Tuberculosis and Respiratory Diseases

  • 제65권4호
  • /
  • Pages.328-333
  • /
  • 2008
  • /
  • 1738-3536(pISSN)
  • /
  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
권호 표지

폐섬유화를 동반한 재발성 박리성 간질성 폐렴

Recurrent Desquamative Interstitial Pneumonia with Fibrotic Lung Disease

  • 김원진 (한림대학교 의과대학 강동성심병원 내과학교실) ;
  • 최정희 (한림대학교 의과대학 강동성심병원 내과학교실) ;
  • 박용범 (한림대학교 의과대학 강동성심병원 내과학교실) ;
  • 조성우 (한림대학교 의과대학 강동성심병원 흉부외과학교실) ;
  • 남은숙 (한림대학교 의과대학 강동성심병원 해부병리학교실) ;
  • 모은경 (한림대학교 의과대학 강동성심병원 내과학교실)
  • Kim, Won Jin (Department of Internal Medicine, College of Medicine, Hallym University) ;
  • Choi, Jeong Hee (Department of Internal Medicine, College of Medicine, Hallym University) ;
  • Park, Yong Bum (Department of Internal Medicine, College of Medicine, Hallym University) ;
  • Cho, Sung Woo (Department of Thoracic Surgery, College of Medicine, Hallym University) ;
  • Nam, Eun Sook (Department of Pathology, College of Medicine, Hallym University) ;
  • Mo, Eun Kyung (Department of Internal Medicine, College of Medicine, Hallym University)
  • 투고 : 2008.07.02
  • 심사 : 2008.08.11
  • 발행 : 2008.10.30
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초록

박리성 간질성 폐렴은 흡연가에 호발하는 비교적 드문 미만성 간질성 폐질환이다. 박리성 간질성 폐렴은 치료에 대한 반응과 예후가 좋은 질환이나, 재발하는 경우가 있고 치료기간이 명확히 정해져 있지 않으며, 심한 섬유화가 동반되는 경우는 드문 질환이다. 저자들은 흉부 전산화단층 촬영에서 견인성 기관지확장증과 초기의 벌집모양 폐 소견과 함께 미만성 간유리혼탁화를 보이는 환자에서 흉강경하 폐 조직 검사로 박리성 간질성 폐렴을 진단하였고, 치료 종결 후 재발한 박리성 간질성 폐렴을 경험하였기에 이를 보고하는 바이다.

Desquamative interstitial pneumonia is an uncommon form of interstitial lung diseases and it has a good prognosis compared with other types of idiopathic interstitial pneumonia. A 69-year old man was admitted to our hospital because of a 3-month history of dyspnea. The patient presented with hypoxemia. High-resolution computerized tomography of the patient showed ground glass opacity and traction bronchiectasis with subpleural early honeycombing on the both lung fields. The pathologic findings of the video-assisted thoracoscopy lung biopsy were compatible with desquamative interstitial pneumonia, and irregularly distributed interstitial fibrosis and inflammation were observed at the peripheral parenchyme. Oral predinsolone was started; his symptoms and chest x-ray were improved, and so he stopped taking the prednisolone. Ten months later, the desquamative interstitial pneumonia recurred. We report here on a case of recurrent desquamative interstitial pneumonia with fibrotic lung disease.

키워드

참고문헌

  1. Liebow AA, Steer A, Billingsley JG. Desquamative interstitial pneumonia. Am J Med 1965;39:369-404. https://doi.org/10.1016/0002-9343(65)90206-8
  2. Carrington CB, Gaensler EA, Coutu RE, Fitzgerald MX, Gupta RG. Usual and desquamative interstitial pneumonia. Chest 1976;69:261-3. https://doi.org/10.1378/chest.69.2_Supplement.261
  3. Hartman TE, Primack SL, Kang EY, Swensen SJ, Hansell DM, McGuinness G, et al. Disease progression in usual interstitial pneumonia compared with desquamative interstitial pneumonia: assessment with serial CT. Chest 1996;110:378-82. https://doi.org/10.1378/chest.110.2.378
  4. Tubbs RR, Benjamin SP, Reich NE, McCormack LJ, Van Ordstrand HS. Desquamative interstitial pneumonitis: cellular phase of fibrosing alveolitis. Chest 1977;72:159-65. https://doi.org/10.1378/chest.72.2.159
  5. Akira M, Yamamoto S, Hara H, Sakatani M, Ueda E. Serial computed tomographic evaluation in desquamative interstitial pneumonia. Thorax 1997;52:333-7. https://doi.org/10.1136/thx.52.4.333
  6. Bjoraker JA, Ryu JH, Edwin MK, Myers JL, Tazelaar HD, Schroeder DR, et al. Prognostic significance of histopathologic subsets in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 1998;157:199-203. https://doi.org/10.1164/ajrccm.157.1.9704130
  7. Davies G, Wells AU, du Bois RM. Respiratory bronchiolitis associated with interstitial lung disease and desquamative interstitial pneumonia. Clin Chest Med 2004;25: 717-26. https://doi.org/10.1016/j.ccm.2004.06.004
  8. Kawabata Y, Takemura T, Hebisawa A, Ogura T, Yamaguchi T, Kuriyama T, et al. Eosinophilia in bronchoalveolar lavage fluid and architectural destruction are features of desquamative interstitial pneumonia. Histopathology 2008;52:194-202. https://doi.org/10.1111/j.1365-2559.2007.02930.x
  9. Hartman TE, Primack SL, Swensen SJ, Hansell D, McGuinness G, Müller NL. Desquamative interstitial pneumonia: thin-section CT findings in 22 patients. Radiology 1993;187:787-90. https://doi.org/10.1148/radiology.187.3.8497631
  10. Carrington CB, Gaensler EA, Coutu RE, FitzGerald MX, Gupta RG. Natural history and treated course of usual and desquamative interstitial pneumonia. N Engl J Med 1978;298:801-9. https://doi.org/10.1056/NEJM197804132981501
  11. Lipworth B, Woodcock A, Addis B, Turner-Warwick M. Late relapse of desquamative interstitial pneumonia. Am Rev Respir Dis 1987;136:1253-5. https://doi.org/10.1164/ajrccm/136.5.1253
  12. Chung JK, Kang HM, Kim KY, Han YC. A case of desquamative interstitial pneumonia. Korean J Med 1981; 24:244-50.
  13. Kondoh Y, Taniguchi H, Kawabata Y, Yokoi T, Suzuki K, Takagi K. Acute exacerbation in idiopathic pulmonary fibrosis: analysis of clinical and pathologic findingsin three cases. Chest 1993;103:1808-12. https://doi.org/10.1378/chest.103.6.1808
  14. Collard HR, Moore BB, Flaherty KR, Brown KK, Kaner RJ, King TE Jr, et al. Acute exacerbations of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2007;176:636-43. https://doi.org/10.1164/rccm.200703-463PP
  15. Kim DS, Park JH, Park BK, Lee JS, Nicholson AG, Colby T. Acute exacerbation of idiopathic pulmonary fibrosis: frequency and clinical features. Eur Respir J 2006;27:143-50. https://doi.org/10.1183/09031936.06.00114004