심장이식으로 치료된 심유육종증 - 1예 보고 -
Cardiac Sarcoidosis Treated by Cardiac Transplantation - A Case Report -
장재정, 민광선, 정경천, 김재중, 이인철,
소속 상세정보
장재정 ( Jang Jae-Jung )
울산대학교 의과대학 서울중앙병원 진단병리학교실
민광선 ( Min Kwang-Seon )
울산대학교 의과대학 서울중앙병원 진단병리학교실
정경천 ( Jung Gyeong-Cheon )
울산대학교 의과대학 서울중앙병원 진단병리학교실
김재중 ( Kim Jae-Joong )
울산대학교 의과대학 서울중앙병원 내과
이인철 ( Lee In-Chul )
울산대학교 의과대학 서울중앙병원 진단병리학교실
KMID : 0357920010350010071
Abstract
Sarcoidosis, in general, has a low mortality rate. But cardiac sarcoidosis (CS) is a serious condition which may lead to death. Here, we report a rare case of CS that was treated by heart transplantation. A 47-year-old male had occasional syncopes and atypical chest pain. Ventricular tachycardia with right bundle branch block was noted by electrocardiogram. Multiple fixed myocardial perfusion defects in the interventricular septum and both the inferiorposterior ventricular walls were observed by thallium scan. Coronary angiography was unremarkable. Neither perihilar nor mediastinal lymphadenopathy was noted. The patient also suffered three times from tonic-clonic generalized seizures in 3 years, but no neurologic abnormalities were detected. The explanted heart displayed multiple white patches on the endomyocardial surface, measuring up to 8x7 cm. On microscopic examination, the lesion consisted of multiple well-formed and confluent granulomas with numerous scattered multinucleated giant cells, CD68-positive epithelioid histiocytes, and T-lymphocytes. Neither microorganisms nor foreign material was identified on special stain and culture study. It has been six months since the heart transplant, and the patient has been doing well.
키워드
Cardiac sarcoidosis;Granuloma;Heart transplantation
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