A Case of Giant Cell Interstitial Pneumonia without History of Exposure to Hard Metal

A 44 year old man was admitted complaining fo exertional dyspnea. The patient denied any occupational history of hard metal exposure. Chest radiography showed an increased interstitial marking at the peripheral portion of both lower lung fields. The spirometric values were within the normal ranges. However, the diffusion capacity of the lungs was lower. In the bronchial lavage fluid, the characteristic multinucleated giant cells were noticed, and the macrophage compartment was 96% and the neutrophils were 4%. High-resolution CT scan revealed ground glass opacities with emphysematous lung changes at the peripheral portion of the whole lung. An open lung biopsy confirmed the presence of numerous multinucleated giant cells (define GIP) with an associated interstitial fibrosis throughout the lung. The radiographic abnormailities and symptoms subsequently improved following treatment with oral corticosteroids.

경금속에 대한 노출력이 없는 거대세포 간질성 폐렴(Giant Cell Interstitial Pneumonia) 1예

경금속 진폐증에 속하는 거대세포 간질성 폐렴은 경금속을 사용한 절삭, 연마의 과정 중 발생하는 분진을 흡입하여 발생하는 것으로 알려져 있으나 이러한 직업력이 불분명한 증례를 개흉생검술을 통해 진단하였기에 보고하는 바이다.