皮下コレステロール性肉芽腫について

SUBCUTANEOUS CHOLESTEROL GRANULOMA

I．はじめに

　最近著者らはきわめて特異な組織像を示す一種の脂肪肉芽腫を経験した。組織学的に肉芽腫の大部分はエステル型コレステロールの結晶によつて占められ，これは1942年にUrbachが報告した皮下コレステロール性肉芽腫（Granuloma choles-terinicum subcutaneum）^1）に一致するものと思われる。以下にこの興味ある症例を報告すると共に本症の成因および独立性について検討を加えたい。

A case of granuloma cholesterinicum subcutaneum was reported of a 72-year-old Japanese woman who had three subcutaneous hard tumors of 1 to 1.5 cm in diameter on the extensor surface of lower third of arms. History of either injection or trauma was negative. Biopsy spec-imens showed a subcutaneous mass surrounded by connective tissue. A large part of the tumor was occupied by a peculiar form of clefts, filled with crystals of cholesterol ester, while calcified areas were seen at the periphery. Cellular infiltrates were composed of xanthoma cells, lymphocytes, plasma cells and a few giant cells.

The condition would be one of the subcutaneous lipogranulomas following fat necrosis, such as that in the female breasts. Although the reason why cholesterol ester deposits in the necrotic tissue is unknown, it would be worth keeping the entity as a specific variant of lipogranulomas because of the characteristic histologic picture. It should be an extremely rare disorder, and no case has been reported since the first case of Urbach.