耳下腺結核の3症例

TUBERCULOSIS OF THE PAROTID GLAND: A REPO-RT OF THREE CASES

　I．緒言

　結核の発生頻度は化学療法の進歩，社会環境の改善に伴って著しく減少し，予後も良くなっている。しかし，結核は根絶されたわけでなく依然として重要な疾患の一つである。特に活動性病変を非特異的炎症あるいは腫瘍と誤診し，適切な処置を怠ると感染源となり，社会的な問題になる危険がある。

　筆者らは昭和47年4月から54年9月までの7年6カ月間に耳下腺結核を3例経験した。3例中1例は顔面神経麻痺を伴い，術前には耳下腺悪性腫瘍と，他の1例は混合腫瘍と診断した例であり，術前に結核を疑い得たのは1例のみであった。

　Three cases of tuberculosis of the parotid gland are reported with consideration on the route of infection. Histological examinations indicated that two cases were resulted from lymphogenous infections. The origin of the other case was obscure. Preoperatively, only one case (Case【II】) having a fistula formation was properly diagnosed as tuberculosis. Case I, a 82-year-old female with slight facial weakness was misdiagnosed as malignant tumor, and Case 【III】, a 20-year-old female, was diagnosed as mixed tumor.

　Since 54 cases of parotid tumors including 25 mixed tumor cases were experienced in our clinic during the identical period, the incidence of tuberculosis of the parotid gland seems rather high in comparison with those reported elsewhere.

　We emphasize that tuberculosis of the parotid gland should be included in the differential diagnosis of the parotid mass.