Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Clinical Analysis of Primary Malignant Lymphoma of the Lung

원발성 폐림프종의 임상 고찰

  • Kim, Jae-Bum (Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Park, Nam-Hee (Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Kum, Dong-Yoon (Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Noh, Dong-Sub (Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Lee, Jae-Hoon (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Han, Seung-Bum (Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Jung, Hye-Ra (Department of Pathology, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Park, Chang-Kwon (Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University School of Medicine)
  • 김재범 (계명대학교 의과대학 동산의료원 흉부외과학교실) ;
  • 박남희 (계명대학교 의과대학 동산의료원 흉부외과학교실) ;
  • 금동윤 (계명대학교 의과대학 동산의료원 흉부외과학교실) ;
  • 노동섭 (계명대학교 의과대학 동산의료원 흉부외과학교실) ;
  • 이재훈 (울산대학교 의과대학 서울아산병원 흉부외과학교실) ;
  • 한승범 (계명대학교 의과대학 동산의료원 내과학교실) ;
  • 정혜라 (계명대학교 의과대학 동산의료원 병리학교실) ;
  • 박창권 (계명대학교 의과대학 동산의료원 흉부외과학교실)
  • Published : 2007.06.05
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Abstract

Background: Primary malignant lymphoma of the lung is a very rare neoplasm. Although the prognosis of lymphoma is favorable, the clinical features, prognostic factors and management have not been clearly defined. Material and Method: We retrospectively reviewed the records of 8 patients we managed between 1994 and 2000. They all had malignant lymphoma on the pathologic examination of the lung wit no evidence of mediastinal adenopathy and extrathoracic disease, and no past history of lymphoma. Result: The study group consisted of 3 males and 5 female patients with a mean age of 53.9 years. Three patients were asymtomatic and 5 patients were seer with pulmonary or systemic symptoms. The diagnostic methods were 3 CT needle aspiration biopsies, 1 bronchoscopic biopsy and 4 surgical methods (wedge resection, lobectomy). There were 3 patients with MALT lymphoma, two with diffuse large B-cell lymphoma, two with small lymphocytic lymphom, and one with follicular lymphoma. The 8 patients were treated with a variety of modalities, including surgery, chemotherapy, radiotherapy and combination therapy. The 8 patients have survived for a median follow-up of 38 months. Conclusiian: Although this entity of lymphoma appears to have a good prognosis, further clinical experience and long-term follow-up are needed to identify its clinical features, prognostic factors and management.

배경: 폐에 생기는 원발성 악성림프종은 매우 드문 종양이다. 비록 림프종의 예후는 좋으나 임상양상이나 예후요소, 치료에 대해서는 명확히 밝혀져 있지 않다. 대상 및 방법: 1994년부터 2006년 사이에 치료한 8명의 환자를 대상으로 하였다. 병리적 검사에서 폐에 악성 림프종으로 나타났으며 종격동림프선비대가 없으며 복부와 골반 단층촬영 및 골수검사에서 폐외 질병이 없으며 과거 림프종의 병력이 없는 경우로 하였다. 결과: 남자가 3명, 여자가 5명이었으며 평균나이는 53.9세였다. 3명은 무증상이었으며 5명은 폐 및 전신증상을 가지고 있었다. 진단은 3명이 흉부컴퓨터 단층촬영하 세침 생검, 1명이 기관지내시경하 생검을 하였으며 수술적으로 진행된 사람은 4명으로 폐쐐기 절제술 2명과 폐엽 절제술 2명을 시행하였다. 3명은 점막관련 림프종이었으며 2명은 큰 B세포 림프종, 2명은 소림프구 림프종이었고 한명은 여포성 림프종이었다. 8명의 환자들은 여러 다양한 치료를 받았는데 관찰, 수술, 항암화학요법 및 방사선치료나 복합치료를 받았다. 8명 모두 현재 생존해있으며 평균추적관찰기간은 38개월이다. 결론: 이 결과에서도 나타나듯 폐의 원발성악성림프종은 좋은 예후를 가지고 있으나 임상증상과 예후요소, 적절한 치료방식을 알아내기 위해서는 더 긴 기간의 추적관찰과 더 많은 임상경험이 필요하다.

Keywords

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