Neurological Surgery 脳神経外科39巻9号

2011年09月発行

症例

脳原発リンパ腫様肉芽腫症の1例

著者： 香川賢司¹ 石田剛² 岡田仁¹

所属機関： ¹国立国際医療研究センター国府台病院脳神経外科 ²国立国際医療研究センター国府台病院中央検査部

ページ範囲：P.883 - P.889

Ⅰ．はじめに

　リンパ腫様肉芽腫症（lymphomatoid granulomatosis：LYG）は稀なリンパ球増殖性肉芽腫性の全身性疾患で，多くは肺に単発あるいは多発性の腫瘤性病変が認められる．病変が皮膚，腎臓，中枢神経系など多臓器に及ぶ場合もあるが，他臓器に病変を伴わない脳原発のLYGは極めて稀である．今回，われわれは視野障害にて発症した脳原発LYGの切除例を経験したので，文献的考察を加えて報告する．

参考文献

1）Bae WK, Lee KS, Kim PN, Kim IY, Lee BH, Lee KS, Bae HG, Yun IG, Kim EH：Lymphomatoid granulomatosis with isolated involvement of the brain. J Korean Med Sci 6：255-259, 1991

2）Fauci AS, Haynes BF, Costa J, Katz P, Wolff SM：Lymphomatoid granulomatosis. Prospective clinical and therapeutic experience over 10 years. N Engl J Med 306：68-74, 1982

3）Guinee D Jr, Jaffe E, Kingma D, Fishback N, Wallberg K, Krishnan J, Frizzera G, Travis W, Koss M：Pulmonary lymphomatoid granulomatosis. Evidence for a proliferation of Epstein-Barr virus infected B-lymphocytes with a prominent T-cell component and vasculitis. Am J Surg Pathol 18：753-764, 1994

4）Guinee DG Jr, Perkins SL, Travis WD, Holden JA, Tripp SR, Koss MN：Proliferation and cellular phenotype in lymphomatoid granulomatosis：implications of a higher proliferation index in B cells. Am J Surg Pathol 22：1093-1100, 1998

5）Hamilton MG, Demetrick DJ, Tranmer BI, Curry B：Isolated cerebellar lymphomatoid granulomatosis progressing to malignant lymphoma. Case report. J Neurosurg 80：314-320, 1994

6）Ishiura H, Morikawa M, Hamada M, Watanabe T, Kako S, Chiba S, Motokura T, Hangaishi A, Shibahara J, Akahane M, Goto J, Kwak S, Kurokawa M, Tsuji S：Lymphomatoid granulomatosis involving central nervous system successfully treated with rituximab alone. Arch Neurol 65：662-665, 2008

7）Katzenstein AL, Carrington CB, Liebow AA：Lymphomatoid granulomatosis：a clinicopathologic study of 152 cases. Cancer 43：360-373, 1979

8）Kawai N, Miyake K, Nishiyama Y, Yamamoto Y, Sasakawa Y, Haba R, Kushida Y, Tamiya T, Nagao S：FDG-PET findings of the brain in lymphomatoid granulomatosis. Ann Nucl Med 20：683-687, 2006

9）Kermode AG, Robbins PD, Carroll WM：Cerebral lymphomatoid granulomatosis. J Clin Neurosci 3：346-353, 1996

10）Kerr RS, Hughes JT, Blamires T, Teddy PJ：Lymphomatoid granulomatosis apparently confined to one temporal lobe. Case report. J Neurosurg 67：612-615, 1987

11）Liebow AA, Carrington CB, Friedman PJ：Lymphomatoid granulomatosis. Hum Pathol 3：457-558, 1972

12）Lipford EH Jr, Margolick JB, Longo DL, Fauci AS, Jaffe ES：Angiocentric immunoproliferative lesions：a clinicopathological spectrum of post-thymic T-cell proliferations. Blood 72：1674-1681, 1988

13）Lucantoni C, De Bonis P, Doglietto F, Esposito G, Larocca LM, Mangiola A, Martini M, Papacci F, Teofili L, Pompucci A：Primary cerebral lymphomatoid granulomatosis：report of four cases and literature review. J Neurooncol 94：235-242, 2009

14）Nicholson AG, Wotherspoon AC, Diss TC, Singh N, Butcher DN, Pan LX, Isaacson PG, Corrin B：Lymphomatoid granulomatosis：evidence that some cases represent Epstein-Barr virus-associated B-cell lymphoma. Histopathology 29：317-324, 1996

15）Nishihara H, Nakasato M, Sawa H, Murakami H, Yamamoto D, Moriyama K, Kato N, Hashimoto I, Kamada H, Tanaka S：A case of central nervous system lymphomatoid granulomatosis；characteristics of PET imaging and pathological findings. J Neurooncol 93：275-278, 2009

16）Okuda T, Akai F, Kataoka K, Taneda M：A case of lymphomatoid granulomatosis followed for 14 months on the basis of clinical and histological findings. Brain Tumor Pathol 25：33-38, 2008

17）Pisani RJ, DeRemee RA：Clinical implications of the histopathologic diagnosis of pulmonary lymphomatoid granulomatosis. Mayo Clin Proc 65：151-163, 1990

18）Tateishi U, Terae S, Ogata A, Sawamura Y, Suzuki Y, Abe S, Miyasaka K：MR imaging of the brain in lymphomatoid granulomatosis. AJNR Am J Neuroradiol 22：1283-1290, 2001

19）Wilson WH, Kingma DW, Raffeld M, Wittes RE, Jaffe ES：Association of lymphomatoid granulomatosis with Epstein-Barr viral infection of B lymphocytes and response to interferon-alpha 2b. Blood 87：4531-4537, 1996