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5748307 정다은 F/24 (Onco 김혜련pf / CS 배미경pf) Multifocal micronodular pneumocyte hyperplasia
Brief Hx.
상기 23세 여환 Xeroderma pigmentosum 과거력 있으며 2010년 7월 eye lid basal cell carcinoma 로 excision 시행하였으며 이후 2011년 4월 LT proximal tibia Giant cell tumor 로 curettage 시행한 후 f/u 하던 중 2012.05.12 chest CT f/u 상 GGO pattern 의 R/O lung meta, breast Rt nodule and both Axillary LNE 소견 보여 Breast, both ALN Bx 상 fibroadenoma, unsatisfactory 소견 보여 f/u 하던 중 2013.6.14, 9.25 CT 상 r/o lung mets, rapid growth 의심되어 2013.10.2 RUL, RML 의 Wedge resection 시행 후 Pathology 상 MMPH 소견 보인 분임.
흡연력: none FHx: 친가 조부, 조모 암 사망
◆ CT Chest HR Study(contrast): 2012.5.12
multiple small GGO or solid nodules in both lungs, but some nodules show increased solid portion
No evidence of lymphadenopathy in the mediastinum and both hilar
enlarged LNs in both axillary fossa
IMP: DDx. multifocal adenocarcinoma with lepidic growth pattern or metastasis.
◆ CT Chest HR Study(contrast): 2013.9.14
multiple small GGO or solid nodules in both lungs, but some nodules show increased solid portion
No evidence of lymphadenopathy in the mediastinum and both hilar
enlarged LNs in both axillary fossa
IMP: DDx. multifocal adenocarcinoma with lepidic growth pattern or metastasis.
◆Breast Bx & Axillar aspiration pathology (2012.6.11)
- Breast, 9H, left, core biopsy : Fibroadenoma
- Right Axilla Aspirate Cytology : Unsatisfactory for evaluation; Cellular paucity
◆Postop pathology (2013.10.02)
- Lung, right upper lobe, wedge resection / Lung, right middle lobe, wedge resection
Consistent with multifocal micronodular pneumocyte hyperplasia : RUL, RML
7715659 최춘자 F/66 (Pul 박무석pf / CS 이창영pf) BOOP, r/o LIP
Brief Hx.
상기 66세 여환 HTN 으로 medication 중 2013.07.13 dyspnea 주소로 일산병원 응급실 경유 입원하여 시행한 chest CT 상 cystic lung disease, lymphocytic interstitial pneumonia 소견 보여 치료 중 Fever develop, 본원 진료 원하여 7/23 본원 내원, Intubation 후 R/O LIP & R/O BOOP 에 대하여 TBLB 시행하였으나 oraganizing pneumonia 소견 보이나 검체 충분하지 않아 VATS-biopsy(7/29) 시행하였고, LUL 의 BOOP 및 LLL 의 Focal peribronchiolar metaplasia 및 Multifocal subpleural lymphoplasma cell infiltrations 소견 보인 분임
흡연력: negative
◆Autoimmune markers(2013.7.23)
-RF quan : <10 IU/mL
-ANA Titration : 1:160w+,1:640-(Homogeneous)
-Anti-DNA Screening : 1:10 negative
-Anti-SS-A/Ro, B/La : Positive(95), Neg
◆ CT Chest HR Study : 2013.7.28
Multiple, variable sized cysts in both lungs, predominant in BLL basal lungs
Multifocal patchy or lobular GGO/consolidations at BUL.
Subpleural peribronchial consolidation at BLL, especially basal lungs.
LIP에서 보이는 전형적인 GGO or ill-defined centrilobular opacity 소견은 보이지 않습니다.
IMP : Cystic lung disese such as BHD or LIP with combined pneumonia or BOOP.
◆ TBLB & BAL (2013.7.24)
Blind TBLB*3, Pathology: Organizing pneumonia
WBC 1600 (Poly 76%, Mono 22%), CD4 65.8% / CD8 41.9%
◆Postop pathology (2013.7.30)
-Lung, left upper lobe, biopsy under VATS / Lung, left lower lobe, biopsy under VATS
Lung, left upper lobe: Consistent with bronchiolitis obliterans organizing pneumonia
Lung, left lower lobe:
1. Focal peribronchiolar metaplasia
2. Multifocal subpleural lymphoplasma cell infiltrations
◆PFT (2013.9.10)
FVC 1.58(61%), FEV1 1.32(72%), FEV1/FVC 84%, DCLO 8.7mL/mmHg/min (53%)
◆Salivary scan(2013.9.3)
Decreased uptake in the left parotid and bilateral submandibular glands.
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