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심부진균증의 방사선학적 고찰
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대한방사선의학회지
권/호정보
1977년|13권 2호|pp.353-367 (15 pages)
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대한영상의학회
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이 논문은 한국과학기술정보연구원과 논문 연계를 통해 무료로 제공되는 원문입니다.
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Total 23 cases of deep mycoses were reviewed on the clinical and radiographic findings, which were coafirmed pathologically at Yonsei Univ College of Medicine, Severence Hospital until 1976. Summary of these was as follows. 1) Aspergillosis: 11 cases. 1. Although one case among them was systemic aspergillosis, all 11 cases had pulmonary aspergillsis. 2. They occured most commonly in 3rd or 4th decade and its main complaints were intermittent hemoptysis for a long time or occasionally massive one for a few days. All cases were treated as pulmonary tuberculosis but the lesions showed poor response to anti-tuberculous medication. 3. Their chest X-ray films revealed irregular mottled infiltrate (6 cases) or collapse and massive, dense consolidation (2 cases). Among them, 7 cases showed various form of“air meniscus sign”suggesting fungus ball, which was able to be detectable on tomography. Another finding was diffuse pneumonic pattern in 2 cases, which was not able to be differen iated from other pathogegic origin pneumonia. 4. Nine cases were belonged to mycetoma form, 2 cases were primary aspergillosis and there is no hypersenitivity aspergillosis in these cases, if these cases were classified. 2) Cryptococcosis: 8 cases. 1. Among 8 cases, 5 cases were crytococcal meningitis, 5 cases of them were thought to be pulmonary crytococcosis, liver biopsy was positive in 4 cases and lymphnode biopsy in 4 cases, including 2 cases of systemic cryptococcosis. 2. It occured commonly at the 1st decade and their clinical findings were multiple lymphadenopathy, uncontrolled fever, meningeal irritation symptoms such as severe headache, vomiting or drowsy mental state, fulminant hepatitis, skin eruption, but chest symptom was not significant. 3. Pulmonary lesions revealed moderate hilar or mediastinal adenopathy in all 5 cases, and miliary or coarse interstitial nodules were scattered in entire lung with lymphadenopathy in 3 cases, which should be differenciated from milia y tuberculosis, sarcoidosis and lymphangitic pulmonary metastasis. 3) Actinomycosis: 2 cases. 1. Both of two cases with subcutaneous abscess were diagnosed as the actinomycotic infection. 2. In one, neighbouring rib showed localized sclerosis and minimal bony rarefaction suggesting chronic osteomyelitis. This radiologic or clinical manifestation of actinomycosis is smeewhat different form the literatures. 4) Mucormycosis: 1 cases 1. A 34 years old, in diabetic coma, was diagnosed as the pulmonary mucormycosis. 2. Pulmonary lesion showed segmental, dense pneumonic consolidation with abscess formation in Lt. lower lung, which was common features of pulmonary mucormycosis. 5) Candidiasis: 1 cases 1. A 19 years old patient was diagnosed as diffuse involvement of Candida infection, with pathologic lesions of lung entire gastrointestinal tract. 2. Pulmonary lesion showed hilar prominency and diffuse coarse disseminated interstitial nodules in both lung fields. 3. The lumen of distal esopha us was narrowed with irregular coarse mucosae with fine, multiple ulceration and minimal mucoasal mucosal thickening of duodenal bulb and ileocecal area was also evident.