리포이드 폐렴(Lipoid pneumonia)으로 오인된 폐에 발생한 림프절 외 변연부 B-세포 림프종 1예

A Case of Low-grade B-cell Lymphoma of Bronchial Associated Lymphoid Tissue Mimicking Lipoid Pneumonia

  • 조진희 (아주대학교 의과대학 호흡기 내과학교실) ;
  • 양민재 (아주대학교 의과대학 호흡기 내과학교실) ;
  • 유수경 (아주대학교 의과대학 호흡기 내과학교실) ;
  • 서경우 (아주대학교 의과대학 호흡기 내과학교실) ;
  • 김효철 (아주대학교 의과대학 종양혈액 내과학교실) ;
  • 신승수 (아주대학교 의과대학 호흡기 내과학교실)
  • Cho, Jin Hee (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Yang, Min Jae (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Yu, Su Kyong (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Soe, Kyoung Woo (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Kim, Hugh Chul (Department of Hemato-oncology, Ajou University School of Medicine) ;
  • Sheen, Seung Soo (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine)
  • 투고 : 2007.06.14
  • 심사 : 2007.08.06
  • 발행 : 2007.08.30

초록

기관에 발생한 림프절 외 변연부 B-세포 림프종(BALT lymphoma)은 폐에서 원발하는 비호지킨스 림프종의 70% 이상을 차지하지만 전체 림프종의 1% 미만을 차지할 만큼 드문 질환으로 흉부 단순 촬영에서 우연히 발견되는 경우가 많고, 예후는 비교적 양호하나 아직 확립된 치료법은 없는 상태이다. 저자들은 흉부 방사선 촬영 상 지속되는 폐침윤 소견을 주소로 내원 후 리포이드 폐렴으로 오인되어 진단과 치료가 늦어 골수 침범까지 진행된 폐에 발생한 림프절 외 변연부 B-세포 림프종을 1예를 경험하여 보고하는 바이다.

BALT(bronchial associated lymphoid tissue) lymphomas are a distinct subgroup of low-grade B-cell extranodal non-Hodgkin's lymphoma, which are classified as a marginal-zone lymphomas. The majority of the patients are asymptomatic or their pulmonary lesions is often discovered incidentally on a routine chest radiograph. A 50-year-old man was admitted for an the evaluation of cough, dyspnea and fever. His chest CT showed ground glass appearance with interlobular septal thickening in both lower lobes, right middle lobe and left lingular division. He had been initially diagnosed with lipoid pneumonia and was kept under observation. However, his chest lesion showed continuous progression and a video-associated thoracoscopy was performed His pulmonary lesion was confirmed histologically to be a BALT(bronchial associated lymphoid tissue) lymphoma. We report a case of a BALT lymphoma, which was initially misdiagnosed as lipoid pneumonia.

키워드

참고문헌

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