본문 바로가기
KERD
논문KCI 등재

성인에서 호산구성 점액에 의해 발생한 중간엽증후군 2예

Right middle lobe syndrome caused by eosinophilic mucoid impaction in adults

0

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류소아과학

초록

Right middle lobe syndrome (RMLS) is defined as a transient or recurrent, chronic collapse of the middle lobe of the right lung by certain pathologic conditions. RMLS is a relatively uncommon condition having multiple etiologies and various clinical presentations. Two patients were referred to Hallym University Sacred Heart Hospital, one for the treatment of coughing and the other for the treatment of pneumonia. A diagnosis of RMLS was identified through X-ray and computed tomography image evaluation for each condition. Bronchoscopy revealed mucus obstruction in the right middle lobe bronchus. Biopsy of the aspirated mucus showed mucus containing many eosinophils and Charcot-Leyden crystals. After removal of impacted mucus, clinical and radiological improvements were observed in both patients. Therefore, eosinophilic mucus impaction can be considered a potential cause of RMLS, irrespective of any underlying asthmatic symptoms.

Abstract

Right middle lobe syndrome (RMLS) is defined as a transient or recurrent, chronic collapse of the middle lobe of the right lung by certain pathologic conditions. RMLS is a relatively uncommon condition having multiple etiologies and various clinical presentations. Two patients were referred to Hallym University Sacred Heart Hospital, one for the treatment of coughing and the other for the treatment of pneumonia. A diagnosis of RMLS was identified through X-ray and computed tomography image evaluation for each condition. Bronchoscopy revealed mucus obstruction in the right middle lobe bronchus. Biopsy of the aspirated mucus showed mucus containing many eosinophils and Charcot-Leyden crystals. After removal of impacted mucus, clinical and radiological improvements were observed in both patients. Therefore, eosinophilic mucus impaction can be considered a potential cause of RMLS, irrespective of any underlying asthmatic symptoms.

참고문헌 (17)

  1. Gudbjartsson T, "Middle lobe syndrome: a review of clinicopathological features, diagnosis and treatment", Respiration, 84, pp.80~86 (2012)
  2. 김호철, "Endobronchial Tuberculosis Presenting as Right Middle Lobe Syndrome:Clinical Characteristics and Bronchoscopic Findings in 22 Cases", Yonsei Medical Journal, 49(4), pp.615~619 (2008), 연세대학교의과대학
  3. 김현옥, "우중엽증후군의 원인 - 최근 수년간 지역 3차 병원의 경험-", Tuberculosis and Respiratory Diseases, 62(3), pp.192~196 (2007), 대한결핵및호흡기학회
  4. Eskenasy A, "Pathology of the middle lobe syndromes. A histopathological and pathogenetic analysis of sixty surgically-cured cases", Med Interne, 20, pp.73~80 (1982)
  5. 김유진, "소아 우중엽 증후군의 원인과 방사선, 기관지 내시경적 소견 및 임상경과에 관한 분석", Allergy Asthma & Respiratory Diseases, 14(4), pp.342~349 (2004), 대한 소아알레르기 호흡기학회
  6. Agarwal R, "Allergic bronchopul-monary aspergillosis: review of literature and proposal of new diagnostic and classification cri-teria", Clin Exp Allergy, 43, pp.850~873 (2013)
  7. Einarsson JT, "Middle lobe syndrome: a nationwide study on clinicopathological features and surgical treatment", Clin Respir J, 3, pp.77~81 (2009)
  8. Lee NH, "Chest computerized tomographic scan and flexible fiberopticbronchoscopy in the diagnosis of middle lobe syndrome", Tuberc Respir Dis, 39, pp.236~241 (1992)
  9. Priftis KN, "Bronchial hyperresponsiveness, atopy, and bronchoalveolar lavage eosinophils in persistent middle lobe syndrome", Pediatr Pulmonol, 41, pp.805~811 (2006)
  10. 이재천, "기도 점액의 생성; 점액소의 합성, 분비 및 희석", 천식 및 알레르기, 32(2), pp.73~80 (2012), 대한천식알레르기학회[DOI]
  11. Rubin BK, "Secretory hyperresponsiveness and pul-mo-nary mucus hypersecretion", Chest, 146, pp.496~507 (2014)
  12. 김은진, "Plastic Bronchitis in an Adult with Asthma", Tuberculosis and Respiratory Diseases, 73(2), pp.122~126 (2012), 대한결핵및호흡기학회
  13. Shah A, "Middle lobe syndrome: a rare presentation of allergic bron-chopulmonary aspergillosis", Eur Ann Allergy Clin Immunol, 46, pp.147~151 (2014)
  14. Rogers DF, "Airway mucus hypersecretion in asthma: an undervalued pathology?", Curr Opin Pharmacol, 4, pp.241~250 (2004)
  15. Nagata K, "Severe asthma compli-cated with large mucoid impaction: successful removal with balloon catheter", Nihon Kokyuki Gakkai Zasshi, 42, pp.914~918 (2004)
  16. 전윤홍, "소아에서 굴곡성 기관지 내시경술을 이용한 무기폐 치료의 유용성", Allergy Asthma & Respiratory Diseases, 1(3), pp.274~279 (2013), 대한 소아알레르기 호흡기학회
  17. 서창덕, "소아 천식 환자에서 발견된 거대한 점액전 1예", 천식 및 알레르기, 30(1), pp.50~54 (2010), 대한천식알레르기학회

관련 논문AI추천

이 간행물의 다른 논문 (11건)