이중풍선 소장내시경으로 진단된 폐암의 공장 전이
Jejunal Metastasis of Lung Cancer Diagnosed with Double Balloon Enteroscopy
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폐암의 소장 전이는 0.2∼0.5% 정도로 드물게 발견되며, 대부분 무증상이나 출혈, 복통, 장폐색, 천공 등 다양한 양상으로 관찰될 수 있다. 소장 출혈이 의심될 때 최근 개발된 캡슐내시경과 이중풍선 소장내시경(DBE)을 시행함으로써 이전의 검사들보다 진단율이 높아졌다. DBE는 고화질의 영상 및 조직검사로 좀더 명확한 진단이 가능할 뿐만 아니라 겸자공 크기가 2.8 mm인 치료용 내시경의 개발로 보다 다양한 치료 술기가 가능해졌다. 만약 18FDG-PET/CT에서 소장 전이가 의심되는 소견이 발견된다면 조직 진단을 위해 DBE를 고려해 볼 수 있다. 저자들은 폐암으로 진단 받은 39세 여자 환자가 혈변을 주소로 내원하여 DBE를 시행하여 비소세포성 폐암의 소장 전이를 진단한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Metastasis from lung cancer to the small bowel is rare and this accounts for 0.2% to 0.5% of all the cases of metastasis from lung cancer. In most cases, the patients are asymptomatic and they can show signs of bleeding, intestinal obstruction, perforation and so on. A better diagnostic approach to the small bowel has recently been made possible through capsule endoscopy and double balloon enteroscopy (DBE), and they have a higher diagnostic rate for small bowel bleeding compared with that of the previous diagnostic tests. DBE makes it possible to diagnose precisely due to the high quality endoscopic images and biopsy specimens. In addition, therapeutic DBE with a 2.8 mm channel enables performing more kinds of therapeutic procedures than diagnostic DBE with a 2.2 mm channel. If small bowel metastasis is suspected on 18FDG-PET/CT, then DBE can be considered for making a pathologic diagnosis. We report here on a case of small bowel metastasis from non small cell lung cancer in a 39-year-old woman who complained of hematochezia and we review the relevant literature.
참고문헌 (20)
- Stenbygaard LE, "Metastatic pattern in non-resectable non-small cell lung cancer", Acta Oncol, 38, pp.993~998 (1999)
- McNeill PM, "Small bowel metastases from primary carcinoma of the lung", Cancer, 15, pp.1486~1489 (1987)
- Rockey DC, "Occult gastrointestinal bleeding", N Engl J Med, 341, pp.38~46 (1999)
- Hartmann D, "A prospective two-center study comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with obscure GI bleeding", Gastrointest Endosc, 61, pp.826~832 (2005)
- Rondonotti E, "Small-bowel neoplasm in patients undergoing video capsule endoscopy: a multicenter European study", Endoscopy, 40, pp.488~495 (2008)
- Yoshimoto A, "Gastrointestinal metastases from primary lung cancer", Eur J Cancer, 42, pp.3157~3160 (2006)
- Burbige EJ, "Metastatic lung carcinoma involving the gastrointestinal tract", Am J Gastroenterol, 74, pp.504~506 (1980)
- 이태희, "이중풍선소장내시경에서 활동성 소장 출혈을 보인 환자의 임상 고찰", Clinical Endoscopy, 37(5), pp.321~327 (2008), 대한소화기내시경학회
- Gralnek IM, "Obscure-overt gastrointestinal bleeding", Gastroenterology, 128, pp.1424~1430 (2005)
- Baum S, "Gastrointestinal hemorrhage. II. Angiographic diagnosis and control", Adv Surg, 7, pp.149~198 (1973)
- Zuckerman GR, "AGA technical review on the evaluation and management of occult and obscure gastrointestinal bleeding", Gastroenterology, 118, pp.201~221 (2000)
- Gerson LB, "Capsule endoscopy and deep enteroscopy: indications for the practicing clinician", Gastroenterology, 137, pp.1197~1201 (2009)
- Iddan G, "Wireless capsule endoscopy", Nature, 405, pp.417~ (2000)
- Cazzato IA, "Diagnostic and therapeutic impact of double-balloon enteroscopy (DBE) in a series of 100 patients with suspected small bowel diseases", Dig Liver Dis, 39, pp.483~487 (2007)
- Kakugawa Y, "Diagnosis of small-bowel metastasis of malignant pleural mesothelioma by capsule endoscopy and double ballon enteroscopy", Endoscopy, 39, pp.E229~E230 (2007)
- Yamamoto H, "Total enteroscopy with a nonsurgical steerable double balloon method", Gastrointest Endosc, 53, pp.216~220 (2001)
- 장현주, "소장의 치료 내시경", Clinical Endoscopy, 39(2), pp.59~65 (2009), 대한소화기내시경학회
- Ross AS, "Enteral stent placement by double balloon enteroscopy for palliation of malignant small bowel obstruction", Gastrointest Endosc, 64, pp.835~837 (2006)
- Gamez C, "PET", CT fusion scan in lung cancer: current recommendations and innovations, 2006, pp.1, 74~77
- Kim MS, "Gastrointestinal metastasis of lung cancer with special emphasis on a long-term survivor after operation", JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY, 135, pp.297~301 (2009), SPRINGER