舌側縁の潰瘍形成に始まつたReticulohistiocytosisの一症例

RETICULOHISTIOCYTOSIS, A CASE REPORT

　I．はじめに

　retikulohistiocytosisまたはhistiocytic medullary reticulosis（以下HMRと略す）は，1939年Scott，Robb-Smithによりatypical Hodgkin's diseaseの中から分離されたもので，臨床的には，発熱，消耗，貧血，肝脾腫，リンパ節腫脹などを主症状とし，多くは6カ月以内に死亡し，組織学的には，histiocyteやprohistiocyteのsystemicproliferationの像を示す疾患である。

　われわれは，最近，舌側縁の潰瘍形成に始まり，両側顎下部リンパ節腫脹を初発症状とし，同時に血清IgE値の著明な上昇を認め，舌側縁の組織生検では，著明なhistiocyte，reticulum cell，lymphocyteのproliferationを示し，臨床経過からみても，HMRと診断され得る症例を経験したので報告する。

　Many cases that are regarded as reticulohistiocytosis or histiocytic medullary reticulosis have been reported in the past.

　Recently, however, we have experienced a case in a 20 year old male whose initial symptoms were severe ulcer on the left side of the tongue, swelling of both submandibular lymph nodes with high temperature.

　The histological findings from the sections of the ulcerative tissues of the tongue taken by biopsy are as follows :

　1. Histiocytic and lymphocytic cells were found markedly infiltrating the subeubepithelial region including the layer of the skeletal muscles.

　2. Polymorphonuclear leukocytes and plasma cells were seen to a lesser degree in this region.

　3. Atypical large bezarre cells with irregularly shaped nuclei were occasionally observed.

　The serum immunoglobin level, especially that of IgE (10,000 U/ml) was much higher than that of the normal individuals.

　The patient died 6 months later with swelling of lymph nodes throughout the body and with high temperature.

　Autopsy was not performed.