Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Bronchus-Associated Lymphoid Tissue(BALT) Lymphoma Treated with Lobectomy

폐엽절제를 통한 BALT 림프종 치료 1 예

  • Choi, Won Sub (Division of Pulmonary, Allergy and Critical Care Medicine of Hallym University Medical Center) ;
  • Cho, Jae Hyun (Division of Pulmonary, Allergy and Critical Care Medicine of Hallym University Medical Center) ;
  • Hwang, Young Il (Division of Pulmonary, Allergy and Critical Care Medicine of Hallym University Medical Center) ;
  • Jang, Seung Hun (Division of Pulmonary, Allergy and Critical Care Medicine of Hallym University Medical Center) ;
  • Kim, Dong-Gyu (Division of Pulmonary, Allergy and Critical Care Medicine of Hallym University Medical Center) ;
  • Jun, Sun-Young (Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Min, Kwangseon (Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Lee, In Jae (Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Lee, Jae Woong (Department of Thorasic and Cardiovascular Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Jung, Ki-Suck (Division of Pulmonary, Allergy and Critical Care Medicine of Hallym University Medical Center)
  • 최원섭 (한림대학교 성심병원 호흡기 알레르기내과) ;
  • 조재현 (한림대학교 성심병원 호흡기 알레르기내과) ;
  • 황용일 (한림대학교 성심병원 호흡기 알레르기내과) ;
  • 장승훈 (한림대학교 성심병원 호흡기 알레르기내과) ;
  • 김동규 (한림대학교 성심병원 호흡기 알레르기내과) ;
  • 전선영 (한림대학교 성심병원 병리학교실) ;
  • 민광선 (한림대학교 성심병원 병리학교실) ;
  • 이인재 (한림대학교 성심병원 진단방사선학교실) ;
  • 이재웅 (한림대학교 성심병원 흉부외과학교실) ;
  • 정기석 (한림대학교 성심병원 호흡기 알레르기내과)
  • Received : 2006.12.28
  • Accepted : 2007.04.24
  • Published : 2007.05.30
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Abstract

The bronchus-asociated lymphoid tissue(BALT) lymphoma is a low-grade primary malignant lymphoma that originates from bronchus associated lymphoid tissue. A 67-year-old woman was admitted for evaluation of cough, sputum, rhinorrhea which had persisted for one month. Physical examination showed decreased breathing sound on the left upper lung field. High resolution chest computed tomography demonstrated consolidation which showed air-bronchogram and surrounding ground glass opacity in left upper lobe. These findings implicated inactive tuberculosis, organizing pneumonia, or bronchiolo-alveolar carcinoma. The histologic findings from percutaneous needle aspiration biopsy revealed aggregated atypical small lymphoid cells with lymphoepithelial lesions. With immunohistochemical staining, the atypical lymphoid cells reacted positively with CD 20 antibody and negatively with CD 3 antibody. Thus, we could diagnosed her as a patient with BALT lymphoma. After left upper lobectomy, she has been well without recurrence of the disease for 14 months. In this country of Republic of Korea, it was the 1st case of BALT lymphoma surgically treated when histological diagnosis had been done. Based on this case, we wanted to demonstrate the importance of early histological diagnosis and treatment of BALT lymphoma.

기관지 연관 림프조직 림프종은 비특이적인 호흡기 증상만을 나타내며, 전산화단층촬영에서 세기관지 폐포암, 림프구성 간질성 폐렴등과 뚜렷이 구분이 되지 않는 결절 외 림프종의 일종이다. 저자들은 비특이적인 호흡기 증상만을 나타내는 병변에 대해 침습적인 방법인 경피 미세흡입생검을 시행하여, 원발성 기관지 연관 림프조직 림프종으로 진단하였으며, 병리적 진단이 내려진 상태에서 치료를 목적으로 좌상엽 절제술을 시행하였다. 기관지 연관 림프조직 림프종은 서서히 진행되는 질환으로, 대부분 최종 진단이 늦어지는 경향을 보인다. 국소적 병변일 경우 외과적 수술로 완치가 가능한 질환이므로, 질환이 의심되는 경우 적극적 검사와 치료를 시도하는 것이 중요할 것으로 생각된다.

Keywords

References

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