High Grade Sarcoma Arising from the Chest Wall of a Chronic Tuberculous Empyema - A case report -

만성 결핵성 농흉과 동반된 흉벽 악성 육종 - 1예 보고 -

  • Chung, Won-Jae (Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine) ;
  • Lee, Sung-Ho (Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine) ;
  • Kim, Kwang-Taik (Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine) ;
  • Kang, Moon-Chul (Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine) ;
  • Chung, Jae-Ho (Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine) ;
  • Son, Ho-Sung (Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine) ;
  • Son, Kuk-Hui (Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine) ;
  • Sun, Kyung (Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine)
  • 정원재 (고려대학교 의과대학 흉부외과학교실) ;
  • 이성호 (고려대학교 의과대학 흉부외과학교실) ;
  • 김광택 (고려대학교 의과대학 흉부외과학교실) ;
  • 강문철 (고려대학교 의과대학 흉부외과학교실) ;
  • 정재호 (고려대학교 의과대학 흉부외과학교실) ;
  • 손호성 (고려대학교 의과대학 흉부외과학교실) ;
  • 손국희 (고려대학교 의과대학 흉부외과학교실) ;
  • 선경 (고려대학교 의과대학 흉부외과학교실)
  • Published : 2008.12.05

Abstract

A 50 year old male patient was admitted due to fever and left upper-quadrant abdominal pain. He had a history of previous treatment for pulmonary TB and splenectomy due to plastic anemia. A large peritoneal abscess with connection to a chronic left side tuberculous empyema thoracis was diagnosed on admission. Chest CT also revealed a soft issue lesion on the left anterior chest wall. Staged drainage of the peritoneal lesion followed by left side pleuropneumonectomy with chest wall resection was performed. The pathologic studies showed a high grade sarcoma of the chest wall.

50세 남자 환자가 좌상복부 동통 및 발열 증상을 주소로 내원하였다. 환자는 과거력상 28년전에 폐결핵 및 늑막염으로 약물치료를 받았으며 8년전 재생불량성 빈혈로 비장 절제술을 받았다. 내원 후 시행한 CT 검사상에서 만성 좌측 농흉과 연결을 보이는 복강내 농양이 진단되었다. 만성 농흉과 더불어 전흉벽에 농흉에 의한 흉벽 침습이 의심되는 병병도 아울러 관찰되었다. 환자는 복강내 농양 배액술 이후 좌측 늑막전폐절제술 및 흉벽 절제술을 시행 받았고 병리 조직 검사상 육종이 진단되었다.

Keywords

References

  1. Myoui A, Aozasa K, Iuchi K, et al. Soft tissue sarcoma of the pleural cavity. Cancer 1991;68:1550-4 https://doi.org/10.1002/1097-0142(19911001)68:7<1550::AID-CNCR2820680716>3.0.CO;2-I
  2. Gleeson MJ, McMullin JP. Squamous cell carcinoma in a chronically draining chest empyema. Irish J Med Sci 1998; 157:242
  3. Hillerdal G, Berg J. Malignant mesothelioma secondary to chronic inflammation and old scars: two new cases and review of the literature. Cancer 1985;55:1968-72 https://doi.org/10.1002/1097-0142(19850501)55:9<1968::AID-CNCR2820550923>3.0.CO;2-9
  4. Iuchi K, Aozasa K, Yamamoto S, et al. Non-Hodgkin's lymphoma of the pleural cavity developing from long-standing pyothorax: summary of clinical and pathological findings in thirty-seven Cases. Jpn J Clin Oncol 1989;19:249-57
  5. Aozasa K, Tsujimoto M, Sakurai M, et al. Non-Hodgkin's lymphomas in Osaka, Japan. Eur J Cancer Clin Oncol 1985; 21:487-92 https://doi.org/10.1016/0277-5379(85)90042-2
  6. Song WC, Choi JH, Myeong CY, et al. T-cell Non-Hodgkin's lymphoma originating in the wall of chronic tuberculous empyema. Korean J Thorac Cardiovasc Surg 1992;25:1102-6
  7. Kim KD, Chung KY, Kim SK, Shin DH. A case of malignant lymphoma developing from the wall of chronic empyema. Korean J Thorac Cardiovasc Surg 1993;26:571-4
  8. Minami M, Kawauchi N, Yoshikawa K, et al. Malignancy associated with chronic empyema: radiologic assessment. Radiology 1991;178:417-23 https://doi.org/10.1148/radiology.178.2.1987602