농흉과 연관된 림프종의 1예
A Case of Chronic Pyothorax-Associated Lymphoma
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초록
농흉과 연관된 림프종은 만성적인 농흉이 발생한 환자들에서 수십 년의 경과 이후에 발생하는 드문 B 세포 림프종으로 엡스타인 바 바이러스와 강한 연관성을 보이는 질환이다. 저자들은 흉부의 종양을 주소로 내원한 66세 남자 환자에서 농흉과 연관된 림프종을 경험하였는데, 환자에서 37년 전 결핵에 의한 늑막염으로 치료받은 이후에 만성적인 농흉의 과거력이 있음을 확인할 수 있었고, 원발 부위의 조직학적 생검으로 미만성 거대 B세포 림프종을 진단할 수 있었다. 농흉과 연관된 림프종은 드문 질환으로 알려져 있으나 만성적인 농흉이 있는 환자에서 늑막을 침범하는 새롭게 발생하는 종양에 대해서는 조직학적 검사를 통한 감별 진단이 필요할 것으로 판단된다.
Abstract
Pyothorax-associated lymphoma is a distinct type of malignant lymphoma composed of lymphocytes, mostly of a B-cell nature. It occurs in patients with a long history of pyothorax and is strongly associated with Epstein-Barr virus infection. We experienced a case of pyothorax-associated lymphoma in a 66-year-old male. The patient had chronic pyothorax after tuberculous pleurisy was treated about 37 years earlier and was hospitalized for a recently occurring chest wall mass. A core needle biopsy of the chest wall mass led to a diagnosis of diffuse large B-cell lymphoma. Pyothorax-associated lymphoma is rare in Korea, but should be considered in patients with chronic pyothorax and a recently occurring pleural mass. (Korean J Med 2011;81:116-120)
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