Poster Session : PS 1225 ; Cardiology : Fibrosing Mediastinitis and Pulmonary Artery Stenosis Accompanied with Severe Pulmonary ypertension: A Case Study

저작시기 2014.01 |등록일 2015.01.05 | 최종수정일 2015.04.23 파일확장자어도비 PDF (pdf) | 1페이지 | 가격 1,000원
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발행기관 : 대한내과학회 수록지정보 : 대한내과학회 추계학술발표논문집 / 2014권 / 1호
저자명 : ( Hyun Ju Yang ) , ( Mi Rim Choi ) , ( Sung Sik Oh ) , ( Jong Hwa Lee ) , ( Myoung Woo Choi ) , ( Ji Eun Song ) , ( Dong Yop Lee ) , ( Jong Pil Park ) , ( Sung Hee Jhon ) , ( Ji Hyun Lim ) , ( Jay Young Rhew )

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fibrosing mediastinitis (FM) is a rare disease that shows excessive fibrosing lesions in the mediastinum. No known etiology has been reported, but its symptoms develop due mainly to the fibrosing mass. Pulmonary artery stenosis is a rare complication of FM, and is accompanied with dyspnea. Ventilation/perfusion unbalance is usually observed in lung scan images, which often mislead to make a diagnosis with pulmonary embolism. FM is known to be a rare cause of pulmonary hypertension. A 70-year old female patient visited the authors` hospital with dyspnea (NYHA Class II-III) that was aggravated since 10 days ago, cough, and sputum. When she was admitted, her vital signs were stable. Her chest X-ray showed haziness in the lower . elds of the both lungs. The findings of D-shape LV, RV enlargement and dysfunction, and severe pulmonary hypertension were observed in echocardiogram. An increase in the D-dimer level was con. rmed. In the chest CT images, thorumbus of pulmonary artery was not evident; the right inferior pulmonary artery was severely narrowed due to the soft tissues and lymph nodes around the mediastinum ; and the bronchus in the right middle lobe (RML) was also narrowed and accompanied with atelectasis. In addition, thickening of the bronchi in the both lungs, consolidation, and haziness were observed. In the culture test, M. tubercula were confirmed. After 6-month tuberculosis treatments, dyspnea was disappeared during the follow-up period. She visited us two years later due to recurring dyspnea, In chest CT images, FM and pulmonary artery stenosis were not significantly changed from the past, Based on the findings of right pulmonary filling defect, she was diagnosed with pulmonary embolism. She underwent anticoagulant therapy, and still uses anticoagulant agents in a stable condition, and in follow-up.

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      Poster Session : PS 1225 ; Cardiology : Fibrosing Mediastinitis and Pulmonary Artery Stenosis Accompanied with Severe Pulmonary  ypertension: A Case Study
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