종격동과 경부 림프절을 침범한 원발성 아밀로이드증: 증례 보고

Primary Amyloidosis Involving Mediastinal and Cervical Lymph Nodes: A Case Report

  • 문성희 (대구가톨릭대학교 의과대학 영상의학과학교실) ;
  • 정경재 (대구가톨릭대학교 의과대학 영상의학과학교실)
  • Mun, Sung-Hee (Department of Radiology, School of Medicine, Catholic University of Daegu) ;
  • Jung, Kyung-Jae (Department of Radiology, School of Medicine, Catholic University of Daegu)
  • 발행 : 2011.08.01

초록

아밀로이드증은 아밀로이드가 다양한 조직과 장기에 침착되는 드문 질환으로 그 중에서도 종격동과 두경부 림프절을 침범하는 국소성 형태는 매우 드물다. 뇌경색으로 입원한 68세 남자 환자가 경부와 종격동의 석회화를 동반한 림프절 종대를 보인 림프절 아밀로이드증으로 진단되었다. 두경부 및 종격동 림프절 종대가 있으며 내부 저음영 부위와 다양한 석회화를 보일 때 감별진단에 포함되어야 할 아밀로이드증의 증례를 CT소견과 함께 보고한다.

Amyloidosis is a rare disease characterized by the accumulation of an insoluble protein called 'amyloid' in various soft tissues and organs. Primary localized amyloidosis involving the mediastinal and cervical lymph nodes is extremely rare. A 68-year-old man was hospitalized a few days ago for recent cerebral infarction and was diagnosed with primary localized amyloidosis manifesting as mediastinal and cervical lymphadenopathy with calcification. In this review, we report a case of primary localized amyloidosis involving the mediastinal and cervical lymph nodes along with its computed tomography findings. Amyloidosis should be considered as part of the differential diagnosis when the lymph nodes show low central attenuation and various types of calcification.

키워드

참고문헌

  1. Ahn MI, Jeon JS, Kim JY, Cha ES, Shinn KS, Kim CH, et al. Primary amyloidosis involving mediastinal and hilar lymph nodes: a case report. J Korean Radiol Soc 1996;34:617-619 https://doi.org/10.3348/jkrs.1996.34.5.617
  2. Gomez AT, Alonso RM, Garcia MM, Fabbricatore AA, Garcia-Tejedor JL. Thoracic amyloidosis: high-resolution computed tomographic findings in 3 cases. J Comput Assist Tomogr 2008;32:926-928 https://doi.org/10.1097/RCT.0b013e31815a3420
  3. Yong HS, Woo OH, Lee JW, Suh SI, Oh YW, Kang EY. Primary localized amyloidosis manifested as supraclavicular and mediastinal lymphadenopathy. Br J Radiol 2007;80:e131-e133 https://doi.org/10.1259/bjr/52539691
  4. Takeshita K, Yamada S, Sato N, Kuwabara K, Kobayashi K, Asano K, et al. An unusual case of mediastinal lymphadenopathy caused by amyloidosis. Intern Med 2000;39:839-842 https://doi.org/10.2169/internalmedicine.39.839
  5. Leiro V, Fernandez-Villar A, Bandres R, Gonzalez A, Represas C, Barros JC, et al. Primary amyloidosis involving mediastinal lymph nodes: diagnosis by transbronchial needle aspiration. Respiration 2008;76:218-220 https://doi.org/10.1159/000098821
  6. Gross BH. Radiographic manifestations of lymph node involvement in amyloidosis. Radiology 1981;138:11-14 https://doi.org/10.1148/radiology.138.1.7455070
  7. Urschel JD, Urschel DM. Mediastinal amyloidosis. Ann Thorac Surg 2000;69:944-946 https://doi.org/10.1016/S0003-4975(99)01391-0
  8. Hiller N, Fisher D, Shmesh O, Gottschalk-Sabag S, Dollberg M. Primary amyloidosis presenting as an isolated mediastinal mass: diagnosis by fine needle biopsy. Thorax 1995;50:908-909 https://doi.org/10.1136/thx.50.8.908
  9. Kim Y, Lee KS, Yoo JH, Rhee C, Koo H, Han J, et al. Middle mediastinal lesions: imaging findings and pathologic correlation. Eur J Radiol 2000;35:30-38 https://doi.org/10.1016/S0720-048X(99)00156-4
  10. Suwatanapongched T, Gierada DS. CT of thoracic lymph nodes. Part II: diseases and pitfalls. Br J Radiol 2006;79:999-1000 https://doi.org/10.1259/bjr/82484604
  11. Gawne-Cain ML, Hansell DM. The pattern and distribution of calcified mediastinal lymph nodes in sarcoidosis and tuberculosis: a CT study. Clin Radiol 1996;51:263-267 https://doi.org/10.1016/S0009-9260(96)80343-6