Helicobacter heilmannii -like Organism으로 유발된 저등급 위 MALT 림프종 1예

A Case of Gastric Low-grade MALT Lymphoma Induced by a Helicobacter heilmannii-like Organism

  • 오동훈 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 김남훈 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 조유정 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 송태준 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 배원기 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 김경아 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 이준성 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 주미 (인제대학교 의과대학 일산백병원 병리학교실)
  • Oh, Dong-Hoon (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kim, Nam-Hoon (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Cho, Yu-Jung (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Song, Tae-Jun (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Bae, Won-Ki (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kim, Kyung-Ah (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Lee, June-Sung (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Joo, Mee (Department of Pathology, Ilsan Paik Hospital, Inje University College of Medicine)
  • 발행 : 2011.07.30

초록

헬리코박터 헤일마니는 양극성 편모를 가지는 그람음성 나선균의 형태를 띠고 요소분해효소를 가지는 헬리코박터 종의 한 종류로서 개와 고양이 등의 애완동물들로부터 인간에게 감염을 유발한다. 헬리코박터 헤일마니는 헬리코박터 파일로리에 비해 매우 낮은 인체 감염율을 나타내지만 위점막의 염증성 변화를 일으킴으로써 위염, 소화성 궤양, 위 말트림프종 등이 발생할 수 있다. 1개월간의 소화불량으로 내원한 54세의 남자에서 상부위장관 내시경검사를 시행하였고 위각부에 나선형태의 미세혈관 확장과 점막의 과립상의 소견이 관찰되었다. 병리조직검사를 통해 저등급 위 말트림프종과 헬리코박터 헤일마니 유사균주를 진단하였고 요소호기검사 양성이었다. 환자는 진돗개를 키우고 있었으며 이로 인한 감염으로 생각하며, 2주 간의 제균요법과 함께 4주 뒤 그리고 2개월 뒤의 추적 내시경검사에서 완치를 확인한 증례를 경험하여 문헌고찰과 함께 보고한다.

Helicobacter heilmannii is a Gram negative, long spiral-shaped organism associated with zoonotic infections acquired from primates including cats and dogs. Infection with H. heilmannii leads to gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue (MALT) lymphoma. We experienced a 54-year-old man with dyspepsia who was diagnosed with primary gastric MALT lymphoma (stage IE1) associated with a H. heilmannii-like organism. Upper gastrointestinal endoscopy revealed only microvascular dilatation and mucosal granularity without elevated or ulcerative lesions at the stomach angle. He was probably infected by a pet dog. The man was treated with eradication therapy for 2 weeks including lansoprazole, amoxicillin, and clarithromycin. Four weeks after eradication of the H. heilmannii-like organism, follow-up endoscopy and pathological biopsy findings showed complete remission of the gastric MALT lymphoma.

키워드

참고문헌

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