literature. J Clin Pathol 1978;31:78-88 https://doi.org/10.1136/jcp.31.1.78