腎移植後の多発性脳悪性リンパ腫の1例

A case of malignant lymphoma after renal transplantation

I．はじめに

　免疫抑制剤の投与に伴い悪性リンパ腫が発生することは諸外国に於いては比較的よく経験されているが，わが国に於いては移植例そのものが少ないことより比較的稀である^{1,10-12,14,21,31,35）}．しかもほとんどが，リンパ節に発生したものであり，脳に発生した報告例はわが国においては調べ得た範囲で2例見られるのみである^8,20）．われわれは，腎移植後の免疫抑制剤投与によると思われた脳の悪性リンパ腫の1症例を経験したので考察と共に報告する．

A case of a primary brain malignant lymphoma after renal transplantation and immunosuppressive therapy is reported. A 41-year-old male patient had been treated with 125mg/day of azathioprine and 10mg/day of pre-dnisolone after renal transplantation. He had also been suffering from various infectious diseases. Multiple brain tumors were found and diagnosed as having B-cell, diffuse large cell type malignant lymphoma. In spite of moderate response to irradiation, he died of pneumonia. The anti-Epstein Barr virus antibodies changed from a negative to a positive level after renal transplantation and they increased markedly after brain malignant lym-phoma had been found. The number of T- and B-lymphocytes also decreased markedly at that time. So the Epstein-Barr virus was suspected to be the cause of the malignant lymphoma.