The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

A Case of Pulmonary Paragonimiasis Mimicking Lung Cancer Diagnosed by EBUS-TBNA

초음파 기관지 내시경으로 진단한 폐암으로 오인된 폐흡충증 1예

  • Lee, Jae June (Department of Internal Medicine, Ulsan University College of Medicine) ;
  • Choi, Chang Min (Department of Internal Medicine, Ulsan University College of Medicine) ;
  • Kwon, Hwuk Hee (Department of Internal Medicine, Ulsan University College of Medicine) ;
  • Kim, Min Soo (Department of Internal Medicine, Ulsan University College of Medicine) ;
  • Kim, Joon-Seok (Department of Internal Medicine, Ulsan University College of Medicine) ;
  • Park, So Young (Department of Internal Medicine, Ulsan University College of Medicine) ;
  • Hwang, Hee Sang (Department of Pathology, Ulsan University College of Medicine)
  • 이재준 (울산대학교 의과대학 내과학교실) ;
  • 최창민 (울산대학교 의과대학 내과학교실) ;
  • 권혁희 (울산대학교 의과대학 내과학교실) ;
  • 김민수 (울산대학교 의과대학 내과학교실) ;
  • 김준석 (울산대학교 의과대학 내과학교실) ;
  • 박소영 (울산대학교 의과대학 내과학교실) ;
  • 황희상 (울산대학교 의과대학 병리학교실)
  • Received : 2012.05.04
  • Accepted : 2012.08.21
  • Published : 2013.03.01
⟨ Previous Next ⟩

Abstract

As the clinical and radiological features of pulmonary paragonimiasis are similar to those of pulmonary tuberculosis and lung cancer, the diagnosis of pulmonary paragonimiasis is very difficult and a biopsy is needed for the diagnosis. Transbronchial needle aspiration (TBNA) using conventional bronchoscopy is frequently used for nodal sampling, but its diagnostic accuracy is questionable due to the blind approach for targeting lymph nodes. Endobronchial ultrasound-guided (EBUS)-TBNA has high diagnostic value due to the direct visualization of lymph nodes, and thereby improves nodal diagnosis accuracy. This paper reports the first patient we experienced with pulmonary paragonimiasis mimicking lung cancer diagnosed by EBUS-TBNA.

폐흡충증은 임상양상이나 방사선학적 소견이 폐결핵, 폐암과 유사하고 최근 우리나라에서 유병률이 낮으므로 조기 진단이 어렵다. 초음파 기관지 내시경은 최근에 각광받고 있는 검사법으로 폐암뿐만 아니라 폐결핵, 사르코이드증 등 많은 질환에서 진단에 도움을 주고 있으며, 기존의 기관지 내시경을 통한 조직검사와 비교하여 안전하고 진단율도 높은 것으로 보고되고 있다. 저자들은 폐암으로 오인되었으나 초음파 기관지 내시경 검사를 통해 조직검사를 시행하여 이후 폐흡충증으로 진단된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Jeon K, Koh WJ, Kim H, et al. Clinical features of recently diagnosed pulmonary paragonimiasis in Korea. Chest 2005; 128:1423-1430. https://doi.org/10.1378/chest.128.3.1423
  2. Song JU, Um SW, Koh WJ, et al. Pulmonary paragonimiasis mimicking lung cancer in a tertiary referral centre in Korea. Int J Tuberc Lung Dis 2011;15:674-679. https://doi.org/10.5588/ijtld.10.0494
  3. Annema JT, Rabe KF. State of the art lecture: EUS and EBUS in pulmonary medicine. Endoscopy 2006;38(Suppl 1):S118-122. https://doi.org/10.1055/s-2006-946671
  4. Kuo CH, Chen HC, Chung FT, et al. Diagnostic value of EBUS-TBNA for lung cancer with non-enlarged lymph nodes: a study in a tuberculosis-endemic country. PLoS One 2011;6:e16877. https://doi.org/10.1371/journal.pone.0016877
  5. Kim KU, Lee K, Park HK, Jeong YJ, Yu HS, Lee MK. A pulmonary paragonimiasis case mimicking metastatic pulmonary tumor. Korean J Parasitol 2011;49:69-72. https://doi.org/10.3347/kjp.2011.49.1.69
  6. Herf SM, Suratt PM. Complications of transbronchial lung biopsies. Chest 1978;73(5 Suppl):759-760. https://doi.org/10.1378/chest.73.5_Supplement.759
  7. Lai RS, Lee SS, Ting YM, Wang HC, Lin CC, Lu JY. Diagnostic value of transbronchial lung biopsy under fluoroscopic guidance in solitary pulmonary nodule in an endemic area of tuberculosis. Respir Med 1996;90:139-143. https://doi.org/10.1016/S0954-6111(96)90155-9
  8. Kambartel K, Krbek T, Voshaar T. Comparison of endobronchial ultrasound (EBUS) and mediastinoscopy (MS) for staging lung cancer. Pneumologie 2012;66:426-431. https://doi.org/10.1055/s-0032-1309400
  9. Darwiche K, Wagner M, Theegarten D. Current value of endobronchial ultrasound (EBUS). Pneumologie 2011;65: 537-548. https://doi.org/10.1055/s-0030-1256666
  10. Oki M, Saka H, Kitagawa C, et al. Prospective study of endobronchial ultrasound-guided transbronchial needle aspiration of lymph nodes versus transbronchial lung biopsy of lung tissue for diagnosis of sarcoidosis. J Thorac Cardiovasc Surg 2012;143:1324-1329. https://doi.org/10.1016/j.jtcvs.2012.01.040
  11. Tremblay A, Stather DR, Maceachern P, Khalil M, Field SK. A randomized controlled trial of standard vs endobronchial ultrasonography-guided transbronchial needle aspiration in patients with suspected sarcoidosis. Chest 2009;136:340-346. https://doi.org/10.1378/chest.08-2768

Cited by

  1. Pleural fluid characteristics of pleuropulmonary paragonimiasis masquerading as pleural tuberculosis vol.30, pp.1, 2013, https://doi.org/10.3904/kjim.2015.30.1.56
  2. A Case of Intra-abdominal Paragonimiasis Mimicking Metastasis of Lung Cancer Diagnosed by Endoscopic Ultrasound-guided Fine Needle Aspiration vol.66, pp.1, 2013, https://doi.org/10.4166/kjg.2015.66.1.41
  3. 객혈과 공동 폐병변으로 폐결핵으로 오인된 폐흡충증 1예 vol.24, pp.3, 2013, https://doi.org/10.14776/piv.2017.24.3.178