急速な喉頭浮腫をきたした悪性リンパ腫の2症例

Aggressive laryngeal edema caused by Malignant lymphoma：a report of two cases

Ⅰ　はじめに

　悪性リンパ腫は，日頃の外来診療で忘れてはならない疾患の1つである。今回，無痛性両側頸部リンパ節腫脹が出現し，1か月後には顔面頸部腫脹，喉頭浮腫が起こり，診断前に気管切開を必要とした悪性リンパ腫症例を2例経験した。2例とも，急速なリンパ節腫脹が内頸静脈を圧迫し，静脈還流障害により浮腫を起こしたことが原因と考えられた。この悪性リンパ腫症例を呈示し，この病態について考察する。

　We report two patients who needed urgent tracheotomy and were subsequently diagnosed with malignant lymphoma. Their initial symptom was a swelling of bilateral cervical lympho nodes. One month later they visited our hospital with dyspnea caused by edema of the laryngeal mucosa,and of the face and neck. Enhanced CT revealed that the multiple enlarged cervical lympho nodes caused obstruction and stenosis of the internal and external jugular veins,but there was no swelling of the mediastinal lympho nodes. Malignant lymphoma was confirmed after tracheotomy and biopsy of a cervical lympho node,and both patients received started chemotherapy.