Lymphoplasmacyte-rich Meningiomaの3例

Lymphoplasmacyte-rich Meningioma : a report of three cases and a review of the literature

I．はじめに

　meningiomaの数ある組織分類の中でlympho-plasmacyteの著明な浸潤を特徴とするlympho-plasmacyte-rich meningiomaがある．一般的にmeningiomaの組織像には炎症細胞の浸潤が認められることもあるが，それらと比較して広範囲にリンパ球や形質細胞の浸潤がみられ，臨床上polyclonal gammopathyやanemiaを伴う^8）．

　今回われわれは，CT及びMRI上腫瘍の大きさに比し広範囲な脳浮腫を伴い，硝酸亜鉛混濁試験（ZTT）値の上昇が認められるテント上の髄膜腫を3例経験した．手術後の病理組織学的所見より，lymphoplasmacyte-rich meningiomaと診断した．

We report three patients (a 36-year-old man, a 41-year-old woman, and a 22-year-old man) withlymphoplasmacyte-rich meningioma who manifested characteristics on radiological and blood examina-tions. Two were hospitalized with gradual deterioration of hemiparesis and one with general convulsiveseizure. Radiological examination revealed typical meningiomas of convexity in two and that of falx in one.Two of the patients showed large perifocal edema. Anemia was found in one patient and an elevated levelin the zinc sulfate turbidity test was noted in all cases. Abnormal findings in laboratory examination im-proved quickly, whereas perifocal edema remained for six months after tumor removal. The tumors werehistologically confirmed to be meningioma with massive infiltrates of plasma cells and lymphocytes. Seven-teen cases of lymphoplasmacyte-rich meningioma that have been reported to date including our three caseswere reviewed.