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要約 19歳男性が5か月前からの右眼球突出と流涙で受診した。矯正視力は右0.7,左1.2であり,眼球突出度は右20mm,左13mmであった。右眼底に脈絡膜皺襞があった。CT検査で右眼窩内に30×20mmの卵円形の腫瘤があり,これを摘出した。腫瘤は充実性で被膜に包まれていた。病理組織検査で,腫瘍細胞はpatternless patternの配列であった。免疫組織染色で,vimentinに陽性,CD34に強陽性を示した。これにより孤在性線維性腫瘍(solitary fibrous tumor)の診断が確定した。術前の磁気共鳴画像検査(MRI)で,腫瘍はT1強調画像で低信号,T2強調画像で不均一な高信号を示し,Gd-DTPAで腫瘍辺縁部に強い造影があった。摘出した腫瘍の被膜には血管成分があり,これが特徴的な画像所見を示した原因であると考えた。
Abstract. A 19-year old male presented with proptosis and epiphora in his right eye. His corrected visual acuity was 0.7 right and 1.2 left. Exophthalmometer by Hertel showed 20 mm right and 13 mm left. His right eye showed choroidal folds. Computed tomography(CT)showed an oval tumor measuring 30×20 mm in the orbit. Surgically excised tumor was solid and encapsulated. By histopathology,the tumor cells were arranged in a patternless patten. By immunohistochemistry,the tumor was positive for vimentin and strongly positive for CD34. These findings led to the diagnosis of solitary fibrous tumor. By magnetic resonance imaging(MRI),the tumor had low intensity in T1-weighted picture,high intensity in T2-weighted one,and was enhanced with gadolinium-DTPA. These finding were compatible with the vascularized capsular membrane of the excised tumor.
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