呼吸器系統ならびに近接腺臓器を侵した原因不明の急性型肉芽腫症の1剖検例

　I．緒言

　原因不明の肉芽腫症として，進行性壊疽性鼻炎，Wegener氏病，ホジキン氏病，茸状肉芽腫，類肉腫，好酸球性肉芽腫，Küttner氏腫瘍及び類ロイマチス性疾患とか，膠原病なる概念の下に包含される多数の肉芽性炎がある。殊に進行性壊疽性鼻炎，Wegener氏病は耳鼻咽喉科領域に見られる原因不明肉芽腫症の代表的なもので，従来その報告も多数ある。

　吾々は最近，恰も悪性腫瘍の如き臨床所見を呈した患者が，急激な経過を辿り，剖検の結果，上記の何れの疾患とも類似しない甚だ特異な肉芽腫を主体とせる症例に遭遇したので，以下症例を述べ，少しく考察を加えて諸賢の御批判を仰ぎたい。

The patient a woman, aged 26, complaining of severe nasal obstruction and persistent cough with findings of moderate degree of dyspnea and marked swelling of glands, paro-tids, submaxillary and mammary, died on the 4th day of hospitalization. In order to esta-blish a diagnosis post mortem examination was performed.

This examination revealed a generalized granulomatous growth that involved the na-sal mucous membrane, paranasal sinuses, parotid, submaxillary and sublingual glands, lungs, branches of bronchial tubes, thoracic lymph nodes, mammary glands and the liver. Neither malignant cells nor acid-fast bacilli were found in these or ans. The authors were forced to regard the cause of this gra-nuloma to be unknown.