Case Report : A Case of Pulmonary Adenocarcinoma Developed on Previous Lesion from Microscopic Polyangiitis = Case Report : A Case of Pulmonary Adenocarcinoma Developed on Previous Lesion from Microscopic Polyangiitis

다국어 초록 (Multilingual Abstract)

Purpose: This report examines a patient with pulmonary adenocarcinoma that developed on a previous lesion from microscopic polyangiitis. A 59-year-old woman had been diagnosed with microscopic polyangiitis in October of 1988 based on her clinical symptoms and serological tests, which were positive for anti- neutrophil cytoplasmic antibodies. Her glomerulonephritis had been well controlled with low-dose prednisolone. She presented in October of 2005 with vague chest discomfort and dyspnea on exertion. Physical examination was unremarkable. A non-contrast computed tomography (CT) scan of the chest showed patch ground-glass opacity at the right lower lobe of the lung. Because we did not believe the lesion to be a definite malignancy, we decided to follow up with chest images over a short interval. During the 18 months following the images, the lesion did not change. However, the opacity of the lesion increased slightly over the last two months, and a non-contrast CT scan of the chest was therefore performed. A CT scan showed persistent ground-glass opacity with a slightly solid portion. To diagnose the previous finding and possibly to provide treatment, a right lower lobectomy of the lung via video-assisted thoracoscopic surgery was performed. The pathologic review of the resected lung revealed an adenocarcinoma, stage pT1N0. After one year, fluorodeoxyglucose positron emission tomography was performed, and no evidence of a recurrent malignancy was found.

참고문헌 (Reference)

1 김희규, "부비동염 및 폐포출혈로 나타난 현미경적 다발성 혈관염 1예" 대한신장학회 24 (24): 832-837, 2005

2 오진원, "급속 진행성 사구체신염으로 시작된 현미경적 다발성동맥염(Microscopic Polyangiitis) 환자의 7년간의장기 추적관찰 1례" 대한소아신장학회 12 (12): 99-104, 2008

3 Greer JM, "Vasculitis associated with malignancy. Experience with 13 patients and literature review" 67 : 220-230, 1988

4 Kurzrock R, "Vasculitis and cancer" 11 : 175-187, 1993

5 Fain O, "Vasculitides associated with malignancies: analysis of sixty patients" 57 : 1473-1480, 2007

6 Gran JT, "Small cell pleomorphic T-cell lymphoma presenting with cutaneous vasculitis" 13 : 628-630, 1994

7 Mody GM, "Rheumatologic manifestations of malignancy" 9 : 75-79, 1997

8 Hamidou MA, "Prevalence of rheumatic manifestations and antineutrophil cytoplasmic antibodies in haematological malignancies. A prospective study" 39 : 417-420, 2000

9 Solans-Laqué R, "Paraneoplastic vasculitis in patients with solid tumors: report of 15 cases" 35 : 294-304, 2008

10 Chun BC, "Mortality and cancer incidence in Korean patients with systemic lupus erythematosus: results from the Hanyang lupus cohort in Seoul, Korea" 14 : 635-638, 2005

11 Pankhurst T, "Malignancy is increased in ANCA-associated vasculitis" 43 : 1532-1535, 2004

12 Ng JP, "Henoch-Schönlein purpura and Hodgkin's disease" 64 : 881-882, 1988

13 오지선, "Clinical Features and Outcomes of Microscopic Polyangiitis in Korea" 대한의학회 24 (24): 269-274, 2009

14 Ahn JK, "Behcet's disease associated with malignancy in Korea: a single center experience" 30 : 831-835, 2010

15 Navarro JF, "Anti-neutrophil cytoplasmic antibody-associated paraneoplastic vasculitis" 70 : 373-375, 1994

16 Haroon M, "A case of ANCA-associated systemic vasculitis induced by atorvastatin"

17 차란희, "A Case of Microscopic Polyangiitis: Glomerulonephritis, Neuropsychiatric Abnormalities, and Urticarial Vasculitis" 대한신장학회 29 (29): 98-103, 2010