頭頸部先天性嚢腫の3例—正中頸嚢腫，側頸嚢腫，口腔底皮様嚢腫

CONGENITAL CYSTS IN THE HEAD AND NECK REGION

　I．はじめに

　北里大学病院が開院されて約6カ月になるが，開院当初に目立つた不備な点が少しずつ改善され，当耳鼻咽喉科も徐々に整備されてくると同時に，しばしば興味ある症例に遭遇するようになつた。今回は，頸部の先天性嚢腫3例を続けて手術を行なう機会に恵まれたので報告し，諸賢のご批判を得たい。

　頸部の腫瘤は多種多様であるだけに，先天性嚢腫が統計上いかなる位置にあるかについて正確に知ることはむずかしい。Engzell^1）の報告によると，甲状腺疾患を除く1091例の頸部腫瘤に対してaspiration biopsyを行なつたところ，25例（2.3％）が先天性嚢腫であつて，転移性扁平上皮癌の1/10ぐらいに当たるということである。比較的少ない疾患と考えてよかろう。

　Three cases of congenital cyst of the head and neck arc reported.

　The first case a woman, aged 30, showed a thyroglossal duct cyst in the midline of the neck, just below the hyoid bone. The X-ray revealed a connection between the cyst and the foramen caecum by an internal fistula. The lining of the cyst was composed of columnar epithelium and stratified squamous epithelium.

　The second case a woman, aged 20, was found affected with a lateral cervical cyst, the so-called branchial cleft cyst. The lesion was located below the left angle of the jaw along the anterior border of the sternomastoid muscle. The microscopic study showed the wall of the cyst to be lined with stratified squamous epithelium and its subepithelial connective tissue contained some lymphoid tissues.

　The third case a woman, aged 34, showed a congenital inclusion dermoid cyst in the sublingual region. Histologically, the cyst wall showed squamous epithelium with dermal elements such as sebaceous and sweat glands with sub-epithelial connective tissues and muscular layers.

　A brief review is added on the subjects of embryology, symptomatology, physical Lndings, differential diagnosis, pathological anatomy and treatments of congenital cyst.