경화성 장간막염과 감별이 어려웠던 총담관암 림프절전이 1예 = Cholangiocarcinoma with Regional Lymph Node Metastasis Masquerading as Sclerosing Mesenteritis

국문 초록 (Abstract)

경화성 장간막염은 장간막에 만성 염증과 섬유화를 보이는 드문 질환으로 비교적 양호한 경과를 가지는 질환이다. 복부 컴퓨터단층촬영을 포함한 특징적 영상소견이 진단에 도움이 된다. 그러나 경화성 장간막염은 몇몇 악성 질환들과 유사한 형태를 보일 수 있으며, 이들은 치료방법 및 경과 자체가 완전히 다르기 때문에 악성 질환에 대한 적극적 배제가 중요하다. 저자들은 체중 감소 및 지속되는 설사 증상으로 내원한 75세 남성 환자가 복부 컴퓨터단층촬영상 장간막 혈관 주변 연무양 감쇄의 특징적 소견을 보여 경화성 장간막염으로 오인하였으나, 추적관찰 및 추가적으로 시행한 조직검사와 양성자방출 컴퓨터단층촬영술을 통하여 최종적으로 총담관암과 그에 동반된 림프절전이로 진단하였던 드문 증례를 경험하여 이를 보고하고자 한다.

다국어 초록 (Multilingual Abstract)

Sclerosing mesenteritis is a rare disease presenting as chronic inflammation and fibrosis of mesentery around the small and large intestine. And in most cases, it shows indolent and benign clinical course resulting in favorable prognosis. It is often diagnosed through characterized radiologic finding in abdominal examinations including computed tomography scan. However, it is important to rule out other conditions involving mesentery when diagnosing sclerosing mesenteritis. In the case of malignancy, the method of treatment and prognosis can be completely different therefore thorough examinations are essential. We herein report a 75-year-old male who suffered from frequent diarrhea and weight loss. Initially, he was diagnosed with sclerosing mesenteritis through abdominal computed tomography scan showing "misty" soft-tissue attenuation around the mesenteric vessel. However, follow up positron emission tomography scan and biopsy finding confirmed the common bile duct cancer with lymph node metastasis.

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