방선균증이 동반된 대장의 미만성 거대 B-세포 림프종 증례
Colonic Diffuse Large B-cell Lymphoma Hidden in Actinomycosis
이상훈, 남승주, 박성철, 강창돈, 최대희, 박진명, 이승구,
소속 상세정보
이상훈 ( Lee Sang-Hoon )
강원대학교 의학전문대학원 내과학교실
남승주 ( Nam Seung-Joo )
강원대학교 의학전문대학원 내과학교실
박성철 ( Park Sung-Chul )
강원대학교 의학전문대학원 내과학교실
강창돈 ( Kang Chang-Don )
강원대학교 의학전문대학원 내과학교실
최대희 ( Choi Dae-Hee )
강원대학교 의학전문대학원 내과학교실
박진명 ( Park Jin-Myung )
강원대학교 의학전문대학원 내과학교실
이승구 ( Lee Seung-Koo )
강원대학교 의학전문대학원 해부병리학교실
Abstract
Actinomycosis can mask malignant diseases. This paper reports a case of colonic diffuse large B-cell lymphoma (DLBCL), which was misdiagnosed as abdominal actinomycosis. A 76-year-old woman presented with right flank pain and weight loss. Abdominal CT and colonoscopy revealed a huge ascending colon mass. Despite the initial impression of a malignancy, a colonoscopic biopsy revealed no malignant cells, but sulfur granules and a filamentous organism suggesting actinomycosis. Intravenous penicillin G was administered under the impression of abdominal actinomycosis but her condition deteriorated rapidly. Follow up CT showed markedly increased colon mass and new multiple nodular lesions around the ascending colon. Sono-guided percutaneous biopsy of the nodular lesion was performed. The pathological result was DLBCL. The patient was scheduled to undergo chemotherapy but the patient expired due to cancer progression. The diagnosis of gastrointestinal infiltrating tumors is often difficult because a superficial biopsy usually does not provide a confirmative diagnosis. This case highlights the difficulty in making a correct diagnosis of lymphoma due to the concomitant actinomycosis.
키워드
Lymphoma; large B-Cell; diffuse; Actinomycosis; Colonic neoplasms; Colonoscopy
원문 및 링크아웃 정보
등재저널 정보