일측성 폐침윤을 보인 폐포양 유육종증 1예

A Case of Pseudoalveolar Sarcoidosis with Unilateral Pulmonary Infiltration

  • 김희경 (전남대학교 의과대학 내과학교실) ;
  • 반희정 (전남대학교 의과대학 내과학교실) ;
  • 지수영 (전남대학교 의과대학 내과학교실) ;
  • 채동렬 (전남대학교 의과대학 내과학교실) ;
  • 조계종 (전남대학교 의과대학 내과학교실) ;
  • 임정환 (전남대학교 의과대학 내과학교실) ;
  • 주진영 (전남대학교 의과대학 내과학교실) ;
  • 권용수 (전남대학교 의과대학 내과학교실) ;
  • 오인재 (전남대학교 의과대학 내과학교실) ;
  • 김규식 (전남대학교 의과대학 내과학교실) ;
  • 김유일 (전남대학교 의과대학 내과학교실) ;
  • 임성철 (전남대학교 의과대학 내과학교실) ;
  • 김영철 (전남대학교 의과대학 내과학교실)
  • Kim, Hee Kyung (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Ban, Hee Jung (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Chi, Su Young (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Chae, Dong Ryeol (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Cho, Gye Jung (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Lim, Jung Hwan (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Ju, Jin Yung (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kwon, Yong Soo (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Oh, In Jae (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Kyu Sik (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Yu Il (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Lim, Sung Chul (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Young Chul (Department of Internal Medicine, Chonnam National University Medical School)
  • 투고 : 2008.01.05
  • 심사 : 2008.01.24
  • 발행 : 2008.02.28

초록

유육종증은 원인 불명의 전신성 질환으로 폐 침윤은 양측 폐 상엽의 결절과, 양측 흉곽내 임파선 비대가 특징적이나 폐포 병변을 보여 폐렴이나 폐암으로 오인될 수 있는 일측성 폐포양 유육종증은 드문 것으로 알려져 있어 문헌 고찰과 함께 보고하는 바이다.

A sarcoidosis is a multisystemic granulomatous disorder that has a predilection for pulmonary involvement, and the common radiological findings for the disease are bilateral nodular or reticulonodular patterns. Pseudoalveolar sarcoidosis is a rare presentation of sarcoidosis. The radiological finding is an alveolar pattern that involves or compresses the alveoli by clustered interstitial granuloma. A 58-year-old man was admitted due to incidental findings of a unilateral consolidative lesion as seen on chest radiography. A chest computed tomography (CT) examination showed multiple bronchoalveolar consolidations that were suspicious of a malignancy. However, a percutaneous needle biopsy revealed non-caseating granuloma with an asteroid body that was compatible with sarcoidosis. After one month, the consolidative lesions improved without any treatment.

키워드

참고문헌

  1. Johkoh T, Ikezoe J, Takeuchi N, Kohno N, Tomiyama N, Akira M, et al. CT findings in "pseudoalveolar" sarcoidosis. J Comput Assist Tomogr 1992;16:904-7 https://doi.org/10.1097/00004728-199211000-00014
  2. Muller NL, Mawson JB, Mathieson JR, Abboud R, Ostrow DN, Champion P. Sarcoidosis: correlation of extent of disease at CT with clinical, functional, and radiographic findings. Radiology 1989;171:613-8 https://doi.org/10.1148/radiology.171.3.2717730
  3. Sahn SA, Schwarz MI, Lakshminarayan S. Sarcoidosis: the significance of an acinar pattern on chest roentgenogram. Chest 1974;65:684-7 https://doi.org/10.1378/chest.65.6.684
  4. Grenier P, Valeyre D, Cluzel P, Brauner MW, Lenoir S, Chastang C. Chronic diffuse interstitial lung disease: diagnostic value of chest radiography and high-resolution CT. Radiology 1991;179:123-32 https://doi.org/10.1148/radiology.179.1.2006262
  5. Battesti JP, Saumon G, Valeyre D, Amouroux J, Pechnick B, Sandron D, et al. Pulmonary sarcoidosis with an alveolar radiographic pattern. Thorax 1982;37:448-52 https://doi.org/10.1136/thx.37.6.448
  6. Nam JE, Ryu YH, Park JG, Choe KO, Im JG, Lee KS, et al. High resolution CT findings of pseudoalveolar sarcoidosis. J Korean Radiol Soc 2002;47:191-6 https://doi.org/10.3348/jkrs.2002.47.2.191
  7. Hamper UM, Fishman EK, Khouri NF, Johns CJ, Wang KP, Siegelman SS. Typical and atypical CT manifestation of pulmonary sarcoidosis. J Comput Assist Tomogr 1986;10:928-36 https://doi.org/10.1097/00004728-198611000-00006
  8. Sharma OP. Sarcoidosis: a worldwide phenomenon. Sarcoidosis 1984;1:11-15
  9. Brauner MW, Grenier P, Mompoint D, Lenoir S, de Cremoux H. Pulmonary sarcoidosis: evaluation with high resolution CT. Radiology 1989;172:467-71 https://doi.org/10.1148/radiology.172.2.2748828
  10. Gibson GJ, Prescott RJ, Muers MF, Middleton WG, Mitchell DN, Connolly CK, et al. British Thoracic Society Sarcoidosis study: effects of long term corticosteroid treatment. Thorax 1996;51:238-47 https://doi.org/10.1136/thx.51.3.238
  11. Newman LS, Rose CS, Maier LA. Sarcoidosis. N Engl J Med 1997;336:1224-34 https://doi.org/10.1056/NEJM199704243361706