欧米型の病像を呈したhairy cell leukemiaの1例
症例は59才,男性.心窩部痛を主訴として来院.左無機能腎,右水腎症および後腹膜腫瘤の存在が判明した.さらに高γ-グロブリン血症,著明な炎症所見,甲状腺機能低下症,汎血球減少,腎不全等多彩な症状が認められた.骨髄像で異型リンパ球様細胞が54%存在し,その核は馬蹄型で,酒石酸抵抗性酸フォスファターゼ強陽性,位相差顕微鏡で典型的なhairy appearanceを示し,欧米型の病像を呈したB cell系のhairy cell leukemia(HCL)と考えられた.本例はα-Interferon投与により著効を示し,骨髄腫瘍細胞は著減し,貧血,甲状腺機能も改善した.また後腹膜腫瘤も縮小傾向を示した....
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| Published in | 日本内科学会雑誌 Vol. 76; no. 7; pp. 1051 - 1057 |
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| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本内科学会
1987
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| Online Access | Get full text |
| ISSN | 0021-5384 1883-2083 |
| DOI | 10.2169/naika.76.1051 |
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| Abstract | 症例は59才,男性.心窩部痛を主訴として来院.左無機能腎,右水腎症および後腹膜腫瘤の存在が判明した.さらに高γ-グロブリン血症,著明な炎症所見,甲状腺機能低下症,汎血球減少,腎不全等多彩な症状が認められた.骨髄像で異型リンパ球様細胞が54%存在し,その核は馬蹄型で,酒石酸抵抗性酸フォスファターゼ強陽性,位相差顕微鏡で典型的なhairy appearanceを示し,欧米型の病像を呈したB cell系のhairy cell leukemia(HCL)と考えられた.本例はα-Interferon投与により著効を示し,骨髄腫瘍細胞は著減し,貧血,甲状腺機能も改善した.また後腹膜腫瘤も縮小傾向を示した.我々は本例を含め本邦のHCLをまとめ,その特徴について若干の考察を行なった. |
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| AbstractList | 症例は59才,男性.心窩部痛を主訴として来院.左無機能腎,右水腎症および後腹膜腫瘤の存在が判明した.さらに高γ-グロブリン血症,著明な炎症所見,甲状腺機能低下症,汎血球減少,腎不全等多彩な症状が認められた.骨髄像で異型リンパ球様細胞が54%存在し,その核は馬蹄型で,酒石酸抵抗性酸フォスファターゼ強陽性,位相差顕微鏡で典型的なhairy appearanceを示し,欧米型の病像を呈したB cell系のhairy cell leukemia(HCL)と考えられた.本例はα-Interferon投与により著効を示し,骨髄腫瘍細胞は著減し,貧血,甲状腺機能も改善した.また後腹膜腫瘤も縮小傾向を示した.我々は本例を含め本邦のHCLをまとめ,その特徴について若干の考察を行なった. |
| Author | 中島, 卓利 乾, 明夫 馬場, 茂明 小川, 秀美 横野, 浩一 木谷, 照夫 萩野, 晴彦 老籾, 宗忠 待井, 隆志 |
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| References | 19) Ratain MJ, et al: Treatment of hairy cell leukemia with recombinant alpha 2 interferon. Blood 65 (3): 644, 1985. 14) Katayama I, Finkel HE: Leukemic reticuloendotheliosis. A clinicopathologic study with review of the literature. Amer J Med 57: 115, 1974. 5) Kitani T, et al: Hairy cell leukemia: A report of 10 cases in Japan and characterization of anti-hairy cell sera. Jpn J Clin Oncology 13 (3): 497, 1983. 6) Naeim F: Clinicopathological subtypes in hairy-cell leukemia. Amer Soc Clin Pathologists 78 (1): 80, 1982. 1) Bouroncle BA, et al: Leukemic reticuloendotheliosis. Blood 13: 609, 1950. 16) 岡本幸春,他: Hairy cell Leukemiaの1例.臨床血液20 (補I): 102, 1978. 4) 本谷照夫,他: Hairy Cell Leukemiaの病態と治療.医学のあゆみ128 (13): 1080, 1984. 17) 三浦亮,他:発症後19年を経て完全寛解後に結腸癌を合併したhairy cell leukemiaの1例.最新医学38: 2538, 1983. 9) 永田ゆみ子,他:腎不全,高カルシウム血症を呈し,胸骨,脊椎に腫瘍細胞の浸潤をみたHairy Cell Leukemiaの1剖検例.臨床血液23 (6): 890, 1982. 10) Hughes GRV, et al: Polyarteritis nodosa and hairy-cell leukemia. Lancet I: 678, 1979. 11) Dorsey JK, Penick GD: The association of hairy cell leukemia with unusual immunologic disorders. Arch Intern Med 142: 902, 1982. 12) Myers T, et al: Hairy cell leukemia and sarcoid. Cancer 43: 777, 1979. 2) Schrek R, Donnelly WJ: “Hairy” cells in blood in lymphoreticular neoplastic disease and “flagellated” cells of normal lymph nodes. Blood 27: 199, 1966. 