Mitsuru Odawara

A CASE OF PRIMARY ACQUIRED AGAMMAGLOBULINEMIA ACCOMPANIED WITH NODULAR LYMPHOID HYPERPLASIA OF THE GASTROINTESTINAL TRACT FROM DUODENUM TO HALF OF JEJUNUM

原発性後天性無γ-globulin血症, WHOの分類試案ではvariable common immunodeficiencyに属するとおもわれる33才の男性症例を経験したので報告する.患者は乳幼児期に麻疹,流行性耳下腺炎に罹患したが正常に回復した.とくに感冒に罹患しやすいということはなかつた. 20才頃から肺炎に反復罹患し,再三37.5°C前後の微熱を生じ,胆嚢炎にも罹患したことがある. 32才のとき無γ-globulin血症を発見された.下痢の反復など消化器症状はない.本症例は,末梢リンパ球数は正常であるが,骨髄に形質細胞はほとんど認められない.免疫グロブリンはIgG, IgA, IgM, IgD, IgEすべてにきわめて低値を示した. T cell, B cel1はほぼ正常に存し,皮内反応(PPD, Candida)は正常に反応した.消化管X線検査,内視鏡では十二指腸球部から空腸上部にかけて微細な半円形の隆起性病変をびまん性に多数みとめ,結節性リンパ過形成(nodular lymphoid hyperplasia; NLH)とおもわれた.以上のように十二指腸から空腸にかけてNLHを有する原発性後天性無γ-globulin血症の1例について報告するとともに,本邦報告例の集計を行ない報告例との比較検討をおこなつた.

Carcino-fetal proteins and gastric cancer

SummaryAlthough several investigators have reported serum α-fetoprotein positive gastric cancer with or without metastasis to the liver, its site of production is still unclear. We studied on the site of α-fetoprotein synthesis in our cases which showed remarkably high level of serum α-fetoprotein, and clarified the presence of αfetoprotein producing gastric cancer by means of direct immunofluorescent technique. However, we also knew the hepatocytes adjacent to the metastatic lesions could also synthesize α-fetoprotein, although these hepatocytes were not known whether under regeneration or degeneration. Through this study, the other carcinofetal proteins such as carcino-placental alkaline phosphatase and CEA were examined using the sera or tumor tissues. Our results will support the idea that cancer is the disease of cell differentiation.