Tuberculosis and Respiratory Diseases

  • 제64권2호
  • /
  • Pages.133-137
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  • 2008
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  • 1738-3536(pISSN)
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  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
권호 표지

양전자 방출 단층촬영에서 폐암으로 의심되었던 고립 폐 결절 형태의 폐흡충증 1예

A Case of Pulmonary Paragonimiasis Presented as Solitary Pulmonary Nodule and Suspected as Lung Cancer on 18F-Fluorodeoxyglucose Positron Emission Tomography

  • 문재영 (고려대학교 의과대학 안산병원 내과학교실) ;
  • 정기환 (고려대학교 의과대학 안산병원 내과학교실) ;
  • 김제형 (고려대학교 의과대학 안산병원 내과학교실) ;
  • 박형주 (고려대학교 의과대학 안산병원 흉부외과학교실) ;
  • 김영식 (고려대학교 의과대학 안산병원 병리학교실) ;
  • 신철 (고려대학교 의과대학 안산병원 내과학교실)
  • Moon, Jae Young (Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine) ;
  • Jung, Ki Hwan (Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine) ;
  • Kim, Je Hyeong (Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine) ;
  • Park, Hyung Joo (Department of Thoracic and Cardiovascular Surgery, Ansan Hospital, Korea University College of Medicine) ;
  • Kim, Young Sik (Department of Pathology, Ansan Hospital, Korea University College of Medicine) ;
  • Shin, Chol (Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine)
  • 투고 : 2008.01.10
  • 심사 : 2008.01.23
  • 발행 : 2008.02.28
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초록

폐흡충증은 폐흡충(Paragonimus westermani)의 중간 숙주인 민물 게, 민물 가재 등의 섭취를 통해 인체에 감염되는 기생충 질환으로, 기흉, 흉수, 낭성 종괴 등 다양한 임상 양상을 보인다. 고립 폐 결절로 형태로 발현하는 경우에는, 폐결핵 및 폐암 등과의 구분이 중요하다. 양전자 방출 단층촬영 검사가 감별 진단에 도움이 되지만, 폐결핵 및 폐 히스토플라스마종 등의 진균 감염에서의 위양성이 보고된 바 있다. 저자들은 48세 남자로 단순흉부촬영상 우연히 발견된 고립 폐 결절에 대한 평가 위해 내원한 환자에게서, 흉부 CT 및 FDG-PET에서 좌폐상엽의 폐문주위에 FDG 섭취가 증가된 고립 폐 결절 양상을 보여 폐암으로 의심하였으나, 폐엽 절제술을 시행 후 폐흡충증으로 진단하여 치료하였기에 문헌 고찰과 함께 보고하는 바이다.

Pulmonary paragonimiasis continues to be a diagnostically challenging parasitic disease, despite a drastically decreased prevalence in South Korea during the past decade. Pulmonary paragonimiasis is characterized by fever, chest pain, and chronic cough with hemoptysis. Numerous radiographic and computed tomographic findings including the presence of pneumothorax, pleural effusion, and parenchymal lesions such as nodular or infiltrative opacities have been reported. The clinical and radiological manifestations of paragonimiasis can resemble those of lung cancer, tuberculosis or a metastatic malignancy. Furthermore, this disease can mimic lung cancer as seen on $^{18}F$-fluorodeoxyglucose positron emission tomography (FDG-PET). We report a case of pulmonary paragonimiasis in a 48-year old man that presented with a solitary pulmonary nodule and was suspected as a lung cancer based on FDG-PET imaging.

키워드

참고문헌

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