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A Case of Lymphocytic Interstitial Pneumonia Manifested as a Multi-focal Consolidation

다발성 경화 소견으로 발현된 림프구성 간질성 폐렴 1예

  • Hwang, Kyu Sig (Department of Internal Medicine, University College of Medicine) ;
  • Roh, Young Wook (Department of Internal Medicine, University College of Medicine) ;
  • Song, Sung Heon (Department of Internal Medicine, University College of Medicine) ;
  • Kim, Sang Heon (Department of Internal Medicine, University College of Medicine) ;
  • Sohn, Jang Won (Department of Internal Medicine, University College of Medicine) ;
  • Yoon, Ho Joo (Department of Internal Medicine, University College of Medicine) ;
  • Shin, Dong Ho (Department of Internal Medicine, University College of Medicine) ;
  • Park, Sung Soo (Department of Internal Medicine, University College of Medicine) ;
  • Oh, Young-Ha (Department of Pathology, University College of Medicine) ;
  • Kim, Tae-Hyung (Department of Internal Medicine, University College of Medicine)
  • 황규식 (한양대학교 의과대학 내과학교실) ;
  • 노영욱 (한양대학교 의과대학 내과학교실) ;
  • 송성헌 (한양대학교 의과대학 내과학교실) ;
  • 김상헌 (한양대학교 의과대학 내과학교실) ;
  • 손장원 (한양대학교 의과대학 내과학교실) ;
  • 윤호주 (한양대학교 의과대학 내과학교실) ;
  • 신동호 (한양대학교 의과대학 내과학교실) ;
  • 박성수 (한양대학교 의과대학 내과학교실) ;
  • 오영하 (한양대학교 의과대학 병리학교실) ;
  • 김태형 (한양대학교 의과대학 내과학교실)
  • Received : 2009.06.03
  • Accepted : 2009.06.30
  • Published : 2009.07.30

Abstract

Lymphocytic interstitial pneumonia (LIP) is a rare disorder characterized by a diffuse infiltration of the alveolar space, interstitium by lymphocytes, plasma cells, and reticuloendothelial cells. Although its etiology is unknown, LIP has been associated with autoimmune disorders and with viral infections. Because it's clinical and radiographic features are nonspecific, a confirmatory diagnosis is performed by open lung biopsy. A 59-year-old female presented dry cough, which had been present for 1 month. On initial findings of multifocal consolidation at the right middle lobe on both lower lobes in chest radiography, the first diagnosis of cryptogenic organizing pneumonia was suggested. On open lung biopsy, LIP was diagnosed. The patient had no autoimmune disease, viral infection or monoclonal gammopathy. After 3 months of corticosteroid treatment, the patient experienced improved symptoms, reduced abnormalities on chest radiography, and improved pulmonary function testing.

LIP는 매우 드문 간질성 폐질환의 일종으로 비특이적인 방사선학적 소견으로 보이므로 타 간질성 폐질환과의 감별을 위해서는 반드시 개흉 폐생검을 하여야 한다. 또한 LIP 진단 후 다른 자가 면역 질환 및 감염의 확인이 치료방향의 결정에 있어 필요하며 폐섬유화 및 폐성심으로의 진행을 막기 위해서 조기에 적극적인 폐생검을 시행하여 적극적인 치료를 시작하여야 한다. 또한 일부 악성 림프종으로의 진행도 보고 되고 있어 정기적인 추적 검사가 필요하다. 저자들은 1개월 간의 기침과 운동 시 호흡곤란으로 내원하여 개흉 폐생검 결과 LIP로 진단 후 스테로이드 치료로 호전된 1예를 경험하였기에 관련 문헌고찰과 함께 보고한다.

Keywords

References

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  1. 일차성 Sjogren씨 증후군에서 발생한 림프구성 간질성 폐렴 1예: 증례보고와 국내문헌고찰 vol.69, pp.5, 2010, https://doi.org/10.4046/trd.2010.69.5.375