Journal of Yeungnam Medical Science

영남대 의대 학술지 편집위원회 (Yeungnam University College of Medicine, Yeungnam University Institute Medical Science)
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결핵성 흉막염으로 오인된 악성중피종

Malignant mesothelioma mistaken for tuberculous pleurisy

  • 양지영 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 송민주 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 박소정 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 천재경 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 유정완 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 최창민 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 김용희 (울산대학교 의과대학 서울아산병원 흉부외과학교)
  • Yang, Ji-Young (Department of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine) ;
  • Song, Min-Joo (Department of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine) ;
  • Park, So-Jung (Department of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine) ;
  • Cheon, Jaekyung (Department of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine) ;
  • Yoo, Jung-Wan (Department of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine) ;
  • Choi, Chang-Min (Department of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine) ;
  • Kim, Yong Hee (Department of Thoracic Surgery, Asan Medical Center University of Ulsan College of Medicine)
  • 투고 : 2014.03.31
  • 심사 : 2014.07.07
  • 발행 : 2015.06.30
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초록

Malignant mesothelioma is a common, primary tumor that can invade pleura, and is associated with previous exposure to asbestos. However, it poses considerable difficulties regarding its diagnosis and treatment, and thus, accurate history taking with respect to exposure to asbestos, and radiologic and pathologic examinations are essential. In addition, the involvement of a multidisciplinary team is recommended in order to ensure prompt and appropriate management using a framework based on radiotherapy, chemotherapy, surgery, and symptom palliation with end-of-life care. Because lymphocyte-dominant, exudative pleural effusion can occur in malignant mesothelioma, adenosine deaminase values may be elevated, which could be mistaken for tuberculous pleurisy, and lead to an incorrect diagnosis and suboptimal treatment. The authors describe a case of malignant mesothelioma initially misdiagnosed as tuberculous pleurisy. As evidenced by the described case, malignant mesothelioma should be considered during the differential diagnosis of patients with lymphocyte-dominant, exudative pleural effusion with a pleural lung lesion.

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