고립성폐결절의 경피적 바늘생검 이후 발생한 결핵성 흉수 1예
A Case of Tuberculous Pleural Effusion Developed after Percutaneous Needle Biopsy of a Solitary Pulmonary Nodule
허진원 (울산대학교)
이혁표 (인제대학교)
최수전 (인제대학교)
염호기 (인제대학교)
최석진 (인제대학교)
김태균 (인제의대)
박성길 (인제의대)
최상분 (인제의대)
김애란 (인제의대)
최상봉 (인제의대)
정훈 (인제대학교)
박이내 (인제의대)
이현경 (인제의대)
- 다운로드 수
- 조회수
초록
결핵성 흉수에는 결핵 단백에 감작된 T-림프구 가 존재하며 결핵 단백이 흉수에 노출되는 경우 지연성 과민 반응이 일어나 결핵성 흉막염이 발생하게 되는 것으로 알려져 있다. 저자들은 고립성 폐결절이 우연히 발견된 52세 남자에서 흉부전산화단층촬영 유도 하 경피적 바늘생검 후 결핵성 흉막염이 발생한 예를 경험하였다. 지연성 과민반응이라는 결핵성 흉수 발생기전에 부합하는 임상상황으로 생각하여 문헌고찰과 함께 보고한다.
- keywords
- Tuberculous pleural effusion, Percutaneous needle biopsy, Solitary pulmonary nodule., Tuberculous pleural effusion, Percutaneous needle biopsy, Solitary pulmonary nodule.
Abstract
A tuberculous pleural effusion may be a sequel to a primary infection or represent the reactivation of pulmonary tuberculosis. It is believed to result from a rupture of a subpleural caseous focus in the lung into the pleural space. It appears that delayed hypersensitivity plays a large role in the pathogenesis of a tuberculous pleural effusion. We encountered a 52 years old man with pleural effusion that developed several days after a CT guided percutaneous needle biopsy of a solitary pulmonary nodule. He was diagnosed with TB pleurisy. It is believed that his pleural effusion probably developed due to exposure of the parenchymal tuberculous focus into the pleural space during the percutaneous needle biopsy. This case might suggest one of the possible pathogeneses of tuberculous pleural effusion. (Tuberc Respir Dis 2007; 63: 268-272)
- keywords
- Tuberculous pleural effusion, Percutaneous needle biopsy, Solitary pulmonary nodule., Tuberculous pleural effusion, Percutaneous needle biopsy, Solitary pulmonary nodule.
참고문헌
Allen JC, (jimmunol1968;101) Experimental pleural effusion as a manifestation of delayed hypersensitivity to tuberculin PPD,
Apicella MA, (jclininvest1969;48) A physiologic differentiation between delayed and immediate hypersensitivity,
Leibowitz S, (brjexppathol1973;54) The tuberculin reaction in the pleural cavity and its suppression by antilymphocyte serum,
Yamamoto S, (immunology1976;30) Studies on delayed hypersensitivity pleural exudates in guinea pigs Demonstration of substances in the cell-free exudate which cause inhibition of mononuclear cell migration in vitro,
Antony VB, (jclininvest1985;76) Bacillus Calmette-Guerin-stimulated neutrophils release chemotaxins for monocytes in rabbit pleural space in vitro,
Riantawan P, (1999) Diagnostic value of pleural fluid adenosine deaminase in tuberculous pleuritis with reference to HIV coinfection and a bayesian analysis,
Stead WW, (amrevtuberc1955;71) Operative and pathologic findings in twenty-four patients with syndrome of idiopathic pleurisy with effusion,
Widstrom O, (eurjrespirdis1982;63) Pleurisy induced by intrapleural BCG in immunized guinea pigs,
Fujiwara H, (chest1986;89) Frequency of tuberculin reactive T-lymphocytes in pleural fluid and blood from patients with tuberculous pleurisy,
Ellner JJ, (seminrespirinfect1988;3) The immunology of tuberculous pleurisy,
Cazzadori A, (respirmed1994;88) Tuberculous pleurisy after percutaneous needle biopsy of a pulmonary nodule,
- 다운로드 수
- 조회수
- 0KCI 피인용수
- 0WOS 피인용수