腫瘤形成性白血病1症例の側頭骨病理

The Temporal Bone Pathology of Tumor-Forming Type Leukemia

　はじめに

　白血病に耳科的症状が合併することは，既に19世紀半ばより知られ，白血病における側頭骨病理について多数の報告^1〜4）がある。しかし，詳細な浸潤様式や経路，また最近の治療の進歩にともなう病態の変化についての検討は少ない。今回われわれは，腫瘤形成性白血病の1症例を通して，白血病細胞が多発・散発性に側頭骨内に浸潤した機序と経路および治療抵抗性のtumor-forming type（腫瘤形成性）の白血病像を呈した点について検討したので報告する。

We examined leukemic infiltration in the tempo-ral bones in a case of acute promyelocytic leukemia. There were different infiltrating patterns of leukemic cells including subcutaneous tumor obstructing the right external auditory meatus, intramucosal inva-sion in different areas of the middle ears and per-ineural invasion in the left facial nerve. There was neither bone destruction nor disruption of the tympanic membrane and the nerve fibers. Each infiltrating area was independent and responsible for the supplying artery. This case showed tumor-forming infiltration in despite of non-solid tumor, which was notable in a poor prognostic sign of leukemia.