眼瞼と結膜下に発生したカポジ肉腫の1例

A case of Kaposi sarcoma in the palpebral and bulbar conjunctiva

要約　目的：AIDS患者の眼瞼と球結膜下に生じたカポジ肉腫の報告。

症例：49歳の男性が3か月前に右眼充血を自覚して近医を受診した。流行性結膜炎と診断され，点眼加療を受けたが改善せず，当科を紹介され受診した。

所見と経過：右眼に強い結膜下出血と充血があり，瞼結膜と球結膜下に無痛性の硬い隆起があった。ベタメタゾンの点眼は奏効しなかった。生検の術前採血でHIV-1抗体が陽性であった。右眼の瞼結膜下の腫瘍を生検し，病理検査でCD31，CD34，D2-40，HHV-8が陽性で，カポジ肉腫と診断した。

結論：結膜炎としての投薬に反応しない無痛性の結膜下に隆起する病変では，カポジ肉腫である可能性がある。

Abstract　Purpose：To report Kaposi sarcoma in the bulbar and palpebral conjunctiva in a case with acquired immune deficiency syndrome（HIV）.

Case：A 49-year-old male had noted hyperemia in the right eye 3 months before. He was diagnosed with epidemic keratoconjunctivitis. Treatment was apparently ineffective. He was then referred to us.

Findings and Clinical Course：The right eye showed marked hyperemia and hemorrhage in the bulbar conjunctiva. Painless elevation was present in the bulbar and palpebral conjunctiva. There was no improvement after topical corticosteroid treatment. He was scheduled for biopsy of the palpebral lesion. Hematological study was positive for CD31, CD34, D2-40 and HHV-8, leading to the diagnosis of human immunodeficiency syndrome（HIV）. By biopsy, the palpebral tumor showed spindle cells and was diagnosed with Kaposi sarcoma.

Conclusion：This case illustrates that Kaposi sarcoma may manifest as tumor of the bulbar or palpebral conjunctiva that withstands routine treatment.