《1》肝腫瘤性病変における超音波カラードプラ画像とその分類
Color doppler ultrasound images and their types liver tumors
肝臓Vol.30(1998)No.11p1637-1638
https://www.jstage.jst.go.jp/article/kanzo1960/30/11/30_11_1637/_pdf
《2》肝血管腫のエコーパターンと病理所見との対比検討
Comparative study between ultrasonographic and pathologic findings in hemangioma of the liver
日本臨床外科学会誌Vol.43(1982)No.11p.1202-1208
https://www.jstage.jst.go.jp/article/ringe1963/43/11/43_11_1202/_pdf
《3》A-Pシャントにより非典型的画像所見を呈し肝細胞癌との鑑別を要した肝血管腫の1例
A case of liver hemangioma with arterioportal shunt presenting atypical manifestation mimicking hepatocellular carcinoma
肝臓Vol.36(1995)No.3p158-161
https://www.jstage.jst.go.jp/article/kanzo1960/36/3/36_3_158/_pdf
A 65-year-old man with a history of C viral liver cirrhosis was pointed out 15mm space occupying lesion in the S8 segment of the liver on dynamic CT, demonstrating rapid disappearance associated with arterioportal shunt, which is commonly regarded as a pathognomonic sign of hepatocellular carcinoma.
However hepatic angiography showed pooling appearance in the S8 segment compatible with liver hemangioma, which atypically associated with arterioportal shunt.
To our knowledge, such an atypical liver hemangioma with arterioportal shunt mimicking hepatocellular carcinoma on dynamic CT is rare in the literature.
《4》A-Pshuntを伴い特殊な病理組織像を呈した肝血管腫の1例
A case of hepatic hemangioma with arterial-portal shunting
肝臓Vol.36(1995)No.7p441-447
https://www.jstage.jst.go.jp/article/kanzo1960/36/7/36_7_441/_pdf
A 57-year-old female was admitted to our hospital because of epigastralgia.
Dynamic CT revealed an enhaced area occupying the left lobe of the liver, but a part of it was not enhanced.
Angiography showed a hypervascular lesion with arterial-portal shunting in the left lobe.
At laparotomy the left lobe was atrophic and a white solid mass was located in the lateral segment.
Left lobectomy was performed.
Histopathologically the white mass consisted of fibrous tissue and thickend fiber of smooth muscle, at the edge of it typical cavernous hemangioma existed, and among the normal liver tissue surrounding it small multiple hemangioma spread.
《5》肝血管腫の自然破裂の一例
A case of spontaneous rupture of a hepatic hemangioma
日本臨床外科学会誌Vol.74(2013)No.6p.1650-1654
https://www.jstage.jst.go.jp/article/jjsa/74/6/74_1650/_pdf
A 52-year-old male was admitted to our emergency room with the sudden onset of right upper abdominal pain.
There was no history of trauma.
The general condition of the patient was stable, but an abdominal CT scan revealed hemoperitoneum and an enhanced tumor in the left lateral segment of the liver, 7 cm in diameter, associated with extravasation of the contrast medium.
Spontaneous rupture of a hepatic hemangioma was diagnosed and transcatheter arterial embolization (TAE) was performed.
In order to avoid the risk of re-bleeding, lateral segmentectomy of the liver was performed 21 days after TAE.
Histological findings were compatible with cavernous hemangiomas.
The postoperative course was uneventful and the patient was discharged from the hospital 13 days after the operation.
Spontaneous rupture of a hepatic hemangioma is very rare, but could be associated with the mortality of 3％.
Ruptured hemangioma should be treated with TAE to achieve hemostasis followed by elective hepatectomy
《6》肝悪性腫瘍との鑑別が困難であったsclerosed hemangiomaの1症例
A sclerosed hemangioma of the liver
肝臓Vol.39(1998)No.9p638-642
https://www.jstage.jst.go.jp/article/kanzo1960/39/9/39_9_638/_pdf
《7》腫瘍内フィブリノーゲン消費を示した巨大な肝血管腫の1治験例
Giant cavernous hemangioma of the liver associated with consumption of the fibrinogen in the tumor‐report a case‐
肝臓Vol.22(1981)No.4p587-592
https://www.jstage.jst.go.jp/article/kanzo1960/22/4/22_4_587/_pdf
A 51-year-old woman with a cavernous hemangioma of the liver and hypofibrinogenemia was presented.
Measurements of the plasma coagulation factor revealed a decreased fibrinogen concentration and an increase of fibrinogen degradation products.
Platelet count and prothrombin time were within normal limit.
Fibrinogen concentration and FDP were improved slightly by the heparinization.
