めまいを呈する症例のヒト側頭骨病理所見

Human temporal bones pathology of patients with vertigo

生前，臨床的にめまい症状を有し，側頭骨病理所見において，このめまいを裏付ける明らかな所見を確認した3症例を紹介する。

　〈症例1〉：81歳女性，生前に繰り返すめまい，左感音性難聴を認めており，死後メニエール病と診断された。側頭骨病理所見では，左側頭骨に内リンパ水腫を認めた。

　〈症例2〉：25歳男性，突然の回転性めまい，頭痛，嘔気，嘔吐，左難聴にて発症，数日後には右難聴も出現し，両側高度感音難聴となった。患者は初発症状から42日後に死亡した。剖検の結果，膵臓癌の脳脊髄膜転移を認めた。側頭骨病理所見では，両側の内耳道に腫瘍細胞の浸潤を認めた。

　〈症例3〉：38歳男性，胃癌の骨髄転移による類白血病症例。死亡13日前に突然の回転性のめまいを伴う両側の高度感音難聴を認めた。側頭骨病理所見では，両側の内外リンパ腔に著しい出血を認めた。

We report 3 cases temporal bone pathology with vertigo in lifetime.

〈Case 1〉81-year-old woman, the giddiness repeated to a lifetime, and left sensory nerve hearing loss, and was diagnosed as the Meniere's disease after death, an endlymphatic edema was accepted in the left temporal bone.

〈Case 2〉25-year-old man. The initial symptoms began with vertigo and headache and the patient noticed left hearing loss on the following day. A few days later, he noticed hearing loss in the right ear, and bilateral hearing was totally lost within two weeks of the onset. The patient's general condition rapidly deteriorated, and he died on the 42nd day after onset. At autopsy it was revealed adenocartinoma of the pancreas and its metastasis to the brain and meninges. Pathological study of the temporal bone showed infiltration of carcinomatous cells along in the bilateral internal auditory canals.

〈Case 3〉38-year-old man. It is leucemoid reaction from bone marrow metastasis of/gastric cancer. This patient had experienced bilateral sudden deafness with sever vertigo, and he died on the 13nd day after onset. The severe hemorrhage was noted in the inner and outer lymph space at bilateral temporal bone.