다발성 경화 소견으로 발현된 림프구성 간질성 폐렴 1예
A Case of Lymphocytic Interstitial Pneumonia Manifested as a Multi-focal Consolidation
노영욱 (한양대학교)
송성헌 (한양대학교)
김상헌 (한양대학교)
손장원 (한양대학교)
윤호주 (한양대학교)
신동호 (한양대학교)
박성수 (한양대학교)
오영하 (한양대학교)
김태형 (한양대학교)
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초록
LIP는 매우 드문 간질성 폐질환의 일종으로 비특이적인방사선학적 소견으로 보이므로 타 간질성 폐질환과의 감별을 위해서는 반드시 개흉 폐생검을 하여야 한다. 또한LIP 진단 후 다른 자가 면역 질환 및 감염의 확인이 치료방향의 결정에 있어 필요하며 폐섬유화 및 폐성심으로의진행을 막기 위해서 조기에 적극적인 폐생검을 시행하여적극적인 치료를 시작하여야 한다. 또한 일부 악성 림프종으로의 진행도 보고 되고 있어 정기적인 추적 검사가필요하다. 저자들은 1개월 간의 기침과 운동 시 호흡곤란으로 내원하여 개흉 폐생검 결과 LIP로 진단 후 스테로이드 치료로 호전된 1예를 경험하였기에 관련 문헌고찰과함께 보고한다.
- keywords
- Lymphocytic interstitial pneumonia, Cryptogenic organizing pneumonia, Interstitial lung disease
Abstract
Lymphocytic interstitial pneumonia (LIP) is a rare disorder characterized by a diffuse infiltration of the alveolar space, interstitium by lymphocytes, plasma cells, and reticuloendothelial cells. Although its etiology is unknown, LIP has been associated with autoimmune disorders and with viral infections. Because it’s clinical and radiographic features are nonspecific, a confirmatory diagnosis is performed by open lung biopsy. A 59-year-old female presented dry cough, which had been present for 1 month. On initial findings of multifocal consolidation at the right middle lobe on both lower lobes in chest radiography, the first diagnosis of cryptogenic organizing pneumonia was suggested. On open lung biopsy, LIP was diagnosed. The patient had no autoimmune disease, viral infection or monoclonal gammopathy. After 3 months of corticosteroid treatment, the patient experienced improved symptoms, reduced abnormalities on chest radiography, and improved pulmonary function testing.
- keywords
- Lymphocytic interstitial pneumonia, Cryptogenic organizing pneumonia, Interstitial lung disease
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