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증 례 : 재생불량성 빈혈과 간염을 동반한 중증 만성 활동성 Epstein-Barr Virus 감염 1예
이자인 ( Ja In Lee ),이승원 ( Sung Won Lee ),한남익 ( Nam Ik Han ),노상미 ( Sang Mi Ro ),노용선 ( Yong Sun Noh ),장정원 ( Jeong Won Jang ),배시현 ( Si Hyun Bae ),최종영 ( Jong Young Choi ),윤승규 ( Seung Kew Yoon ) 대한소화기학회 2016 대한소화기학회지 Vol.67 No.1
Epstein-Barr virus (EBV) causes various acute and chronic diseases. Chronic active EBV infection (CAEBV) is characterized by infectious mononucleosis-like symptoms that persist for more than 6 months with high viral loads in peripheral blood and/or an unusual pattern of anti-EBV antibodies. Severe CAEBV is associated with poor prognosis with severe symptoms, an extremely high EBV-related antibody titer, and hematologic complications that often include hemophagocytic lymphohistiocytosis. However,CAEBV which led to the development of aplastic anemia (AA) has not been reported yet. A 73-year-old woman was admitted to our hospital with intermittent fever, general weakness and elevated liver enzymes. In the serologic test, EBV-related antibody titer was elevated, and real-time quantitative-PCR in peripheral blood showed viral loads exceeding 104 copies/μg DNA. Liver biopsy showed characteristic histopathological changes of EBV hepatitis and in situ hybridization with EBV-encoded RNA-1 was positive for EBV. Pancytopenia was detected in peripheral blood, and the bone marrow aspiration biopsy showed hypocellularity with replacement by adipocytes. AA progressed and the patient was treated with prednisolone but deceased 8 months after the diagnosis due to multiple organ failure and opportunistic infection. Herein, we report a rare case of severe CAEBV in an adult patient accompanied by AA and persistent hepatitis.(Korean J Gastroenterol 2016;67:39-43)
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수술 후 방사선 단독 치료를 시행한 원발성 척수 종자세포종 1예
정준원 ( Joon Won Jeong ),노상영 ( Sang Young Roh ),양지현 ( Ji Hyun Yang ),노상미 ( Sang Mi Ro ),이정의 ( Junguee Lee ),김인호 ( In-ho Kim ) 대한내과학회 2018 대한내과학회지 Vol.93 No.4
원발성 척수 종자세포종은 매우 드물게 발생하는 질환으로 국내에서는 아직까지 문헌상으로 보고된 증례가 매우 드물기에, 저자들의 병원에서 발견된 예를 경험하고 보고하는 바이다. 영상 검사만으로는 감별진단이 어려울 수 있으므로 조직학적 검사가 거의 항상 요구되며, 조직 소견에서 융합세포영양막성 거대세포의 존재 유무는 질병의 경과 및 재발을 예측하게 해주는 중요한 지표이므로 이를 반드시 확인하는 과정이 필요하다. 수술적 치료 후에는 방사선 치료나 항암치료를 시행할 수가 있으나 종자세포종은 일반적으로 방사선 치료에 좋은 반응율을 보이므로, 본 증례에서는 수술적으로 완전절제 후 방사선 치료를 시행함으로써 현재까지 재발의 소견이 없는 상태이다. A 32-year old male came to our hospital with chief complaint of paraplegia. He had symptom of radiating pain to right leg 3 months ago before paraplegic symptom appeared. Magnetic resonance (MR) imaging from outside hospital showed intramedullary mass involving from T8 to T10 level of spinal cord. According to the imaging result, tumor removal with total laminectomy was performed between T8 and T10 level in our hospital. Pathologic result was compatible with germinoma. Spine radiation (39.6 Gy/22 fx) from T7 to T12 level without chemotherapy was performed 3 weeks later since tumor removal. Follow-up MR imaging showed no recurrence without any distant metastasis. And our patient’s neurologic symptom had been improved. According to this case, postoperative radiotherapy is thought to be effective to primary spinal germinoma. (Korean J Med 2018;93:404-408)
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