Plumonary lymphoproliferative disorder ¥ê¥ó¥ÑÁý¿£À­ÇÙ¼À´µ¡¡

Ç٤ηëÀá/¼ðáî¾õ¤¢¤ë¤¤¤Ï¤Ó¤Þ¤óÀ­¥ê¥ó¥Ñµå·ÏºÙ˦(¥ê¥ó¥Ñµå, ·Á¼ÁºÙ˦¾)¿»½áÁý¿£À­ÉÂÊÑ. È¿±þÀ­¤«¼ðáçÀ­¤«¤Î¿ÇÃǤξ, IgG4´ØÏ¢¼À´µ¤ämulticentric Castleman disease¤Ê¤ÉÁ´¿ÈÀ­¼À´µ¤ÎÇÙÉÂÊѤȤ·¤Æ¸½¤ì, ´ÕÊÌ¿ÇÃǤ¬É¬Íפˤʤë.

 

Pulmonary lymphoproliferative disorders*1

1. Nodular lymphoid hyperplasia (NLH)

2. MALT/ BALT lymphoma

3. lymphoid interstitial pneumonia (LIP)

4. IgG4 related lung disease

5. multicentric Castleman disease (MCD) --->MCDÇÙÉÂÊѤΥڡ¼¥¸

6. lymphomatoid granulomatosis (LYG) ---> LYG¾ÉÎ㡦²òÀâ¥Ú¡¼¥¸

nodular lymphomatoid hyperplasia (NLH)

ÉôʬŪ¤ËÀþ°Ý²½¤Îǧ¤á¤é¤ì¤ëæõÃæ¿´¤ò¤â¤Ä¥ê¥ó¥ÑßÉ˦·ÁÀ®¤Î¤á¤À¤ÄË­É٤ʥê¥ó¥ÑÁÈ¿¥ÁýÀ¸¤«¤é¤Ê¤ë¸Â¶ÉÀ­È¿±þÀ­ÉÂÊÑ.

  • µ¶¥ê¥ó¥Ñ¼ð¤È¤è¤Ð¤ì¤Æ¤¤¤¿¤¬, ¾ÉÎã¤Î¤«¤Ê¤ê¤Î¿ô¤¬Ã±¥¯¥í¡¼¥óÀ­Áý¿£¤ÎMALT¥ê¥ó¥Ñ¼ð¤Ç¤¢¤ê, ¥â¥Î¥¯¥í¡¼¥Ê¥ë¤ÊÁý¿£¤¬¸«¤¤¤À¤»¤Ê¤¤ÉÂÊѤËÂФ·, ÉÂÊÑ̾¤È¤·¤Æ»ÈÍѤ¹¤ë.
     
  • ¶»Ëì²¼ÇÙÁÈ¿¥Æâ¤Ë¶­³¦ÌÀÎÆ¤Ê·ëÀ᤬1¸Ä¤Ê¤¤¤·¿ô¸Äǧ¤á¤é¤ì¤ë. 0.5cm°Ê¾å¤Î¥µ¥¤¥º¤Ç5.0cm¤ò¤³¤¨¤ë¤â¤Î¤Ï¤Þ¤ì.
     
  • ¶»Ë켫¿È, µ¤´É»Ù¤Ë±è¤Ã¤¿Ê¬Éۤ϶¯¤¯¤Ê¤¤. ÇÙ˦Êɤ˱è¤Ã¤¿ºÙ˦¿»½á¤Ïǧ¤á¤Ê¤¤.
     
  • ´û¸¤ÎÇÙ¹½Â¤¤òÃÖ´¹¤·¤Æ, æõÃæ¿´¤ò¤â¤Ä¿¿ô¤Î¥ê¥ó¥ÑßÉ˦·ÁÀ®¤Ë¤è¤ë·ëÀá¤ò¼¨¤¹. ¥ê¥ó¥ÑßÉ˦¤Ï°Å, ÌÀÂÓ¤ÎÁؤò¼¨¤¹Àµ¾ïæõÃæ¿´¼þ°Ï¤ò¥Þ¥ó¥È¥ëÂÓ(IgDÍÛÀ­)¤¬°Ïå夹¤ë. ßÉ˦´Ö¤Ë¤ÏTºÙ˦¤¬Ë­ÉÙ¤ÇÀµ¾ï¤Ê¥ê¥ó¥ÑÁÈ¿¥Ìȱֹ½Â¤¤òÊݤäƤ¤¤ë.
     
  • À®½Ï¥ê¥ó¥Ñµå, ·Á¼ÁºÙ˦¤¬·ëÀáÀ­¤ËÁýÀ¸¤·, ÉÂÊÑÃæ¿´¤Ë¤·¤Ð¤·¤Ð¼ï¡¹¤ÎÄøÅÙ¤ÎÀþ°Ý²½¤òǧ¤á¤ë¤¬²õ»à¤Ï¤ß¤é¤ì¤Ê¤¤.
     
  • ·Á¼ÁºÙ˦¤Ë¤ÏRussell body¤äMott cell¤¬¸«¤é¤ì¤ë. °Û·¿½ê¸«¤Ç¤¢¤ëDutcher body(³ËÆâÉõÆþÂÎ)¤Ï¸«¤é¤ì¤Ê¤¤.
     
  • ¼þ°ÏÇÙÁÈ¿¥¤Ëµ¤¹ÐÆâ´ï¼Á²½(organizing pneumonia:OP)½ê¸«¤¬»¶¸«¤µ¤ì¤ë¤³¤È¤¬¤¢¤ë.
     
  • MALT lymphoma¤Î½ê¸«¤Ç¤¢¤ë, LEL¤äfollicular colonization¤Ï¤Ê¤¤.
     
  • Ìȱ֥°¥í¥Ö¥ê¥óLº¿¤Ïpolyclonal pattern. IgHºÆ¹½À®¤Ï¸¡½Ð¤µ¤ì¤Ê¤¤.
     
  • LIP¤È¤Ï, ÇÙ˦Êɤ˱褦ºÙ˦¿»½á¤Ï·ÚÈù¤Ç¤Ó¤Þ¤óÀ­ÉÂÊѤǤϤʤ¯, ·ëÀáÀ­/¼ðáî·ÁÀ®À­ÉÂÊѤǤ¢¤ë¤³¤È¤Ç´ÕÊ̤¹¤ë.

*1  »ûºêÂÙ¹° ÇÙ¡¦Èó¼ðáçÀ­¼À´µ(ÇÙ¼À´µ¤ÎΩÂÎŪÍý²ò¤Ë¸þ¤±¤Æ)­¶:´Ö¼ÁÀ­ÇÙ±ê°Ê³°¤ÎÈó¼ðáçÀ­¼À´µ ¥ê¥ó¥ÑÁý¿£À­ÇÙ¼À´µ ÉÂÍý¤ÈÎ×¾² 2014; 32(10):1109-1116

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Last-modified: 2020-07-16 (ÌÚ) 13:56:31 (191d)