The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Metastatic Pulmonary Calcification in a Patient with Adult T-Cell Leukemia/Lymphoma

성인 T세포 백혈병/림프종 환자에서 전이성 폐 석회화 1예

  • Kim, SooJung (Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Kang, Won Chan (Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Kim, Sun Woong (Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Lee, Yoon Jeong (Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Kim, WookYoun (Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Kim, Hyun Jeong (Department of Laboratoy Medicine, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Lee, Hong Ghi (Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine)
  • 김수정 (건국대학교 의학전문대학원 건국대학교병원 내과) ;
  • 강원찬 (건국대학교 의학전문대학원 건국대학교병원 내과) ;
  • 김선웅 (건국대학교 의학전문대학원 건국대학교병원 내과) ;
  • 이윤정 (건국대학교 의학전문대학원 건국대학교병원 내과) ;
  • 김욱연 (건국대학교 의학전문대학원 건국대학교병원 병리과) ;
  • 김현정 (건국대학교 의학전문대학원 건국대학교병원 진단검사의학과) ;
  • 이홍기 (건국대학교 의학전문대학원 건국대학교병원 내과)
  • Received : 2014.04.02
  • Accepted : 2014.06.16
  • Published : 2014.12.01
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Abstract

Adult T-cell leukemia/lymphoma (ATLL) is a highly aggressive disease that is geographically clustered, mirroring areas endemic for human T-cell lymphotropic virus type 1 infection. Most patients with ATLL present with aggressive manifestations such as severe hypercalcemia, lymphadenopathy, hepatosplenomegaly, and bone marrow involvement with progressive thrombocytopenia. We herein report a case of a patient with ATLL exhibiting increased uptake in both lungs as shown on a bone scan using $^{99m}Tc$-methylene diphosphonate. This finding is thought to have been caused by metastatic calcification associated with ectopic parathyroid hormone production.

HTLV-1 관련 ATLL은 다양한 임상양상을 나타낼 수 있으며 그 중 고칼슘혈증이 동반된 급성형의 경우 그 예후는 좋지 않을 수 있다. 저자는 HTLV-1 관련 ATLL 환자에서 고칼슘혈증 및 전이성 석회화 폐결절이 진단된 환자에서 항암치료 변경투약 및 감염치료를 지속하였음에도 호전되지 않는 치명적인 증례를 경험하였기에 문헌고찰과 함께 이를 보고 하는 바이다.

Keywords

References

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