眼底出血を呈した組織球貧食性脂肪織炎の1例

A case of cytophagic histiocytic panniculitis with retinal hemorrhage

（P3-1-12）　症例は70歳男性。眼球運動時の痙痛のため当科を紹介され受診した。両眼眼底出血と白斑を認め．当初貧血によるものと考えた。皮下結節生検により，組織球貪食性脂肪織炎と診断され，ステロイド治療を行った。再診時に眼底出血は消え，白斑もほぼ消失していた。この時には皮下結節は治癒していたが，貧血は改善していなかった。この症例でみられた眼底所見は．貧血によるものでなく，組織球貪食性脂肪織炎の炎症が網膜に及んだためと考えられた。

A 70-year-old male was referred to us for ocular pain during eye movement. Severe anemia and thrombocytopenia had been detected shortly before. He had subcutaneous nodules in the extremities and the cheek. Painful tumor was also present in the scrotum. Biopsy of the skin and scrotum lesions led to the diagnosis of cytophagic histiocytic panniculitis. Funduscopy showed hemorrhagic patches and soft exudates in both eyes. The visual acuity was not affected. Systemic corticosteroid led to improvements in the skin and fundus lesions. Anemia and thrombocytopenia resisted treatments including blood transfusion. This case illustrates that cytophagic histiocytic panniculitis may involve the fundus as an inflammatory manifestation.