手指壊疽を免れたクリオグロブリン血症─B細胞リンパ腫の早期治療により手指の冷感が改善した症例─

・手指の壊死所見からクリオグロブリン血症が疑われ，全身精査の結果B細胞リンパ腫が発見された1例を報告した．・クリオグロブリン血症およびB細胞リンパ腫の診断に対して皮膚科的なアプローチが有効であり，リンパ腫の治療が早期に行われたことで手指の壊死を最小限にとどめられ切断を免れた．（「症例のポイント」より）

A case of cryoglobulinemia in which early diagnosis and treatment prevented her from digital amputation Washio, Ken1）Fujii, Shotaro2）Hashimoto, Akiko3）Shinzato, Isaku3）Hashimoto, Kimio4）Masaki, Taro2） 1）Department of Internal Related, Division of Dermatology, Kobe University Graduate School of Medicine 2）Department of Dermatology, Kobe City Nishi-Kobe Medical Center 3）Department of Immunology and Hematology, Kobe City Nishi-Kobe Medical Center 4）Department of Pathology, Kobe City Nishi-Kobe Medical Center Abstract We report a case of cryoglobulinemia caused by B-cell lymphoma. An 83-year-old female was referred to our hospital for digital discoloration with pain. A close examination revealed cryoglobulinemia. Also, a biopsy from infraspinatus muscle confirmed B-cell lymphoma. We performed R-THPCOP therapy against the lymphoma which led to the improvement of digital blood flow. A dermatological approach was effective for early diagnosis of cryoglobulinemia and B-cell lymphoma so that we could prevent her from digital amputation.