13) Crofts MAJ, et al: Rheumatoid arthritis and hairy-cell leukemia. Lancet II: 203, 1979. 15) Turner A, Kjeldsberg CR: Hairy cell leukemia: A review. Medicine 57: 477, 1978. 20) Thompson JA, et al: Recombinant alpha-2 interferon in the treatment of hairy cell leukemia. Cancer treatment reports 69 (7-8): 791, 1985. 7) 藤原史郎,他:最近経験した白人のhairy cell leukemiaの1例.日内会誌67: 454, 1978. 8) 中岡秀光,他: Hairy Cell Leukemiaの1例.臨床血液23 (2): 242, 1982. 3) 片山勲,他: Hairy Cell Leukemia本邦例と欧米例の比較.臨床血液24: 803, 1983. 18) Quesada JR, et al: Alpha interferon for induction of remission in hairy-cell leukemia. New Engl J Med 310 (l): 15, 1984. |
| References_xml | – reference: 16) 岡本幸春,他: Hairy cell Leukemiaの1例.臨床血液20 (補I): 102, 1978. – reference: 9) 永田ゆみ子,他:腎不全,高カルシウム血症を呈し,胸骨,脊椎に腫瘍細胞の浸潤をみたHairy Cell Leukemiaの1剖検例.臨床血液23 (6): 890, 1982. – reference: 2) Schrek R, Donnelly WJ: “Hairy” cells in blood in lymphoreticular neoplastic disease and “flagellated” cells of normal lymph nodes. Blood 27: 199, 1966. – reference: 14) Katayama I, Finkel HE: Leukemic reticuloendotheliosis. A clinicopathologic study with review of the literature. Amer J Med 57: 115, 1974. – reference: 5) Kitani T, et al: Hairy cell leukemia: A report of 10 cases in Japan and characterization of anti-hairy cell sera. Jpn J Clin Oncology 13 (3): 497, 1983. – reference: 4) 本谷照夫,他: Hairy Cell Leukemiaの病態と治療.医学のあゆみ128 (13): 1080, 1984. – reference: 12) Myers T, et al: Hairy cell leukemia and sarcoid. Cancer 43: 777, 1979. – reference: 1) Bouroncle BA, et al: Leukemic reticuloendotheliosis. Blood 13: 609, 1950. – reference: 11) Dorsey JK, Penick GD: The association of hairy cell leukemia with unusual immunologic disorders. Arch Intern Med 142: 902, 1982. – reference: 13) Crofts MAJ, et al: Rheumatoid arthritis and hairy-cell leukemia. Lancet II: 203, 1979. – reference: 17) 三浦亮,他:発症後19年を経て完全寛解後に結腸癌を合併したhairy cell leukemiaの1例.最新医学38: 2538, 1983. – reference: 18) Quesada JR, et al: Alpha interferon for induction of remission in hairy-cell leukemia. New Engl J Med 310 (l): 15, 1984. – reference: 20) Thompson JA, et al: Recombinant alpha-2 interferon in the treatment of hairy cell leukemia. Cancer treatment reports 69 (7-8): 791, 1985. – reference: 8) 中岡秀光,他: Hairy Cell Leukemiaの1例.臨床血液23 (2): 242, 1982. – reference: 10) Hughes GRV, et al: Polyarteritis nodosa and hairy-cell leukemia. Lancet I: 678, 1979. – reference: 7) 藤原史郎,他:最近経験した白人のhairy cell leukemiaの1例.日内会誌67: 454, 1978. – reference: 15) Turner A, Kjeldsberg CR: Hairy cell leukemia: A review. Medicine 57: 477, 1978. – reference: 3) 片山勲,他: Hairy Cell Leukemia本邦例と欧米例の比較.臨床血液24: 803, 1983. – reference: 19) Ratain MJ, et al: Treatment of hairy cell leukemia with recombinant alpha 2 interferon. Blood 65 (3): 644, 1985. – reference: 6) Naeim F: Clinicopathological subtypes in hairy-cell leukemia. Amer Soc Clin Pathologists 78 (1): 80, 1982. |
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| Title | 欧米型の病像を呈したhairy cell leukemiaの1例 |
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