Wegener肉芽腫症に甲状腺癌,子宮頸癌を合併した1症例

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A case of Wegeners granulomatosis followed by cancers of the thyroid gland and the cervix uteri was reported.A 46 years old house wife visited Osaka University Hospital on June 21, 1974, complaining gradual inspiratory dyspnea of six months duration.Otolaryngological examination revealed saddle nose without nasal septal perforation, crust formation in the nasal cavity and granulation tissue in both nasal cavity, and subglottic region.After emergency tracheotomy was performed, biopsy specimens were obtained from the granulation tissues in nasal cavity and subglottic space which were diagnosed as Wegeners granulomatosis. Another specimen which was obtained from paratracheal region was diagnosed as papillo-follicular adenocarcinoma of the thyroid.Labolatory data revealed elevated ESR, proteinuria, anemia, lymphocytopenia, inverted A/G ratio, increase of IgG and serum complement level and negative Mantaux test.She was treated continuously with cortico-steroid, which resulted in decreased granulation.But about eleven months later, cancer of the uterine cervix (stage TIV NX MO) was disgnosed. Pathohistologically it was poorly differentiated squamous cell carcinoma. The cancer advanced rapidly and she died about three months 1 later. Autopsy was not performed.Wegeners granulomatosis of subglottis with dy spnea is rare. Wegeners granulomatosis is recognized as an autoimmune disease.Combinations of cancers and this disease, like this case, suggest the interaction between immune-deficiency and carcinogenesis.
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Wegener肉芽腫症に甲状腺癌,子宮頸癌を合併した1症例

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