Sweet病に合併した非特異性小腸潰瘍の1例

Nonspecific Multiple Ileal Ulcers Associated with Sweet Disease, Report of a Case

要旨　患者は47歳，男性．1974年に皮疹出現し皮膚科でSweet病として経過観察されていたが，1985年腹痛，下血にて発症．X線検査および内視鏡検査にて腸間膜対側に不整地図状の多発潰瘍と粘膜集中像，著明な炎症性ポリープがみられた．切除標本では，回盲弁を含む回腸末端部に，4.0×2.5cm大のUl-Ⅳの潰瘍および潰瘍瘢痕と，更に口側には，Ul-Ⅱの浅い潰瘍瘢痕を2個認めた．組織学的には非特異性潰瘍であり，潰瘍の分布や形態は腸型Behcet病，単純性潰瘍に類似するものと考えられたが，著明な炎症性ポリープの合併があり興味がある1例と思われ報告した．

　A 47-year-old male who had been followed up at the department of dermatology, Kitasato University Hospital, under the diagnosis of Sweet disease since 1974 was hospitalized because of abdominal pain and melena. Barium enema and endoscopical study showed multiple ulcers with converging folds and multiple inflammatory polyps in the antimesenteric area of the terminal ileum. Examination of the resected specimen revealed an open ulcer (Ul-VI), wide irregular ulcer scar, 4.0×2.5 cm in size, with multiple mucosal tag-like polyps and the pseudopolyps. Two small ulcer scars (Ul-II) were also found at the proximal ileum. Histologically, neither specific inflammatory changes nor epithelioid cell granuloma was seen in these lesions. The findings described above resemble to those of either intestinal Behçet disease or so-called simple ulcer. The inflammatory polyps seen in this case, though interesting, were not clear in etiology.