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ケニア西部におけるrhinoscleromaと鼻腔内腫瘍


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Title: ケニア西部におけるrhinoscleromaと鼻腔内腫瘍
Other Titles: Rhinoscleroma in Western Kenya: Report of Three Cases with Characteristic Features
Authors: 鳥山, 寛 / 宇津, 田含 / 千馬, 正敬 / 板倉, 英世 / KAMIDIGO, NOAH. O.
Authors (alternative): Toriyama, Kan / Uzuta, Fukumu / Senba, Masachika / Itakura, Hideyo / Kamidigo, Noah O.
Issue Date: 27-Dec-1986
Publisher: 長崎大学熱帯医学研究所 / Institute of Tropical Medicine, Nagasaki University
Citation: 熱帯医学 Tropical medicine 28(4). p241-249, 1986
Abstract: RhinoscleromaはKlebsiella rhinoscleromailsを原因菌とする,主として鼻腔粘膜に生じる慢性肉芽腫性疾患である.かつては欧米先進諸国にも存在したが,現在では熱帯,亜熱帯地方に局在しており特にエジプトを中心とする北アフリカ,エルサルバドルを中心とする中南米からの報告が多い.過去にケニアからの詳細な報告はなかったが,我々は1979年から1985年にわたってケニア西部,リフトバレー,ニャンザ,ウエスタン州の外科生検材料,総数23,721のうち48例の鼻腔内腫瘍様病変を検索し3例のrhinoscleromaを得た.患者は3例とも比較的,降水量の多い農村地帯に居住する成人であった.病理組織学的にrhinoscleromaは病変部におけるミクリッツ細胞及び形質細胞由来であるラッセル小体の浸潤を特徴としており組織球由来のミクリッツ細胞に貧食されたK. rhinoscleromatisと思われる桿菌はWarthin-Starry法で明瞭に染色された.腫瘍及び腫瘍様疾患としては扁平上皮癌,rhinosporidiosis.未分化悪性腫瘍,悪性黒色腫の順に多かったがrhinoscleromaと他の悪性腫療との合併,或いはrhinoscleromaの悪性変化はみられなかった. / We report three cases of rhinoscleroma in western Kenya with their characteristic histological features. During the period of seven years from 1979 to 1985, 23, 721 surgical pathological specimens were examined in western Kenya. Fortyeight cases were diagnosed clinically as tumor or tumorous lesion in the nasal cavity. Three of them were identified as rhinoscleroma histologically. Rhinoscleroma showed characteristic appearances. There was moderate infiltration of foamy-shaped histiocytes (Mikulicz's cells), plasma cells with Russell's bodies and lymphocytes beneath the nasal mucosa. Rod-shaped bacilli were phagocitized by Mikulicz's cells and were demonstrated clearly by Warthin-Starry stain. Rhinoscleroma is a relatively rare disease in this area. All patients were adults and lived in the tropical areas with relatively plentiful rainfalls. The most common tumor or tumorous lesion in the nasal cavity in western Kenya was histologically squamous cell carcinoma, followed by rhinosporidiosis, undifferentiated malignant tumor and malignant melanoma. We have not seen any rhinoscleroma which showed malignant transformation or was complicated by other malignant tumors.
URI: http://hdl.handle.net/10069/4454
ISSN: 03855643
Type: Departmental Bulletin Paper
Appears in Collections:Volume 28, No. 4

Citable URI : http://hdl.handle.net/10069/4454

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