다발성 간전이 혹은 간내 담관암으로 오인한 원발성 간 림프종 1예 (A Hepatic Lymphoma Mimicking Multiple Liver Metastases or an Intrahepatic Cholangiocarcinoma)

서지정보

· 발행기관 : 대한내과학회
· 수록지 정보 : 대한내과학회지 / 93권 / 3호 / 285 ~ 290페이지
· 저자명 : 오주현, 최문석, 신동현, 김석진, 강태욱, 고영혜

초록

저자들은 상복부 통증으로 내원한 56세 여성에서 다발성간 종괴에 대해 원발성 간 광범위큰B세포림프종으로 진단하였고 항암화학요법으로 치료한 증례를 경험하였다. 현재까지 원발성 간 림프종에 대한 발병 기전, 원인, 치료, 예후에대해 잘 알려지진 않았으나 조기에 의심하고 적극적으로 평가하는 것이 예후에 있어 중요하다.

영어초록

A primary hepatic lymphoma (PHL) is a rare malignancy; misdiagnosis and mistreatment are very common. We report the case of a 56-year-old female who presented with a 2-week history of upper abdominal pain. She exhibited no risk factors for hepatocellular carcinoma (HCC) and her serum tumor marker levels were normal. A computed tomography scan and gadolinium- enhanced magnetic resonance imaging of the liver revealed multiple liver masses, suggestive of multiple liver and lung metastases or an intrahepatic cholangiocarcinoma with lung metastasis. A diagnosis of PHL (a diffuse large B cell lymphoma) was confirmed by biopsy followed by immunohistochemistry. This case emphasizes that a PHL must be considered in the differential diagnosis of space-occupying liver lesions in patients with no risk factors for HCC and normal levels of serum tumor markers. It is notable that neither B cell lymphoma symptoms nor an elevated lactate dehydrogenase level were apparent in this case. We thus report a case of PHL mimicking multiple liver metastases or an intrahepatic cholangiocarcinoma, and we review the literature.

참고자료

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