髄内血腫による脊髄横断症状をきたしたAstrocytomaの1例

A Case of Spinal Astrocytoma Presenting Spinal Transverse Sign due to Hematomyelia

I．はじめに

　急性の脊髄横断症状をきたす疾患のなかで，脊髄髄内腫瘍による腫瘍内出血は念頭に置くべき疾患であるが，その報告は少なく，なかでもastrocytomaからの髄内血腫により脊髄横断症状をきたして発症したとする報告はきわめてまれである^1,2,13,17）．

　今回，われわれは急性の脊髄横断症状をきたして発症し，MRIにより原因不明の髄内血腫と診断し，緊急手術により血腫を摘出したが，その採取した血腫腔組織からastrocytoma grade 2と病理組織学的に診断された1例を経験したので，本症例を提示するとともに文献的考察を加え報告する．

An unusual case of cervical astrocytoma due to hematomyelia was reported.

A 68-year-old man was admitted to our institute be-cause of sudden onset of paraplegia and urinary and bowel disturbance. CT and plain X ray on admission showed no abnormal findings, but emergency MRI re-vealed a high signal intensity area in Th 8-9 level on T1 weighted image. Preoperative diagnosis was idiopathic hematomyelia and emergency laminectomy was performed.

After the dural incision from Th 8-10, the intramedul-lary hematoma was totally removed, but at the cephalic portion within the hematoma cavity an abnormal tumorous tissue was detected. It was noticed with the bleeding sauce of hematomyelia, and it, too, was totally removed.

The microscopic finding concerning the surgical specimen was fibrillary astrocytoma (grade 2), and its vascular component was relatively rich.