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Neurological Surgery No Shinkei Geka Volume 28, Issue 2 （February 2000）

Neurological Surgery 脳神経外科 28巻2号（2000年2月発行）

Japanese English

症例

慢性硬膜下血腫の血腫細胞診および外膜の病理所見から悪性腫瘍が判明した3症例 Chronic Subdural Hematoma Associated with Malignancy : report of three cases 増山祥二 ¹ , 府川修 ¹ , 三谷慎二 ¹ , 伊藤誠康 ¹ , 伊藤健司 ² , 浅野重之 ³ Shoji MASHIYAMA ¹ , Osamu FUKAWA ¹ , Shinji MITANI ¹ , Seikou ITO ¹ , Kenji ITO ² , Shigeyuki ASANO ³ ¹いわき市立総合磐城共立病院脳神経外科 ²いわき市立総合磐城共立病院病理科 ³いわき市立総合磐城共立病院血液内科 ¹Departments of Neurosurgery, Iwaki Municipal Sogo Iwaki Kyoritsu Hospital ²Departments of Pathology, Iwaki Municipal Sogo Iwaki Kyoritsu Hospital ³Departments of Hematology, Iwaki Municipal Sogo Iwaki Kyoritsu Hospital キーワード： chronic subdural hematoma , cytological examination , pathological finding , malignancy Keyword: chronic subdural hematoma , cytological examination , pathological finding , malignancy pp.173-178

発行日 2000年2月10日 Published Date 2000/2/10

DOI https://doi.org/10.11477/mf.1436901851

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Abstract 文献概要
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I．はじめに

　慢性硬膜下血腫（以下CSH）は，血腫穿頭術で比較的容易に治癒が得られる疾患であるが，基礎疾患がある場合必ずしもよくないことがある．今回われわれは，同疾患で手術を行った際の血腫smearによる細胞診所見あるいは血腫外膜の病理所見から，悪性腫瘍が判明した3症例を経験したので，文献的考察を加え報告する．

Three cases of chronic subdural hematoma (CSH) associated with malignancy are reported.

Case 1; A one-year-old girl was referred for vomiting and convulsions. Left CSI I was removed, and her symptoms disappeared. Cytological examination of chronic subdural hematoma revealed abnormal white blood cells. A clinical diagnosis of acute monocytic leukemia was made after the laboratory examination. Remission was achieved by chemotherapy, but she died one year after the operation.

Case 2 ; A 72-year-old woman was referred for right hemiparesis and urinary incontinence. Left CSH was irrigated, and her clinical symptoms immediately disappeared. Cytological examination of chronic sub-dural hematoma revealed abnormal white blood cells. A clinical diagnosis of chronic lymphocytic leukemia was made after the laboratory examination. No treatment was given since there were no clinical symptoms of chronic lymphocytic leukemia.

Case 3 ; A 70-year-old woman who had been affected with early gastric cancer and mammary cancer for the previous two years was admitted to our clinic because of headache, right hemiparesis and conciousness disturbance. Left CSH was irrigated, and her clinical symptoms improved. However, there was a tendency to bleed because disseminated intravascular coagulation had occurred, and CT showed bilateral subdural hematoma. A second irrigation was performed, but her symptoms did not improve. Left acute subdural hematoma, which was removed by craniotomy, occurred three days after the second operation. Pathologi-cal examination of the outer membrane of the subdural hematoma revealed invasion of adenocarcinoma.She died three clays after the third operation.

It is recommended that both the cytological and the histological examinations be performed when possi-ble, since they are simple to perform and very useful in some cases.