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간세포암과 유사한 방사선학적 소견을 보인 간의 혈관근지방종 2예
나호균(Ho Guun Na),이용찬(Yong Chan Lee),윤영준(Young Jun Yun),정재연(Jae Yean Jung),조용석(Yong Suk Cho),한광협(Kwang Hyub Han),전재윤(Chae Yoon Chon),문영명(Young Myoung Moon),김명진(Myeong Jin Kim),박영년(Young Nyun Park) 대한소화기학회 2000 대한소화기학회지 Vol.36 No.3
Hepatic angiomyolipoma (AML), a rare benign mesenchymal tumor, is composed of fatty tissue, proliferated blood vessels, and smooth muscle cells. Since the proportion of this three components is variable, radiologic and pathologic findings of the tumor can show different features, which makes its diagnosis difficult. On ultrasonography, it is usually a well defined hyperechoic mass and has occasional posterior enhancement of echoes as seen in hemangioma. On dynamic enhancement study, it shows not only prominent enhancement on the arterial-dominant phase and gradual hypoattenuation on the delayed phase, but also gradual and prolonged enhancement, and thus, it can be misdiagnosed as hepatocellular carcinoma or hemangioma. Positive reactivity for HMB-45, melanoma-specific antibody, makes the diagnosis possible and reactivity for smooth muscle actin confirms the diagnosis. We report two cases of hepatic AMLs, which were initially thought to be hepatocellular carcinomas because of early enhancement of the arterial phase and gradual hypoattenuation of the delayed phase on dynamic study of CT or MRI. One case was treated by chemoembolization of hepatic artery followed by hepatic resection, and the other was treated by hepatic resection after gun biopsy under ultrasound guidance. (Kor J Gastroenterol 2000;36:424 - 430)
전신성 홍반성 루푸스에 동반된 폐동맥 고혈압과 좌측 성대마비
김도영 ( Do Young Kim ),서정훈 ( Jung Hoon Suh ),강신명 ( Shin Myung Kang ),김창오 ( Chang Oh Kim ),나호균 ( Ho Guun Na ),김중선 ( Joong Sun Kim ),송정식 ( Jung Sik Song ),박용범 ( Yong Beom Park ),이원기 ( Won Ki Lee ),최홍식 ( H 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.3
There have been few case reports on the association of vocal cord palsy and pulmonary hypertension in a systemic lupus erythematosus (SLE) patient. Most cases had left vocal cord palsy caused by compression of left recurrent laryngeal nerve secondary to pulmonary hypertension, and only two cases in the literature were caused by vasculitis or inflammation of the right recurrent laryngeal nerve not related to pulmonary hypertension. Recently, we have experienced a 23-year-old female patient who presented hoarseness and multiple joint pain. She was diagnozed as SLE and left vocal cord palsy, and echocardiographic examination demonstrated enlargement of right atrium, right ventricle, and elevated right ventricular pressure (systolic pressure 47mmHg). She took high-dose glucocorticoid and calcium channel blocker. About one month later, there was significant improvement of hoarseness, arthritis, and cardiomegaly, and showed improvement of the left vocal cord palsy on the laryngoscopic examination. We report a case of left vocal cord palsy and pulmonary hypertension accompanied by SLE who experienced improvement of hoarseness after steroid treatment.