局所への非根治的放射線照射後に退縮をみた—高齢者非ホジキン・リンパ腫の1例

Remission of Non-Hodgkin's lymphoma after Radiotherapy:Report of a Case

　はじめに

　悪性リンパ腫は，一般に放射線感受性が高い腫瘍として知られている。また，この腫瘍では稀に自然退縮^1）や放射線照射を受けた部位以外の腫瘍組織が反応（退縮）するというabscopal effect^2）が報告されている。今回われわれは，咽頭・頸部・縦隔に発生した非ホジキン型悪性リンパ腫が，咽頭局所への少量放射線照射後に他部位の病変も含めて退縮した症例を経験したので，ここに報告する。

An 85-year-old male complained of nasal obstruc-tion, and a nasopharyngeal mass and enlarged cer-vical lymph nodes were observed. A bulky medias-tinal mass was revealed on CT. The diagnosis of non-Hodgkin's lymphoma (diffuse small clear cell type) was made by biopsy of the nasopharyngeal mass.

Dyspnea and dysphagia were appeared because of increasing nasopharyngeal tumor 4 weeks later. The non-curative dose of irradiation to the pharyngeal tumor was initiated. However, irradiation (total 7.2 Gy) was discontinued because of development of sepsis.

For the following two weeks, the patient im-proved in his clinical symptoms, and the pharyngeal tumor and the enlarged cervical lymph nodes disappeared. We thought this phenomenon a “spon-taneous regression” or an “abscopal effect”.