증례 : 신장이식 후 피부나 림프샘 병변 없이 다발성 폐결절 형태로 발생한 카포시육종의 치료 후 호전 사례
분야
의약학 > 병리학
저자
김시연 ( Si Yeon Kim ) , 이효정 ( Hyo Jung Lee ) , 정윤정 ( Yun Jung Chung ) , 신승수 ( Seung Soo Sheen ) , 이종훈 ( Jong Hoon Lee ) , 오창권 ( Chang Kwon Oh )
발행기관
대한이식학회
간행물정보
대한이식학회지 2012년, 제26권 제4호, 299~304페이지(총6페이지)
파일형식
17806284.pdf [무료 PDF 뷰어 다운로드]
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    영문초록
    Kaposi`s sarcoma is one of the most serious complications associated with immune suppression treatment after kidney transplantation. Because it usually manifestations as skin lesions or lymphadenopathies, its clinical suspicion and tissue diagnosis is relatively easy. However, Kaposi`s sarcoma presented as multiple pulmonary nodules without skin manifestations is not easily detected early and usually has a deadly prognosis. We present the case of a 36-year-old male who underwent kidney transplantation 13 months ago and has been on tacrolimus and mycophenolate mofetil (MMF)-based immune suppression presented dry cough, blood tinged sputum, and multiple pulmonary nodules without any skin lesions. Both bronchoscopic washing cytology and fine needle aspiration cytology of peripheral lung tissues were performed but failed due to low cellular yields. A video-assisted thoracoscopic biopsy subsequently revealed Kaposi`s sarcoma. Following the diagnosis, we changed the immune suppression from a tacrolimus and MMF-based regimen to a sirolimus-based regimen. Respiratory symptoms gradually disappeared and we found complete remission on follow-up radiologic evaluations. Thus sirolimus may be the preferred method of treatment for patients with immune suppression after kidney transplantation.
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