Amiodarone 복용 후 유발된 폐 독성 환자의 기관지 폐포 세척액의 세포학적 및 전자현미경적 소견 - 1예 보고 -
Bronchoalveolar Lavage (BAL) Cytology and Ultrastructural Findings in a Patient with Amiodarone-Induced Pulmonary Toxicity: A Case Report
이선, 김민아, 심영수, 이춘택, 지제근, 정두현,
소속 상세정보
이선 ( Lee Sun )
서울대학교 의과대학 병리학교실
김민아 ( Kim Min-A )
서울대학교 의과대학 병리학교실
심영수 ( Shim Young-Soo )
서울대학교 의과대학 내과학교실
이춘택 ( Lee Chun-Taek )
서울대학교 의과대학 내과학교실
지제근 ( Chi Je-Geun )
서울대학교 의과대학 병리학교실
정두현 ( Chung Doo-Hyun )
서울대학교 의과대학 병리학교실
KMID : 0357920020360030175
Abstract
Amiodarone is a potent antiarrhythmic agent and can cause potentially life-threatening pulmonary fibrosis. Of the numerous side effects associated with amiodarone therapy, lugn toxicity is one of the most serious adverse reactions. Recently, we experienced a case of amiodarone-induced pulmonary toxicity (APT), which induced severe dyspnea and productive coughing, confirmed by cytologic and electron microscopic examination of the bronchoalveolar lavage (BAL). The symptoms and abnormalities in the chest X-ray were improved after the withdrawal of amiodarone. Cytologic examination of the BAL revealed numerous foam cells with cytoplasmic vacuoles or small particles. Ultrastructurally, the foam cells demonstrated characteristic lysosomal inclusions, which were electron-dense multilamellated bodies, crystalloid bodies, and mixed forms with small lipid vacuoles. It is strongly suggested that only cytologic and electron microscopic examination of the BAL without open lung biopsy is enough for diagnosis of APT, when APT is clinically suspected in a patient who has a history or ingestation of amiodarone.
키워드
Amiodarone;Bronchoalveolar Lavage;Lung;Microscopy;Electron
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