先天性心室中隔欠損児にみられた脳の低酸素性変化および基質細胞の残存

A CASE OF THE CHRONIC HYPOXEMIA OF THE BRAIN DUE TO CARDIAC INSUFFICIENCY

　5カ月の女児，妊娠中母体の重症悪阻，手術侵襲あり。生後先天性心室中隔欠損により頻回チアノーゼに襲われ，末期には脳炎様症状を主症状として死亡した症例の脳で，大脳皮質および一部脳幹部神経核の神経細胞の広汎な壊死，脱落，小軟化巣の形成等elektive Parenchymnekroseの像をみるとともに脳幹部にShaper　＆　Cohen^14）の示す5Xの領域に巨細胞，異型性を示す前癌的性格をうかがわせる未分化細胞の集団残存を認めた。

Five months femals infant taking the epi-sode of heavy emesis and operation during the intrauterine life has been repeatedly suf-fered from evident cyanosis and dead. Clini-cally she has been treated under the suspicion of encephalitis.

The brain showed so-called "elective paren-chyme necrosis" appearing extended necrosis and disappearing of the ganglia cells or small softened foci at the cerebral cortex and some nuclei. These changes are considered to be derived from the chronic hypoxemia of the brain due to cardiac insufficiency. At the heart the congenital defect of Ventricular septum was seen. Additionally many groups at the region forward of the thalamus, which was called as 5 X by Shaper and Cohen.

Cytological examination on them revealed many anaplastic patterns and occasionally formed multinucleated giant cells.

Such cellulous appearance is interested to suggest their precarcinomatous nature.