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자궁경부암 환자에서 sentinel lymph node 탐색을 위해 isosulfan blue dye 사용시 발생한 급성 과민반응 1예

A Case of Anaphylactic Reactions to Isosulfan Blue Dye in A Cervical Cancer Patient.

대한산부인과학회지 2003년 46권 2호 p.484 ~ 487
임채춘 (  ) - 한림대학교 의과대학 산부인과학교실

안경화 (  ) - 가톨릭대학교 의과대학 산부인과학교실

Abstract

The sentinel lymph node is defined as the first node of a regional lymphatic basin that receives the lymphatic drainage from a tumor, thus representing an elective site of lymph node metastasis. According to the sentinel lymph node hypothesis, histologically negative sentinel lymph nodes can guarantee the histological negativity of the remaining regional lymph nodes. These assumptions suggest that the sentinel node can be a suitable marker of regional lymph node status. Thus sentinel node biopsy may be a reasonable alternative to unnecessary pelvic lymph nodes dissection and a suitable method for limited control of early stage cervical cancer. To improve the sentinel node detection in surgical procedures, we investigated lymphatic mapping of sentinel lymph nodes with isosulfan blue dye (lymphazur 1%) and technetium-99m colloid albumin. We have made it a rule to inject 5 ml of isosulfan blue dye in the peritumoral area of cervix. It is reported that isosulfan blue dye has been safe and easily used in the detection of sentinel lymph node in melanoma, breast cancer and vulvar cancer. We experienced a case of anaphylactic reactions to isosulfan blue dye in cervical cancer patient, so we report it with a brief review of literature.


Sentinel lymph node를 찾기 위한 시각적 표식자로 Isosulfan blue dye 의 이용이 malignant lymphoma, breast cancer, thyroid cancer, head and neck surgery 및 산부인과 영역에서는 cervical cancer, vulvar cancer 수술시 많이 이용될 것으로 기대된다. 비교적 안전하며, 인체에 무해한 것으로 알려진 isosulfan blue dye 가 투여 후 20분 이내에는 급성 과민반응이 일어날 수 있음을 문헌을 통해, 그리고 실제로 경험한 바 이를 보고하는 바이다.


키워드

Anaphylactic reactions; Isosulfan blue dye; Sentinel lymph node; 급성 과민반응
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