심인성 폐부종과 폐포성 출혈을 보인 갈색세포종

• Published in: Tuberculosis and respiratory diseases Vol. 64; no. 3; pp. 219 - 223
• Main Authors: 정종필, Jong Pil Jeong, 반희정, Hee Jung Ban, 김수옥, Soo Ock Kim, 손준광, Jun Gwang Son, 주진영, Jin Yung Ju, 권용수, Yong Soo Kwon, 오인재, In Jae Oh, 김규식, Kyu Sik Kim, 김유일, Yu Il Kim, 임성철, Sung Chul Lim, 김영철, Young Chul Kim
• Format: Journal Article
• Language: Korean
• Published: 대한결핵 및 호흡기학회 30.03.2008
• Subjects: Alveolar hemorrhage; Cardiogenic pulmonary edema; Pheochromocytoma
• ISSN: 1738-3536; 2005-6184

저자들은 대량 객혈로 내원한 환자에서 폐 출혈과 함께 반복적인 심인성 폐부종, 카테콜라민 유도성 심부전이 합병된 드문 형태의 갈색세포종을 경험하여 이러한 임상 증상시 폐나 심장 질환 외에 갈색세포종에 대한 고려가 필요할 것으로 생각되어 문헌고찰과 함께 보고하는 바이다. Pheochromocytoma is derived from the chromaffin tissue. The typical finding of pheochromocytoma is paroxysmal hypertension accompanied with various signs and symptoms that are due to the excess of catecholamines or other bioactive substances. Yet the diagnosis is sometimes difficult to make because its clinical presentation is quite variable. Especially, hemoptysis is a very rare symptom, so the diagnosis is often missed or delayed. Without making the correct diagnosis and then subsequently administering treatment, the condition may be fatal. We herein report on a 68 year-old woman who was admitted because of abdominal pain and hemoptysis. The initial radiologic findings suggested pulmonary edema with alveolar hemorrhage. The urine catecholamine levels were elevated and she developed catecholamine-induced cardiomyopathy. We performed bronchial arterial embolization and we administered alpha blocker medication for controlling the hemoptysis and hypertension. After the temporary symptomatic improvement, her clinical course was aggravated by pneumonia and pulmonary edema. In spite of performing definitive surgery for pheochromocytoma, she died of postoperative hemodynamic instability. (Tuberc Respir Dis 2008;64:219-223)