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증례 : 하시모토 갑상선중독증 및 휘트르레 선종과 동반된 본태성 혈소판증가증 1예
민슬기 ( Seul Ki Min ),공승진 ( Seung Jin Kong ),이호권 ( Ho Gwon Lee ),신동훈 ( Dong Hun Shin ),송헌호 ( Hun Ho Song ),이성진 ( Seong Jin Lee ),최문기 ( Moon Gi Choi ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
저자들은 심계항진과 전경부 종괴를 주소로 내원하여 시행 받은 갑상선기능검사, 갑상선 자가항체검사, 병리조직학적 검사 및 골수조직검사에서 하시모토 갑상선중독증 및 휘트르레 선종과 동반된 본태성 혈소판증가증으로 진단된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Hashitoxicosis, a rare cause of primary hyperthyroidism, is diagnosed by presence of thyrotropin receptor antibody, increased radioiodine uptake and histological finding of lymphoid follicle with lymphcytic infiltration. Thrombocytopenia associated with hyperthyroidism including hashitoxicosis is probably caused by increased destruction of platelets in reticuloendothelial phagocytic system although it is partially compensated by increased production of magakaryocytes in bone marrow. Because essential thrombocythemia in hyperthyroid state has not been reported, most cases of thrombocytosis developed in the treatment of hyperthyroidism are considered as secondary thrombocytosis without any further examination. We experienced fourty-seven year-old woman presenting with palpitation and anterior neck swelling. By endocrinological and histological examinations, she was diagnosed as hashitoxicosis and Hurthle cell adenoma. For evaluation of progressive thrombocytosis, bone marrow biopsy was performed, in which essential thrombocythemia was diagnosed. In summary, we report the first case of an essential thrombocythemia with hashitoxicosis and Hurthle cell adenoma. (Korean J Med 69:S856-S860, 2005)
증례 : 양측 부신 전이를 동반한 비소세포폐암에서 발현된 부신피질기능저하증 1예
이주용 ( Jue Yong Lee ),공승진 ( Seung Jin Kong ),전만조 ( Man Jo Jeon ),이성진 ( Seong Jin Lee ),송헌호 ( Hun Ho Song ),최문기 ( Moon Gi Choi ),이명구 ( Myung Goo Lee ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
전신무력감, 오심, 구토 등의 비특이적 증상을 호소하여 시행한 호르몬검사 및 방사선검사에서 양측 부신 전이를 동반한 비소세포폐암에서 발현된 부신피질기능저하증 증례를 경험하였기에 이를 보고하는 바이다. Metastatic tumor is the most common malignancy in adrenal glands, and high occurrence of adrenal metastasis is closely related to its rich sinusoidal blood supply. Lung is common origin of metastatic tumor, and 42% of non-small cell lung cancer is associated with metastasis to adrenal glands. In spite of high incidence of adrenal metastasis, metastatic tumor very rarely causes adrenocortical insufficiency possibly because adrenal cortex must be almost completely destroyed before development of adrenocortical insufficiency. Symptoms of adrenocortical insufficiency such as fatigue, generalized weakness, anorexia, nausea, vomiting, abdominal pain are usually nonspecific, and insidiously occur. In addition, these symptoms are often overlooked or misdiagnosed as symptoms of cancer progression, thereby adrencortical insufficiency is not properly managed. We report a 68-year-old man who presented with nonspecific symptoms, and was diagnosed as adrenocortical insufficiency associated with bilateral adrenal metastasis of non-small cell lung cancer by hormonal and radiologic studies including rapid ACTH stimuation test and furosemide challenge test. (Korean J Med 69:S846-S850, 2005)