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7년간 추적관찰에서 진행과 자발적 퇴행을 함께 보인 폐의 다결절성 상피양 혈관내피종: 증례 보고 및 영상 소견 고찰

Pulmonary Multinodular Epithelioid Hemangioendothelioma with Mixed Progression and Spontaneous Regression during a 7-Year Follow-Up: A Case Report and Review of Imaging Findings

  • 이가영 (이화여자대학교 의과대학 이대목동병원 영상의학과) ;
  • 김유경 (이화여자대학교 의과대학 이대목동병원 영상의학과) ;
  • 김관창 (이화여자대학교 의과대학 이대서울병원 흉부외과) ;
  • 박혜성 (이화여자대학교 의과대학 이대서울병원 병리학과)
  • Ga Young Yi (Department of Radiology, Ewha Womans University College of Medicine, Ewha Womans University Mokdong Hospital) ;
  • Yoo Kyung Kim (Department of Radiology, Ewha Womans University College of Medicine, Ewha Womans University Mokdong Hospital) ;
  • Kwan Chang Kim (Department of Thoracic and Cardiovascular Surgery, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital) ;
  • Heae Surng Park (Department of Pathology, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital)
  • 투고 : 2021.08.02
  • 심사 : 2021.10.12
  • 발행 : 2022.07.01

Abstract

폐 상피양 혈관 내피종은 경계성 또는 저등급 악성의 드문 혈관성 종양이며 그 예후를 예측하기는 어렵다. 이 논문에서는 다발성 폐결절이 있는 47세 무증상 여성에서 7년의 추적 기간 동안, 초기 검사에서 크기가 크고 높은 18F-fluorodeoxyglucose 흡수를 보이는 결절은 크기가 증가하는 진행을 보였고, 1 cm 미만의 대부분의 작은 결절은 말초 가장자리 석회화 또는 결절 석회화와 함께 자발적인 퇴행을 보여주었다. 환자는 폐 상피양 혈관내피종으로 진단되었으며 크기가 커진 결절에 대해 수술적 절제술을 받았다. 이 사례는 한 개인에서 질병의 진행과 퇴행이 동시에 나타난 혼합적인 반응을 보여준다는 점에서 주목할 만하며 이 논문을 통해 예후를 예측하는 데 도움이 될 수 있겠다.

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare vascular tumor of borderline or low-grade malignancy, and its prognosis is unpredictable. Herein, we describe the case of a 47-year-old asymptomatic female with a diagnosis of multinodular PEH. During a 7-year follow-up, the nodules with large size and high 18F-fluorodeoxyglucose uptake in the initial study showed progression with increasing sizes; however, most small nodules (size < 1 cm) demonstrated spontaneous regression with peripheral rim or nodular calcification. The patient underwent surgical resection for an enlarged nodule. Of note, it is unusual for an individual to have mixed progression and regression concomitantly, which may be helpful in predicting the prognosis.

Keywords

References

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