폐 결핵종과 감별이 어려웠던 폐 침윤성 비호즈킨 림프종

저자들은 비호즈킨 림프종과 결핵성 림프절염으로 복합 항암화학요법과 항결핵 제제에 의하여 완전 관해에 도달한 후 재발한 비호즈킨 림프종 환자에서 구제 항암화학요법 도중 폐 실질에 결절성 병변이 발생하여 결핵종과 감별이 어려웠던 비호즈킨 림프종 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. We report a 63-years-old woman who developed a nodular lesion in right upper lobe (RUL) of lung after achieving a partial response with salvage chemotherapy for relapsed non-Hodgkin's lymphoma (NHL). Previously, she had been diagnosed as NHL and tuberculous lymphadenitis resulting a complete response with 8 cycles of CHOP regimen and anti-tuberculosis medication for 1 year. CT scan of the chest showed an irregular marginated soft tissue density in RUL with internal punctate calcifications and this lesion was difficult to discriminate between pulmonary tuberculosis and parenchymal involvement of NHL. Because the pulmonary infiltrations progressed despite empirical anti-tuberculosis medication, we performed bronchoscopic biopsy, showing diffuse large B-cell lymphoma. Thereafter, the pulmonary infiltrations were markedly improved with salvage chemotherapy. However, she died of refractory NHL despite high-dose chemotherapy with autologous peripheral blood stem cell transplantation.(Korean J Med 62:109-113, 2002) KCI Citation Count: 0