非定型抗酸菌（Mycobacterium avium）腸炎の1例

Mycobacterium-Avium Enteritis, Report of a Case

要旨　患者は40歳代，女性．便潜血検査陽性にて注腸X線検査と下部消化管内視鏡検査を施行された．回腸末端の拡張不良と盲腸部の潰瘍瘢痕，上行結腸の輪状傾向を有する不整潰瘍を認めた．内視鏡的には腸結核が疑われたが生検培養，腸液の吸引培養にてMycobacterium avium（M. avium）が検出された．病理組織像は，明らかな乾酪壊死巣のない肉芽腫が認められ，多核巨細胞も伴っていた．また結核菌では通常みられない非壊死性組織球反応や好中球性反応がみられ，培養の結果と合わせて非定型抗酸菌症に矛盾しないと考えられた．非定型抗酸菌腸炎についての報告は少なく，貴重な症例と考えられた．

　A woman of about 40 years of age underwent Barium-enema for further examination of occult blood in the stool. Barium enema examination revealed an ulcerative lesion in the ascending colon, so she was referred to our hospital. Colonoscopy revealed shallow and circumferential ulcerations in the ascending colon. Intestinal tuberculosis was suspected, but only Mycobacterium-avium was detected from culture of the biopsy specimen and intestinal liquid. Histological findings of the biopsy specimens from the ulcer showed non-caseous epitheloid cell granuloma. We considered that Mycobacterium-avium was pathogen. Mycobacterium-avium enteritis in healthy subjects is rare, so this case was thought to be of value.