小腸に穿孔をきたした鼻悪性細網症の1例

概要

論文の詳細を見る
An autopsy case of malignant granuloma of the nose with intestinal involvement was presented.A male, aged 24, who developed rightnasal obstruction and bleeding, visited us on April 10, 1974. On examination, necrotic granulom atous changes of the right turbinate were found.Repeatd biopsies of the nasal lesion, however, showed only inflammatory changes and necrosis. He did not respond to antibiotics and corticosteroid therapy, and malignant lymphoma of the nose was suspected. A satisfactory response was obtained by radiation therapy. Four months later, he had pain of the right eye and exophthalmus. Biopsy of the nasal lesion revealed infiltration of atypical histiocytes.Inspite of irradiation, antibiotics and corticosteroid therapy, he complained of severe pain in the orbit and over the abdomen.Laparotomy revealed many necrotic lesions of small intestine with a perforation, and microscopic examination of the lesion showed diffuse infiltration of atypical histiocytes into the muscle of small intestine, and also atrophy of the muscle.He died of bleeding from the small intestine after 6 months from the oncet. Autopsydisclosed diffuse infiltration of atypical histiocytes into many organs, stomach, duodenum, small intestine, pancreas, kidney et al.Based on the experiences of the similar 10 cases, the following points were stressed.1) In the non-healing granuloma of the nose, there are at least 2 different diseases, one reticulum cell sarcoma or malignant reticulosis, another Wegeners granulomatosis. Initial changes of the diseases are similar and biopsies of the lesions show only the same inflammatory changes and necrosis.2) One must consider malignant reticulosis rather than Wegeners granulomatosis in case showing no characterisic laboratory findings of Wegeners granulomatosis.........elevated BSR, Positive RA, decreased A/G ratio, elevated Ig, IgG, IgA and serum complement level.3) When a patient with no definite histopathological features and laboratory findings develops abdominal pain, intermittent fever, jaundice or dyspnea in times, the infiltration of atypical histiocytes to the intestine, kidney, lung or pericardium should be suspected.
社団法人日本耳鼻咽喉科学会の論文

小腸に穿孔をきたした鼻悪性細網症の1例

スポンサーリンク

概要

著者

関連論文

スポンサーリンク