한국임상수의학회지 (Journal of Veterinary Clinics)

  • 제31권3호
  • /
  • Pages.233-236
  • /
  • 2014
  • /
  • 1598-298X(pISSN)
  • /
  • 2384-0749(eISSN)
한국임상수의학회 (The Korean Society of Veterinary Clinics)
권호 표지

개에서 발생한 의인성 부신피질기능항진증과 속발성 폐 석회화 진단 1례

Pulmonary Mineralization Secondary to Iatrogenic Hyperadrenocorticism in a Dog

  • 심사 : 2014.04.25
  • 발행 : 2014.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

피부염 치료를 위해 스테로이드를 처방받은 경력이 있는 11년령 수컷 시추가 비만, 얇은 피모, 복부 팽만으로 내원하였다. 방사선 사진상 폐야 전반에 기관지-간질패턴과 뚜렷한 흉막음영이 관찰되었으나 신체검사상 이와 관련한 증상은 보이지 않았다. 복부 초음파상 부신은 정상크기이며 간실질의 에코성 상승을 나타내었다. 컴퓨터 단층촬영상 폐 중앙부는 간유리음영을 나타내었으며 변연부는 중앙부에 비해 저감약성을 띄고, 고감약성 결절음영이 폐 실질전반에 산재되어 있었다. 영상진단학적 소견과 부신피질자극 호르몬 검사결과를 바탕으로 의인성 부신피질기능항진증과 속발성 폐 석회화로 진단하였다.

An 11-year-old, intact male Shih Tzu presented with obesity, thin hair coat, and abdominal distention. The patient had previously received corticosteroid therapy for dermatitis. Thoracic radiographs showed incidental findings of a generally diffuse bronchointerstitial pattern and markedly radiolucent pleural lines between the middle and caudal lung lobes, but clinical signs related to the thoracic radiographic findings were absent. Echogenicity of the hepatic parenchyma was increased and bilateral adrenal glands were not enlarged on ultrasonography. On computed tomography, the central regions of the lung lobes showed ground-glass attenuation, the peripheral regions of the lung lobes were relatively hypoattenuated compared with the central regions, and hyperattenuated nodules were distributed throughout the pulmonary parenchyma. Iatrogenic hyperadrenocorticism and secondary pulmonary mineralization was diagnosed on the basis of diagnostic imaging and adrenocorticotropic hormone stimulation test.

키워드

참고문헌

  1. Berry CR, Ackerman N, Monce K. Pulmonary mineralization in four dogs with Cushing's syndrome. Vet Radiol Ultrasound 1994; 35: 10-16. https://doi.org/10.1111/j.1740-8261.1994.tb00170.x
  2. Bogart SD. Disseminated pulmonary calcinosis with pulmonary alveolar microlithiasis. N Y state J Med 1980; 80: 1283-1284.
  3. Brown ML, Swee RG, Olson RJ, Bender CE. Pulmonary uptake of 99mTc diphosphonate in alveolar microlithiasis. Am J Roentgenol 1978; 131: 703-704. https://doi.org/10.2214/ajr.131.4.703
  4. Burns MG, Kelly AB, Hornof WJ, Howerth EW. Pulmonary artery thrombosis in three dogs with hyperadrenocorticism. J Am Vet Med Assoc 1981; 178: 388-393.
  5. Capen CC. The endocrine glands. In: Pathology of domestic animals, 3rd Ed. Orlando: Academic Press. 1985: 287-304.
  6. Chan ED, Morales DV, Welsh CH, McDermott MT, Schwarz MI. Calcium deposition with or without bone formation in the lung. Am J Respir Crit Care Med 2002; 165: 1654-1669. https://doi.org/10.1164/rccm.2108054
  7. Chung MJ, Lee KS, Franquet T, Muller NL, Han J, Kwon OJ. Metabolic lung disease: Imaging and histopathologic findings. Eur J Radiol 2005; 54: 233-245. https://doi.org/10.1016/j.ejrad.2004.07.003
  8. Corcoran HL, Renner WR, Milstein MJ. Review of high resolution of the lung. Radiographics 1992; 12: 917-939. https://doi.org/10.1148/radiographics.12.5.1529134
  9. Davidson BL, Rozanski EA, Tidwell AS, Hoffman AM. Pulmonary Thromboembolism in a Heartworm-Positive Cat. J Vet Intern Med 2006; 20: 1037-1041. https://doi.org/10.1111/j.1939-1676.2006.tb01826.x
  10. Fluckiger MA, Gomez JA. Radiographic findings in dogs with spontaneous pulmonary thrombosis or embolism. Vet Radiol Ultrasound 1984; 25: 124-131. https://doi.org/10.1111/j.1740-8261.1984.tb01923.x
  11. Goggs R, Benigni L, Fuentes VL, Chan DL. Pulmonary thromboembolism. J Vet Emerg Crit Care 2009; 19: 30-52. https://doi.org/10.1111/j.1476-4431.2009.00388.x
  12. Goodman LR, Curtin JJ, Mewissen MW, Foley WD, Lipchik RJ, Crain MR, Sagar KB, Collier BD. Detection of pulmonary embolism in patients with unresolved clinical and scintigraphic diagnosis: helical CT versus angiography. Am J Roentgenol 1995; 164: 1369-1374. https://doi.org/10.2214/ajr.164.6.7754875
  13. Huang HP, Yang HL, Liang SL, Lien YH, Chen KY. Iatrogenic hyperadrenocorticism in 28 dogs. J Am Anim Hosp Assoc 1999; 35: 200-207. https://doi.org/10.5326/15473317-35-3-200
  14. Huntley K, Frazer J, Gibbs C, Gaskell CJ. The radiographic features of canine Cushing's syndrome: A review of forty-eight cases. J Small Anim Pract 1982; 23: 369-380. https://doi.org/10.1111/j.1748-5827.1982.tb02071.x
  15. Kazerooni EA. High-resolution CT of the lungs. Am J Roentgenol 2001; 177: 501-519. https://doi.org/10.2214/ajr.177.3.1770501
  16. King RR, Mauderly JL, Hahn FF, Wolff RK, Muggenburg BA, Pickrell JA. Pulmonary function studies in a dog with pulmonary thromboembolism associated with Cushing's disease. J Am Anim Assoc 1985; 21: 555-562.
  17. Mayo JR. High resolution computed tomography. Technical aspects. Radiol Clin North Am 1991; 29: 617-621.
  18. Penninck DG, Feldman EC, Nyland TG. Radiographic features of canine hyperadrenocorticism caused by autonomously functioning adrenocortical tumors: 23 cases (1978-1986). J Am Vet Med Assoc 1988; 192: 1604-1608.
  19. Schwarz LA, Tidwell AS. Alternative imaging of the lung. Clin Tech Small Anim Pract 1999; 14: 187-206. https://doi.org/10.1016/S1096-2867(99)80011-5
  20. Turktas H, Ozturk C, Guven M, Ugur P, Erzen C. Pulmonary alveolar microlithiasis with the absence of technetium-99m MDP of lungs. Clin Nucl Med 1988; 12: 883-885.
  21. Westermark N. On the roentgen diagnosis of lung embolism. Acta Radiol 1938; 19: 357-372. https://doi.org/10.3109/00016923809137770
  22. Widmer WR, Guptil L. Imaging techniques for facilitating diagnosis of hyperadrenocorticism in dogs and cats. J Am Vet Med Assoc 1995; 206: 1857-1864.