국소진행성 췌장암 환자에서 종격동 림프절 전이로 오인된 종격동 방선균증
Mediastinal Actinomycosis Mimicking Mediastinal Lymph Node Metastasis in a Patient with Locally Advanced Pancreatic Cancer
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초록
방선균증(actinomycosis)은 비특이적인 임상 양상과 종괴를 형성하는 특성으로 인해 흔히 종양과 혼동되는 경우가 많으며 특히 흉부형의 경우 폐암으로 오인된 예들이 다수 보고되었다. 본 증례의 경우 췌장암 환자에서 폐 실질에는 병변이 없이 종격동의 림프절 비대 양상으로만 발현하여 종양의림프절 전이를 동반한 진행과 구분이 어려웠고, 양전자 컴퓨터단층촬영에서도 18F-FDG의 국소적 섭취 증가를 보여 감별이 어려웠다. 이에 문헌고찰과 함께 보고하는 바이다.
Abstract
Actinomycosis is a rare chronic suppurative infectious disease caused by Actinomyces spp. Actinomyces are anaerobic Gram-positive bacteria that colonize the mouth, digestive tract, and genital tract. Thoracic actinomycosis is caused by the aspiration of oropharyngeal materials or the spread of cervicofacial infections. Therefore, poor oral hygiene, smoking, and immunodeficiency are risk factors. Actinomycoses are frequently misdiagnosed as anatomical malignancies and thus assessments of the diseases underlying malignancies are often complicated by the presence of actinomycoses. Here, we report a case of mediastinal actinomycosis presenting with clinical and radiological features of metastatic pancreatic cancer. Clinicians should consider the presence of actinomycosis when cancer patients fail to respond to anti-cancer treatments.
참고문헌 (10)
- Valour F, "Actinomycosis: etiology, clinical features, diagnosis, treatment and management", Infect Drug Resist, 7, pp.183~197 (2014)
- Mok GS, "Actinomycosis imitating parotid cancer with metastatic lymph nodes in FDG PET", CT, 2011, pp.36, 309~310
- Katsenos S, "Primary bronchopulmonary actinomycosis masquerading as lung cancer: apropos of two cases and literature review", Case Rep Infect Dis, 2015, pp.609637~ (2015)
- 이유경, "Pelvic Actinomycosis with hydronephrosis and colon stricture simulating an advanced ovarian cancer", Journal of Gynecologic Oncology, 19(2), pp.154~156 (2008), 대한부인종양학회
- Petersen S, "Actinomyces infection mimicking tumor-progression in rectal cancer under neoadjuvant therapy", Acta Oncol, 51, pp.270~272 (2012)
- 조인래, "재발성 췌장암으로 항암화학요법을 시행한 환자에서 발생한 복부 방선균증", 대한내과학회지, 85(4), pp.401~405 (2013), 대한내과학회[DOI]
- Lee IJ, "Abdominopelvic actinomycosis involving the gastrointestinal tract: CT features", Radiology, 220, pp.76~80 (2001)
- Kim SR, "Pulmonary actinomycosis during the first decade of 21st century: cases of 94 patients", BMC infect Dis, 13, pp.216~ (2013)
- Alborzi A, "Actinomycosis as a neglected diagnosis of mediastinal mass", Jpn J Infect Dis, 59, pp.52~53 (2006)
- Hahn M, "Frequency of mediastinal lymph node metastases in patients undergoing EUS evaluation of pancreaticobiliary masses", Gastrointest Endosc, 54, pp.331~335 (2001)