단일풍선 소장내시경으로 진단한 공장의 MALT 림프종 1예
A Case of Jejunal Extranodal MALT Lymphoma Diagnosed by Single-balloon Enteroscopy
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
소장 병변은 과거의 소장내시경 방법으로는 중요한 기술적인 문제로 임상에 도움이 되지 않거나 영상 검사방법으로도 정확한 진단이 어려워 대부분 침습적인 수술을 통해 진단되는 경우가 많았다. 수년 전부터 이중풍선 또는 단일풍선 소장내시경이 본격적으로 임상에 도입됨에 따라 향후에는 MALT 림프종 등 대부분의 소장 병변에 대해 조기에 정확한 진단과 내시경 치료가 가능할 것으로 기대한다. 비교적 드물게 발생하는 공장의 MALT 림프종을 소장내시경으로 진단해 약물 치료한 예는 아직 국내외에 보고된 바 없었다. 저자들은 만성 복통과 빈혈 과거력 등 소장 병변이 의심되었던 62세 여자에서 단일풍선 소장내시경으로 4기의 공장 MALT 림프종을 진단하고 약물 치료한 증례를 문헌 고찰과 함께 보고한다.
Abstract
Small bowel lesions located in long and multiple complex loop configurations were difficult to diagnose early because of vague clinical manifestations and because of the poor diagnostic yield of conventional examination methods. In this setting, double-balloon enteroscopy (DBE) was an epoch-making diagnostic and therapeutic tool for the management of patients with small bowel disease. Single-balloon enteroscopy (SBE), lacking a balloon at the endoscopic tip, is also a useful method for investigating and managing suspected small bowel lesions. Mucosa associated lymphoid tissue (MALT) lymphoma of the small bowel is relatively uncommon and remains a localized disease for long periods in most patients. Recently, we experienced a case of advanced-stage MALT lymphoma in the jejunum. A 60-year old female, with a history of anemia of unknown etiology and who was suspected of having a small bowel lesion, presented with complaints of vague abdominal pain and dizziness. She had undergone SBE via the oral route. She was diagnosed with MALT lymphoma of the jejunum and treated with medical management.
참고문헌 (19)
- Yamamoto H, "Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases", Clin Gastroenterol Hepatol, 2, pp.1010~1016 (2004)
- Choi H, "Korean experience with double balloon endoscopy: Korean association for the study of intestinal diseases multi-center study", Gastrointest Endosc, 66, pp.22S~25S (2007)
- Kim KW, "A case with mucosa-associated lymphoid tissue (MALT) lymphoma and tuberculous enteritis at jejunum", Korean J Med, 58, pp.594~598 (2000)
- 김탁용, "재발성 출혈과 천공을 보인 저등급 공장 MALT 림프종 1예", 대한내과학회지, 68(1), pp.116~120 (2005), 대한내과학회
- 장원철, "소장 천공을 유발한 원발 공장 MALT 림프종", 대한소화기학회지, 51(4), pp.215~218 (2008), 대한소화기학회[DOI]
- Isaacson PG, "Malignant lymphoma of mucosaassociated lymphoid tissue. A distinctive type of B-cell lymphoma.", Cancer, 52, pp.1410~1416 (1983)
- Jaffe ES, "Classification of lymphoid neoplasm: the microscope as a tool for disease discovery", Blood, 112, pp.4384~4399 (2008)
- d'Amore F, "Clinicopathological features and prognostic factors in exranodal non-Hodgkin's lymphoma", Eur J Cancer, 27, pp.1201~1208 (1991), Danish LYFO Study Group
- Lewin KJ, "Lymphomas of the gastrointestinal tract: a study of 117 cases presenting with gastrointestinal disease", Cancer, 42, pp.693~707 (1978)
- d'Amore F, "Non-Hodgkin's lymphoma of the gastrointestinal tract: a population-based analysis of incidence, geographic distribution, clinicopathologic presentation features and prognosis", J Clin Oncol, 12, pp.1673~1684 (1994), Danish Lymphoma Study Group
- Ko YH, "REAL classification of malignant lymphoma in republic of Korea: incidence of recently recognized entities and changes in clinicopathologic features", Cancer, 83, pp.806~812 (1998), Hematolymphoreticular study group of the Korean society of pathologists. Revised European-American lymphoma
- Cavalli F, "MALT lymphoma", Hematology Am Soc Hematol Educ Program, pp.241~258 (2001)
- Leval L, "Biology of lymphoid malignancy : in Clinical hematology", pp.505~534 (2006), Mosby
- Kim I, "Diagnostic criteria and characteristics of extra-gastric MALT lymphomas", Korean J Med, 59, pp.251~253 (2000)
- Nakamura S, "A clinicopathologic study of primary small intestine lymphoma: prognostic significance of mucosa associated lymphoid tissue derived lymphoma", Cancer, 88, pp.286~294 (2000)
- Tada M, "Small-bowel endoscopy", Scand J Gastroenterol, 102, pp.39S~52S (1984)
- Kawamura K, "Clinical evaluation of a newly developed single-balloon enteroscope", Gastrointest endosc, 68, pp.1112~1116 (2008)
- Collins RH Jr, "Gastrointestinal Lymphoma : in Sleisenger and Fordtran's gastrointestinal and liver disease: pathophysiology, diagnosis and managment", pp.565~587 (2006), Saunders Co
- Nakamura S, "Primary gastrointestinal lymphoma in Japan: a clinicopathologic analysis of 455 patients with specific reference to its time trends", Cancer, 97, pp.2462~2473 (2003)