松果体腫の組織構造を有する腦腫瘍の一例

A Case of Pinealoma

I．緒言

　松果体腫瘍は分泌学的，病理学的及び臨牀的に極めて興味深いものがある。その報告例は比較的稀で外国に於ては約200例があり，本邦では大正二年武谷氏の報告に始り，その後40例内外を数えるに過ぎない。而もその大部分は定型的に松果体から発生したものであり松果体以外から出たものは本邦では三症例を散見するに過ぎない。私共は，頭痛，全身倦怠，記憶力減退等で始り，次いで左側顔面神経不全麻痺，同側半身不髄及び興味ある神経症状，精神症？を来した15歳の男子を診療し脳腫瘍と診断したが，剖検の結果，視束交叉部附近から発生したと考えられる略定型的な松果体腫が確認されたので，以下その症例を報告する。

Of a case of pinealoma, clinical and patho-logical findings are here going to be reported. 1) The patient was a middle school-boy of 15 years of age. The onset began with head-ache, general fatigue, vomiting, lethargia and the weakness of memory. These symp-toms became more conspicuous gradually for seven months and thereafter they were accom-panied with paresis of the left half of the face, the left side hemiplegia, hemihyperes-thesia in the right and hemihypesthesia in the left half of the body and finally distur-bance of impressibility, conscioūsness and orientation etc. He died after he had been suffering from his illness about nine months, Whenever tried a lumbal punctur, I found that the pressure was high and cerebrospinal fluid was in the state of pleocytosis. 2) This tumor was formed by projecting cysts of a finger-tip size in the chiasmal region and in this tūmor slightly tūrbid fluid (Ca 100cc) was contained and involved the adjacent parts ardunds the third ventricle, j. e., Nucl. cau.-datus et lentiformis, thalamus, capsula inte-rna, and hypothalamic region of the right sade and further a part of Nucl. caudatus and thalamus of the left side. But pituitary and pineal body were not invaded by tumor cells. 3) Bilateral hydrocephalus internus, especially marked at the right side, caused by the blockade of the passaway of cerebro-spinal fluid at the Foramen interventiculare and the stricture of the third ventricle. This tumor was exposed on the surface of side ventricle. 4) We could confirm a nearly typical Pinealoma by means of histological search.