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증례 : 혈액종양 ; 신세포암의 폐 전이와 원발성 폐암이 혼동된 1예
김진동 ( Jin Dong Kim ),권윤재 ( Yun Jae Kwon ),이은서 ( Eun Seo Lee ),김유석 ( You Suk Kim ),이유정 ( You Jung Lee ),공성민 ( Sung Min Kong ),지준호 ( Jun Ho Ji ) 대한내과학회 2015 대한내과학회지 Vol.89 No.5
폐 종괴를 처음 발견하였을 때는 예후와 치료 방법이 달라질 수 있기 때문에 원발성 종양에 대한 고려, 영상학적 소견, 임상소견을 충분히 고려하여 원발성 폐암인지, 전이성 폐암인지에 대한 구별이 필요하다. 저자들은 신세포암으로 우측 신장 절제술을 받은 62세 남자가 특이 증상 없는 컴퓨터 단층촬영 상의 양측 각각 26 mm, 4 mm 크기의 종괴로 내원하여 시행한 조직 검사에서 우측 폐에서 원발성 편평상피세포암 진단 후 우측 우상측 폐엽 절제술 시행 및 그 후 좌상측 폐 종괴의 조직검사 통해 신세포암의 전이가 발견된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Renal cell carcinoma (RCC) is rare relative to other urological cancers, but relatively common overall among males. Even when primary tumors are successfully removed by surgery, metastases are often noted within a few years. On the other hand, masses found at other sites in patients with RCC may represent different primary cancers. We present the case of a 63-year-old man with a right lung mass and a left lung nodule who underwent radical right nephrectomy for RCC. We found no local recurrence of RCC in the abdomen. Despite treatment for RCC, the right lung mass increased in size. We performed a lung needle biopsy and diagnosed primary lung cancer. Postoperatively, the remaining left lung nodule also increased in size. It was diagnosed as an RCC metastasis upon biopsy and removed by wedge resection. The patient was treated with everolimus after the second surgery. (Korean J Med 2015,89:576-580)
이현수 ( Hyoun Soo Lee ),정창욱 ( Chang Uk Jeong ),이은서 ( Eun Seo Lee ),권윤재 ( Yun Jae Kwon ),김유석 ( You Suk Kim ),김진동 ( Jin Dong Kim ),이유정 ( You Jung Lee ) 대한내과학회 2017 대한내과학회지 Vol.92 No.5
총간관에서 발생하는 부신경절종은 국내에서 아직 보고된 바가 없다. 저자들은 폐쇄성 황달을 유발한 총간관 부신경절종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Paragangliomas are rare extra-adrenal neoplasms of neural crest origin. The neoplasms may develop at various sites, but most are located in the para-aortic space along the sympathetic chain. A paraganglioma in the bile duct is very rare; only four cases of such tumors in the hepatic bile duct have been reported to date. Herein, we report on the first Korean case of a malignant paraganglioma in the common hepatic duct (with hepatic metastases) in a 75-year-old male. Computed tomography of the abdomen revealed a heterogeneously enhancing lesion in the common hepatic duct with dilatation of the intrahepatic ducts. After balloon sweeping, the mass exited spontaneously through the Ampulla of Vater. The mass was about 1.5 × 1.3 × 0.5 cm in its dimensions and the surface appeared to be necrotic and edematous. Microscopically, the tumor cells were arranged in a Zellballen pattern. The tumor was diagnosed as a malignant paraganglioma. (Korean J Med 2017;92:467-470)