황달로 나타난 췌장과 신장의 과립구 육종 1예
A case of granulocytic sarcoma of the pancreas and kidney in a patient presenting with jaundice
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과립구 육종은 드물지만 전신의 여러 기관을 침범할 수 있으며 다양한 임상양상으로 나타날 수 있어서 본 증례와 같이 폐쇄성 황달의 원인이 될 수 있으며 이러한 경우에 방사선학적 검사만으로 진단하기는 아주 어려우므로 치료 결정을 위해 반드시 조직학적인 진단이 필요하다고 생각된다. 이러한 과립구 육종은 질환이 진행되면 사망하는 경우가 대부분이어서 정확한 조기 진단과 더불어 가능하다면 골수 이식과 같은 적극적인 치료가 매우 중요하다. 그러므로 급성 골수성 백혈병 환자 중 고위험군 환자나 골수외 병변에서 대세포 림프종과 유사하거나 분화되지 않은 악성 종양 병변이 있을 경우 반드시 과립구 육종을 고려해 보는 것이 필요하다고 생각된다.색인 단어 : 과립구육종, 췌장, 신장, 황달
Abstract
Granulocytic sarcoma is an extramedullary tumor composed of immature cells of the granulocytic series known to occur in patients with myelodysplastic syndrome, chronic myeloid leukemia, or acute myeloid leukemia. and occasionally it has been presented without overt leukemia. Involvement of pancreas and kidney is relatively rare in granulocytic sarcoma. We present an extremely rare case of granulocytic sarcoma of pancreas and kidney in a 56-year-old male patient of acute myeloid leukemia presenting with obstructive jaundice due to a pancreatic mass and peri-lymphadenopathy consisting of myeloblast and review the literatures. It should be kept in mind that granulocytic sarcoma is a possible cause of obstructive jaundice in patient with acute myeloid leukemia.(Korean J Med 70:78-83, 2006)
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