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新生児及び乳児の先天性脳腫瘍は,臨床的に出生時既に頭蓋周囲径の拡大による難産があり,また生後窒息あるいは痙攣などの諸症状を呈し,漸次先天性内脳水症が著しくなる。さらにその脳脊髄液にはリンパ球増多や,蛋白濃度増加が見られるので,一見炎性機転を思わせるものが多い(S-APIN)25)。病理解剖学的には,小児腫瘍とは趣きを異にして,天幕上腫瘍が多いと云われる。
桂教授等16)は,日本における脳腫瘍3312例の統計的観察のなかで,日本においては欧米より先天性脳腫瘍が多いと述べている。然し教授の云う先天性脳腫瘍としては,Craniopharyngiomaが多数挙げられているが,Craniopharyngiomaの悉くが胎児・新生児及び乳児の先天性脳腫瘍とは看做しにくい。そこで新生児及び生後1年以内の乳児における先天性脳腫瘍と考えられる症例はMAIER (1861)19)による奇形腫の報告以来,文献上約40例が蒐集せられた(表)。日本においては先天性脳腫瘍3剖検例があるに過ぎず,石塚等14)や吹田等12)による8カ月胎児における奇形腫2例と,青柳1)による11カ月女児における髄芽腫例が挙げられる。
Six-Months old male infant; It was a full term delivery accompanied by dystocia and asphyxia. One month and half after the birth, he showed symptoms such as slow reaction to light, vomiting, tremors, a marked hydro-cephalus with fever. Although he received lumbar and ventricular punctures, the aspi-ration of the fluid gradually became difficult, and died about four and half months after the onset of the illness.
Postmortem examination: The infant had a head circumference of 55 cm, and the brain weighed 2,010g. A light grayish white and well-defined tumor, 7×6×7cm in size, was found in the left cerebral hemisphere. The left cerebral ventricle was markedly compressed by the tumor, while the right ventricle was greatly dilated, revealing internal hydro-and pyocephalus due to purulent leptomeningi-tis. In addition, congenital cysts could be recognized in the cerebellum.
Microscopically, there could be observed epithelioid structure, a rosette formation, so-called "Strahlenkrone" and papillary as well as diffuse proliferation of tumor cells.
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