著明な腹水と低γ-globulin血症を認め結核を併発した原発性骨髄線維症の一剖検例

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A 57 year old man. Hepatosplenomegaly was found on routine physical examination and he was admitted on October 26, 1971. The liver was palpable two fingerbreadths below the right costal margin. The spleen was extended three fingerbreadths below the navel. Peripheral blood showed normochromic anemia and leucoerythroblastosis. So called tear drop cells were seen in blood smear. Ph1chromosome was negative. Alkaline phosphatase score of neutrophils was normal level. Biochemical examination revealed hypogammaglobulinemia, particularly IgG was decreased. Ferrokinetics study showed delayed plasma iron disappearance rate and the failure of red cell utilization. Bone marrow aspiration was difficult. Fibrosis was found by surgical biopsy. Testosterone propionate and prednisolone were ineffective. Because of increased anemia, frequent transfusions were nescessary. On the course of admission, ascites was seen occa-sionally. He died of lung tuberculosis on August, 28, 1972. At postmortemn examination, there was generalized fibrosis of the bone marrow. Tuberculosis was recognized in the lung, liver and lymphnodes.
学校法人昭和大学・昭和医学会の論文