最近の咽喉頭結核

CURRENT CASES OF PHARYNGO-LARYNGEAL TUBERCULOUSIS

　最近，予防医学の発達ならびに抗結核剤の出現によつて，結核性疾患が激減し，かつては耳鼻咽喉科領域においてもつとも重篤な悲惨な臨床的経過を示した咽喉頭結核は一般にほとんどみられなくなつたことは大いに喜ばしいことである。しかし，これらの結核性疾患は必ずしも根絶したものではなくて，過去におけるほど，激甚で，悲観的予後が予測されるものはないが，やや変つた形で出現し，ときには，腫瘍性疾患と間違えられることがある。以下，最近経験した症例を示して，若干の知見を述べてみたい。

　This presentation concerned 6 cases with pharyngeal tuberculosis recently diagnosed at our out-patient clinic. The pharyngolaryngeal lesions were either heamatogenous or lupous and were characterized by edematous inflammation with shallow ulceration in the tonsils, lateral bands and soft palate, and/or tumorous swelling of the epiglottis. The histological examination of the biopsies of the lesions revealed productive tubercles consisting of epitheloid cells and giant cells. The chest X-ray films showed milliar dissemination due to acute exacervation of latent pulmonary tuberculosis in 4 cases and no marked changes in 2 cases with lupus except calcification of parabronchial lymphnodc tuberculosis. Nowadays, the so-called heamatogenous pharyngo-laryngeal tuberculosis is prone to be found, but the so-called bronchogenous laryngeal tuberculosis, which develops at the vocal region, is rather rare in our clinic.