喉頭のspindle cell squamous carcinomaの1例

A CASE OF SPINDLE CELL SOLTAMOUS CARCINOMA OF THE LARYNX

　I．はじめに

　bimorphic patternすなわちsquamous cellcarcinomaとsarcoma-like stromaよりなる一群の疾患に対しては，pseudocarcinosarcoma（1931，Dal Pozzo），carcinosarcoma（1938，Saphir andVass），carcinoma with spindling sarcomatousareas（1940，Frank and Lev），pseudosarcoma（1957，Lane），spindle cell carcinoma（1963，Sherwin），squamous cell carcinoma with sarcomalikc stroma（1965，Appelman），pleomorphiccarcinoma（1965，Himalstein），spindle cell squamous carcinoma（1970，Lichtiger）など，多くの名称とともにstroma様部分の主微をなすspindle cellのhistogenesisおよびそのmalignantpotentialに関する問題についての議論も多く存在する。われわれは最近，喉頭に原発したspindlecell squamous carcinomaを経験したので，その組織学的な特徴に文献的考察を加え報告する。

　Bimorphic pattern, squamous carcinoma and a stroma composed of malignant-appearing spindle cells, is a rare and controversial lesion reported in many organs including the larynx. This report describes spindle cell squamous carcinoma of the larynx in which a surgical procedure was necessary for progressive airway obstruction by recurrent polypoid mass in the tracheal remnant 8 months after laryngectomy.

　In this case, a transition from squamous to spindle-shaped cells was observed, and the carcinoma occupied relatively large portion of tumor and it was moderately well differentiated, whereas the sarcoma-like areas were anaplastic. This was not reparative or reactive process, because there was no capillary proliferation in the apparently sarcomatous areas.