Cronkhite-Canada症候群の1剖検例

An Autopsy Case of Cronkhite-Canada's Syndrome

　脱毛，色素沈着，爪の萎縮，低蛋白血症を伴うびまん性の消化管polyposisが，1955年はじめてCronkhiteおよびCanada¹⁾によって報告せられ，それ以来この稀な疾患はCronkhite-Canada症候群とよばれている．

　最近われわれはこの症候群と考えられる1症例を経験し剖検する機会を得た．ポリープの病理組織学的検索によりAdenomatous polypとは全く異った興味ある所見を得たので報告する．

　We had an autopsy case of Cronkhite-Canada's syndrome. The patient, 49-year-old male, developed emaciation, hyperpigmentation, alopecia and nail dystrophy. Laboratory investigations revealed marked hypoproteinemia, abnormal fecal ¹³¹I-PVP excretion (29%), hypoacidity of gastric juice and hypoglycemia. Roentgenographic examination showed numerous polypoid filling defects in the stomach and large intestine. He died from cachexia 5 months after the onset of his illness.

　Autopsy revealed giant rugal hypertrophy of the stomach with numerous polypoid protrusions. In the intestine, numerous polyps were found throughout the ileum and colon and a few in the rectum and duodenum. Hypertrophic rugae and petechial bleeding were also observed here.

　Microscopic examination of the polyps revealed cystic dilatation of the glands filled with inspissated mucus substance, hypersecretion of glandular epithelium, erosions with loss of mucosal surface and slight granulomatous inflammation with edema and lymphangiectasia in the lamina propria. These histologic findings were quite similar to those of juvenile polyp. Malignancy was not found in any specimen of the polyps.