흉막 결핵에 병발된 흉막 Mantle 세포 림프종 1 예

저자들은 흉막 생검 검체 결핵균 배양 검사에서 양성으로 진단되어 결핵 치료 도중 호전이 없어 재생검한 흉막 및 흉수 검체에서 면역표현형검사 (CD5 (+), CD10 (-), CD23 (-))와 생검 흉막의 조직학적 검사를 통해 mantle 세포 림프종으로 진단되었던 환자 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Mantle cell lymphoma is relatively rare and generally difficult to differentiate from other types of lymphoma. The clinical course is very aggressive. We recently experienced a very rare patient with pleural mantle cell lymphoma associated with pleural tuberculosis. A 60-year-old female patient was admitted because of dyspnea. Chest films revealed pleural effusion. Analysis of pleural effusion was not diagnostic, but we started therapeutic trial for tuberculosis. After 2 months of anti-tuberculosis medication, the pleural effusion was not improved. We repeated pleural biopsy. Histologic finding was chronic inflammation but AFB culture was positive. After another 3 months of medications for tuberculosis, there was no improvement. We repeated pleural biopsy and thoracentesis. Repeated biopsy and the result of flow cytometry of pleural effusion were consistent with mantle cell lymphoma. We started chemotherapy for lymphoma. After three cycles of chemotherapy, pleural effusion was decreased, but she worsened and died of hepatic failure probably due to viral hepatitis.(Korean J Med 62:469-474, 2002)