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간내담관암종 파열과 감별이 어려웠던 간피막하 혈종을 동반한 간농양
김청호 ( Chung Ho Kim ),김지훈 ( Ji Hoon Kim ),이현정 ( Hyun Jung Lee ),이영선 ( Young Sun Lee ),최종환 ( Jong Hwan Choi ),정영걸 ( Young Kul Jung ),연종은 ( Jong Eun Yeon ),변관수 ( Kwan Soo Byun ) 대한소화기학회 2009 대한소화기학회지 Vol.53 No.3
Subcapsular hematoma is a very rare complication of liver abscess. We report a case of liver abscess with sub-capsular hematoma mimicking ruptured hepatic cholangiocarcinoma. A 59-year old man presented with right upper quadrant pain and febrile sense. Computed tomography showed a low attenuated mass with extensive subcapsular hematoma on the right hepatic lobe. The initial impression was a hematoma caused by the rupture of cholangiocarcinoma. Hepatic arteriography was performed, but no active bleeding focus was found. After drainage of the subcapsular hematoma, a hematoma wall biopsy through the drainage catheter and a liver biopsy of the low attenuated mass were performed. The biopsies showed many neutrophils, macrophages, and granulation tissues consistent with an abscess, but no malignant cells were detected. After antibiotics therapy for 6 weeks, computed tomography was performed 4 months later, and revealed complete resolution of the hematoma and the low attenuated hepatic lesion. (Korean J Gastroenterol 2009;53:202-205)
사례보고 : 원발성 간세포암종의 늑골전이를 경동맥화학색전술로 치료한 1예
정영걸 ( Young Kul Jung ),연종은 ( Jong Eun Yeon ),김청호 ( Chung Ho Kim ),이현정 ( Hyun Jung Lee ),이영선 ( Young Sun Lee ),윤아일린 ( Eileen L. Yoon ),정은석 ( Eun Suck Jung ),최종환 ( Jong Hwan Choi ),김지훈 ( Ji Hoon Kim ),변 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.3
뼈는 간세포암종의 전이 장소 중 세 번째로 흔하게 발생하는 곳으로 이에 대한 치료는 제한적이다. 55세 남자 환자가 우하흉부 통증으로 내원하여 원발성 간세포암종과 우측 8번 늑골전이로 진단되었다. 혈관조영술에서 우측 8번 늑간동맥으로부터 공급되는 늑골의 종양이 관찰되어 총 3회의 경동맥 화학색전술을 시행하였고, 이후 두 차례의 컴퓨터 단층촬영에서는 우측 8번 늑골 종양 부위에 치밀한 리피오돌 침착이 관찰되었으며, 통증은 소실되었다. 이에 저자들은 경동맥화학색전술로 치료한 원발성 간세포암종 환자의 늑골전이 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Bone is a common site of metastasis in patients with hepatocellular carcinoma (HCC). We report a rare case of rib metastasis from HCC treated by transcatheter arterial chemoembolization (TACE). A 55-year-old man with liver cirrhosis presented with right lower chest pain. The diagnosis was an HCC with a bone metastasis in the right eighth rib. Intra-arterial injections of doxorubicin mixed with Lipiodol and Gelfoam particles were instituted through the right eighth intercostal artery. Computed tomography and a Tc99-labeled scan performed 2 months after the third TACE revealed no viable HCC in the right eighth rib. (Korean J Hepatol 2009;15:357-361)
정은석,김청호,현영율,고강지,황병연,정희진,김우주,원남희 대한감염학회 2004 감염과 화학요법 Vol.36 No.6
전신성 혈관염은 다양한 임상상을 나타내는 전신 질환으로 종종 불명열의 형태로 나타나며, 신장 침범시 특징적인 조직소견을 보인다. 저자들은 3개월간 발열이 반복되어 불명열로 내원한 환자에서 부비동염, 중이염 및 폐렴의 발생과 함께, ANCA 양성 및 미세혈뇨를 근거로 시행한 신조직검사상 면역침착이 적은 반월상 사구체신염 소견을 보여 신장을 침범한 전신성 혈관염을 진단하였고, 스테로이드와 cyclophosphamide 치료 후 발열이 사라지고, 임상적으로 호전되어 문헌 고찰과 함께 보고하는 바이다. Fever of unknown origin (FUO) means fever that does not resolve spontaneously in the period expected for self-limited infection and whose cause cannot be ascertained despite considerable diagnostic efforts. We experienced a case of FUO associated with systemic vasculitis, which was diagnosed with clinical manifestation, radiographic findings, the presence of anti-neutrophil cytoplasmic antibody (ANCA), and renal biopsy. A 54-year-old female was admitted to our hospital with remittent fever of 3 months. A paranasal sinus (PNS) view revealed maxillary and ethmoidal sinusitis, and urine analysis showed microscopic hematuria. We performed a renal biopsy on the basis of positive ANCA and microscopic hematuria. The renal biopsy showed pauci-immune crescentic glomerulonephritis without granuloma, interstitial inflammation, and small vessel vasculitis. Under the diagnosis of ANCA-associated systemic vasculitis, she was treated with steroid and cyclophosphamide. She showed marked clinical improvement.