肝臓とステロイドホルモン産生臓器との関連に関する形態学的研究:第一編 肝疾患時にみられるステロイドホルモン産生臓器, 殊に副腎皮質の形態学的所見について
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The morphology of steroidhormone producing organs, especially the adrenal cortex, was studied in 134 cases of human liver diseases, such as atrophy, cirrhosis and carcinoma of the liver. <BR>1) In each case of acute hepatitis there were hypertrophy, necrosis and hemorrhage of the adre-nocortical cells. The lipid granules in the adrenal cortex became much finer and less in content. <BR>2) In cases of subacute or chronic hepatitis (liver atrophy), no marked histological changes were recognized in the adrenal cortex except for a diminution in number and irregular distribution of the lipid granules in the fasciculata. <BR>3) In the fasciculata of the adrenal cortex in the cases of liver cirrhosis, especially of atrophic cirrhosis, morphological changes were not remarkable. The fasciculata did not undergo any significant changes except that the lipid granules became coarse, while the glomerulosa showed striking changes, such as becoming finer and a marked depletion or disappearance of the lipid granules. There were some deposits of brown pigment in the cytoplasm of the reticular cells. <BR>4) Whenever there was much jaundice, there were marked necrotic or degenerative changes and a decrease of lipid droplets in the adrenal cortex. <BR>5) Histological findings of the adrenal cortex in the cases of liver carcinoma were essentially the same as in cirrhosis of the liver. However, in the cases with advanced liver cancer and severe emaciation and jaundice, the lipids in the adrenal cortex were greatly diminished. <BR>6) In the cases of liver disorders, there were generally atrophic changes in the testicles, such as decreased spermatogenesis, thickening of the basal membrane and proliferation of the connective tissue in the interstitium. On the other hand, Leydig's cells showed no atrophic changes, but in many cases there were a few deposits of brown pigment in the protoplasm. <BR>7) The ovaries showed no specific pathological changes in any case of human liver disease. But a decrease in follicle formation and an enlargement of the lipid granules in the theca interna and lutein cells were sometimes seen. <BR>8) The above observations suggest that abnormalities of steroidhormone metabolism in cases of chronic liver damage, especially cirrhosis, do not result from faulty hormone synthesis by the steroid-hormone producing organs, but are probably caused by disturbances in the process of steroidhormone metabolism in the liver. The abnormalities in steroidhormone metabolism had continued over a long period and were followed by morphological changes in steroidhormone producing organs.
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