臨床症状を呈した松果腺嚢腫の1剖檢例

A Case of Pineal Cyst with Neurological Symptoms and Mental Disorders

　吾々が日常遭遇する脳腫瘍のうち，四疊體部腫瘍は眼球の上方瞻視運動障碍を中核とする比較的截然とした特有な局在徴候によつて際立つて居るが，吾々の教室に於て過去3年間に手術或いは剖檢によつて確認せられた腦腫瘍70例のうち該部腫瘍は僅かに1例にすぎず，從つて此は臨床的に比較的稀な疾患と云い得る。さて松果腺自體に起る病的機轉として重要なものは腫瘍と嚢腫であるが，此のうち松果腺腫瘍に就いては比較的多くの症例が報告されて居り中田教授によれば該腫瘍は吾國に於ては歐米に比しやや高率に見られて居ると云う。他方病理解剖學上極めて高率に發見され，最近の小宅氏の檢索によれば實に210例中40.9％に逹したと云われる松果腺嚢腫に就ては．その臨床症状を中心とする報告例は少なく，殊に吾國に於ては著者の渉獵した範圍に於ては未だ文献上その種の記載を見ないものの樣である。著者は最近四疊體部の局所症状と特有な精神神症状を主訴として入院死亡した例を剖檢し，第三腦室と交通を有する定型的松果腺嚢腫を證明する機會を得たので報告する。

　A 54 year-old female with cystic degeneration of pineal gland was investigated from both clinical and neuropathological viewpoints. This case is reported here because of the fact that she had peculiar neurological and psychiatric symptoms. It is said to be rather exceptional that the case of pineal cyst presents some clinical symptoms, and this is the first case reported in Japan, so far as the author knows.

　For the past year she has had progressive neurological symptoms such as ataxia, defect of conjugate ocular deviation upwards and disturbances of visual as well as auditory function on the one hand, and some psychiatric symptoms, namely, emotional disturbances and deterioration of mental ability on the other hand. She became unconcious immediately after the carotid angiography had been done and died three days thereafter.

　Autopsy revealed the pineal cyst, sparrowegglarge in size, which communicated with the third ventricle. Histological examination showed the typical picture : the inside of the cyst was covered with the glial wall.

　It is possible to explain all the clinical symptoms on the basis of neuropathological findings.