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다발성 원발성 악성종양: 남성 환자에서 유방의 점액성 선암과 유방외 미만성 거대 B세포 림프종이 병발한 증례 보고

Multiple Primary Malignant Neoplasms: A Case Report of Breast Mucinous Carcinoma and Extramammary Diffuse Large B-Cell Lymphoma in a Male Patient

  • 김수영 (인제대학교 일산백병원 영상의학과) ;
  • 이지영 (인제대학교 일산백병원 영상의학과)
  • Su Young Kim (Department of Radiology, Inje University, Ilsan Paik Hospital) ;
  • Ji Young Lee (Department of Radiology, Inje University, Ilsan Paik Hospital)
  • 투고 : 2020.06.11
  • 심사 : 2020.08.27
  • 발행 : 2021.05.01

초록

다발성 원발성 악성 종양은 한 환자에서 2개 이상의 원발성 악성 종양이 각각 독립적으로 발생하는 경우를 말한다. 저자들은 78세 남자 환자에서 동시에 발생한 유방의 점액성 선암과 유방외 림프종의 증례를 경험하여 보고하고자 한다. 환자는 2개의 만져지는 덩이를 주소로 내원하여 외과적 생검을 통해 좌측 유방의 점액성 선암과 우측 서혜부의 미만성 거대 B세포 림프종을 확진하였다. 이후 수술 전 시행한 PET/CT에서 좌측 혀편도의 우연종이 발견되었고, 절제 생검을 통해 미만성 거대 B세포 림프종을 확진하였다. 유방암 환자에서 불특정한 림프절 비대가 발견되는 경우 전이성 병변으로 간주되기 쉬우나, 이 증례의 환자와 같이 고령의 환자군에서는 림프종을 감별 진단으로 함께 고려함으로써 오진 및 치료 지연을 방지할 수 있을 것이다.

Multiple primary malignant neoplasms refer to two or more malignancies in an individual that are not related. We report a case of a 78-year-old male with concurrent breast mucinous carcinoma and extramammary lymphoma. The patient initially presented with palpable masses in the left breast and the right groin, which were pathologically confirmed after a surgical biopsy as breast mucinous carcinoma and diffuse large B-cell lymphoma, respectively. He underwent whole-body 18-fluorine deoxyglucose PET/CT before surgery, and an enhancing nodular lesion in the left lingual tonsil was found incidentally. It was later confirmed as a diffuse large B-cell lymphoma, a pathology of the same type as the right inguinal mass. Unspecified lymphadenopathies in breast cancer patients may easily be considered as metastatic lesions. However, this case suggests that lymphomas should be included in the differential diagnoses to avoid misdiagnosis and treatment delay, especially in older adult patients.

키워드

참고문헌

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