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Brain and Nerve No to Shinkei Volume 44, Issue 11 （November 1992）

Brain and Nerve 脳と神経 44巻11号（1992年11月発行）

Japanese English

症例報告

ベーチェット病に続発した頭蓋内原発悪性リンパ腫の1例 Intracranial Primary Malignant Lymphoma Following Behçet's disease : Case Report 原田克彦 ¹ , 大津力津康 ¹ , 中山顕児 ¹ , 高木繁幸 ¹ , 杉田保雄 ² , 鳥越隆一郎 ³ Katsuhiko Harada ¹ , Katsuyasu Ohtsuru ¹ , Kenji Nakayama ¹ , Shigeyuki Takagi ¹ , Yasuo Sugita ² , Ryuichiroh Torigoe ³ ¹大牟田市立病院脳神経外科 ²久留米大学医学部脳神経外科 ³聖マリア病院脳神経センター脳神経外科 ¹Department af Neurosurgery, Omuta City Hospital ²Department of Neurosurgery, Kurume University School of Medicine ³Department of Neurosurgery, Institute of Neurosciences, St Mary's Hospital キーワード： primary intracranial malignant lymphoma , malignant lymphoma , Behçet disease , colchicine , immunosuppression therapy Keyword: primary intracranial malignant lymphoma , malignant lymphoma , Behçet disease , colchicine , immunosuppression therapy pp.1029-1033

発行日 1992年11月1日 Published Date 1992/11/1

DOI https://doi.org/10.11477/mf.1406900410

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Abstract 文献概要
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　ベーチェット病に続発した頭蓋内原発性悪性リンパ腫の1例について報告した。症例は43歳の女性で，不全型ベーチェット病によるブドウ膜炎の治療にcolchicineが使用された。その投与開始後6カ月目に小脳症状が出現し，生検と全身的検索から頭蓋内原発性悪性リンパ腫と診断された。免疫抑制剤の使用後に発生した悪性リンバ腫は，azathioprine, steroid, cyclophosphamide，さらにcyclosporinを使用した報告がほとんどである。本症例においては，広義の免疫抑制剤とされるcolchicineの投与がその発生に関与していた可能性も考えられた。

We reported a case of intracranial primary malignant lymphoma following Behçet disease treated with col-chicine.

A 43-year-old female with a past history of oral ulcer and folliculitis visited the Department of Ophthalmol-ogy on December, 1990, because of her impaired visual acuity. A diagnosis of uveitis due to incomplete type Behcet disease was made from funduscopic examination and her past history. She had been received 1.0mg/day colchicine for six months in the outpatient clinic. She was referred to our department on August 19, 1991,with nausea and headache. On admission, neurological exam-ination revealed slight right cerebellar ataxia showing dysmetria and dysdiadochokinesis. Computed tomogra-phy scan and magnetic resonance images demonstrated a malignant lymphoma in the left cerebellar hemi-sphere. Stereotaxic biopsy resulted in the B cell type malignant lymphoma (Diffuse large cell type). Gallium-scintigraphy, physical examination and peripheral blood examination disclosed no systemic abnormalities. There was a reduction of lymphocyte's response to PHA (phytohemagglutinin) stimulation (1.24). The tubercu-lin reaction was negative. Colchicine was discontinued and the therapy with radiation and prednisolone (20mg/ day) was started under the diagnosis of intracranial primary malignant lymphoma. She was discharged without any neurological deficits on November 25, 1991. She still suffers from impaired visual acuity, but has no problems in daily life.

To our knowledge no intracranial primary malignant lymphoma following Behcet disease has been reported previously. The relationship between Behcet disease treated with colchicine and the occurrence of malignant lymphoma is discussed. In our case we speculated that malignant lymphoma might have occurred in an im-munosuppressive state due to administration colchicine.