Podophyllotoxin製剤VP-16により寛解をみた悪性リンパ腫の1例

Remission of malignant lymphoma with podophyllotoxin (VP-16). Report of a case

　眼症状を初発とし，皮下腫瘤生検の結果悪性リンパ腫と診断された50歳男子の1症例を経験した．

　入院時に認められた両眼瞼腫脹，眼球運動障害，左眼瞼下垂に加え，両眼線維素性虹彩毛様体炎症状の出現，増悪をみた．眼窩部CT検査では右外直筋および左内直筋の肥厚を認めるものの，masslesionは認められなかった．

　この症例に対しVP-16（総量3,400mg）を投与し，眼症状および全身症状の改善をみた．

A 50-year-old male presented with bilateral ophthal-moplegia and lid swelling, followed by iridocyclitis and soft exudates in the fundus. Biopsy of the subdermal tumor led to the diagnosis of malignant lymphoma of diffuse and large cell type. Computed tomography showed swelling of the extraocular muscles and absence of tumor-like lesion in the orbit.

The patient developed, two months later, swelling of inguinal and subclavicular lymphnodes, subdermal tumor in the abdomen, hepatosplenomegaly, pleocytosis in the cerebrospinal fluid, atrioventicular block and exudative pleuritis. Improvement in ocular manifesta-tions and general symptoms resulted following systemic use of podphyllotoxin derivative, VP-16, in a total dosis of 3,400 mg.