悪性腫瘍を疑った扁桃結核の1例

A Case of Tonsillar Tuberculosis:Diagnostic Dilemma with Tonsillar Carcinoma

　緒言

　化学療法の発達と結核対策の普及に伴って結核症は減少した。耳鼻咽喉科領域における結核性病変も例外ではないが，未だわれわれの日常診療において散見される。平成2年度厚生省の結核統計では今なお年間約5万人もの患者が新たに登録されている^1）。今回われわれは，扁桃原発の悪性腫瘍を疑って生検を施行したところ，扁桃結核と判明した1症例を経験したので報告する。

A 42-year-old man complained of severe sore throat especially during swallowing. The left tonsil revealed a reddish, swallen mass with rough surface.

The tonsillar swelling was extended from the lateral pharyngeal lymphatic band toward the mesopharynx. Biopsy was performed from the left tonsil. Because of the appearance of the mass, malignancy was suspected. However, pathology revealed the findings compatible with tuberculosis. The patient was treated with antituberculous agents, Streptomycin, INH, and RFP. Although tuberculosis is no longer a popular disease in Japan, we still have to bear in mind that it happens in some patients. In this case, the correct differential diagno-sis between tuberculosis and carcinoma was impor-tant.