속립성 결핵과 감별이 필요했던 가속형 규폐증 1례
A Case of Accelerated Silicosis Mimicking Miliary Pulmonary Tuberculosis
김상하 (연세대학교)
리원연 (연세대학교)
용석중 (연세대학교)
신계철 (연세대학교)
정순희 (연세대학교)
권우철 (연세대학교)
이명 (연세대학교)
최훈 (부산가톨릭대학교)
이낙원 (연세대학교)
홍태원 (연세대학교)
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초록
규폐증은 유리규산에 노출될 수 있는 다양한 작업장에서 발생할 수 있는 질환으로 호흡성 분진의 축적에 의한 폐실질의 병리학적 변화를 가져오는 대부분 만성적인 경과를 보이는 질환이다. 하지만 드문 경우에 노출된 분진의 강도와 노출기간에 따라 임상양상이 급격하게 진행되는 경우가 있을 수 있다. 저자들은 진폐증으로 진단하였던 환자가 약 2개월 동안의 급격한 방사선학적 소견의 진행을 보여, 속립성 결핵과의 감별을 위해 시행한 경기관지 폐생검을 통하여 진단하였던 가속형 규폐증 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
- keywords
- Silicosis, Miliary tuberculosis, Silicosis, Miliary tuberculosis
Abstract
Silicosis is a chronic fibrosing lung disease that is initiated by prolonged and extensive exposure to respirable free crystalline silica. Accelerated silicosis is rare and is clinically identical to the classic form of silicosis with the exception that the time from initial exposure to the onset of the disease is shorter and the rate of disease progression is dramatically faster. We describe a case of accelerated silicosis, which mimicked miliary pulmonary tuberculosis. The patient had worked in a mine coal for a period of 9 years. Subsequently, he worked in construction dealing with cement and sand for 14 years until he visited this clinic. The clinical course was notable for the rapid progression of the radiological features of silicosis over a period of 2 months. Polarizing light microscopic studies of the biopsied specimens by a transbronchial lung biopsy showed polarizing particles, which were typical of silica. To the best of our knowledge, this is the first case report of accelerated silicosis in Korea. (Tuberc Respir Dis 2005; 59: 684-689)
- keywords
- Silicosis, Miliary tuberculosis, Silicosis, Miliary tuberculosis
참고문헌
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