131I-Fibrinogen was accumulated at the site of the tumor on the liver scintigram, this accumulation corresponded with defect of the liver scintigram with 99mTc-phytate.
A consumption of fibrinogen in the hemangioma was considered.
The resected tumor by extended right lobectomy of the liver was 2500g. in weight and 17×15×16cm in size.
Fibrin was histopathologically proved in the section of the tumor by phosphotangstic acid hematoxylin staining.
Fibrinogen concentration and FDP was normalized respectively after the surgery.
《8》肝切除術後もDICが遷延し死亡した巨大肝血管腫によるKasabach-Merritt症候群の1例
A case of kasabach-Merritt syndrome died to massive hepatic necrosis caused by prolonged disseminated intravascular coagulation after the resection of a giant hepatic hemangioma
肝臓Vol.45(2004)No.1p39-45
https://www.jstage.jst.go.jp/article/kanzo1960/45/1/45_1_39/_pdf
《9》腫瘍内で局所的な凝固線溶系の亢進を認めた肝細胞癌の1例
日内会誌Vol.83(1994)No.11p1982-1983
https://www.jstage.jst.go.jp/article/naika1913/83/11/83_11_1982/_pdf
《10》肝細胞癌との鑑別に難渋した右尾状葉原発肝血管腫の1切除例
A resected case of cavernous hemangioma situated in the right caudate lobe of the liver difficult to differentiate from hepatoma
日本臨床外科医学会誌Vol.49(1988)No.2p344-349
https://www.jstage.jst.go.jp/article/ringe1963/49/2/49_2_344/_pdf
A 56-year-old female complaining of macrohematuria was accidentally found to have a liver tumor by ultrasonography.
Selective celiac angiography showed a hypervascular hepatic lesion with haphazard marked neovascularity, dilated feeding artery and mottled tumor stain, 90 mm in diameter, in the middle and cranial portion of the liver.
On angio-CT, dense accumulation of contrast material near the periphery of the lesion in early contrast scan, accumulation spreading toward the center of the tumor with time, and marked reduction of the low density area in the late scan were recognized.
The lesion was diagnosed as hepatoma as a result of the findings on angiography, although hemangioma was strongly suggested by angio-CT.
At laparotomy the tumor was found in the right caudate lobe, and extended medial segmentectomy (caudate, middle and right anterosuperior segments) was performed.
The cut surface of the resected specimen was spongy and dark red in color except for a whitish area at the center of the tumor.
Histologically it was liver cavernous hemangioma without malignancy.
The fact that many abnormal arteries were recognized near the capsul of the tumor reflected the findings of neovascularity on angiography.
We should pay careful attention to differential diagnosis between hepatoma and hemangioma with neovascularity on angiography
《11》肝嚢胞に隣接して発生し嚢胞内容液と血清CEAが異常高値を示したS状結腸癌肝転移の1例
A case of hepatic metastasis from the sigmoid colon cancer growing around the hepatic cyst with high CEA value in both serum and cystic fluid
日消外会誌35(1):49-53,2002
https://www.jstage.jst.go.jp/article/jjgs1969/35/1/35_1_49/_pdf
A 73-year-old woman underwent a sigmoidectomy April 30, 1999, after being diagnosed with sigmoid colon cancer.
The histopathological diagnosis was moderately differentiated adenocarcinoma（se,INFβ,ly2,v1,n0）.
After the first operation, the serum CEA value increased a second time, and a tumor to the cranial side of a hepatic cyst with a diameter of 10 cm and transformation around the cyst was observed by CT in January 2000.
An exploratory aspiration and biopsy of the tumor showed a high CEA value in the cystic fluid（38,900ng/ml）and a moderately differentiated adenocarcinoma was identified.
A right lobectomy, including the hepatic cyst, was performed on March 25.
Macroscopically, the tumor measured 6×5cm and was located in segment8.
It pressed against the hepatic cyst.
Microscopically, the cancer cells had infiltrated the tissue near the cystic
wall but were not found inside the cyst.
The serum CEA value decreased to 3.7ng/ml six months after the second operation, and no signs of recurrence have been observed.
The relation between serum and hepatic cyst CEA values may be of interest in cases of hepatic metastasis of colon cancer.
･･････････････････
《12》重症先天性トキソプラズマ症の一例
A case of a neonate with severe congenital toxoplasmosis
福岡大学医紀:39(3/4),257-261,2012
http://www.adm.fukuoka-u.ac.jp/fu844/home2/Ronso/Igakubu/v39-34/v39-34-04.pdf
A 3,372-gram male neonate was delivered transvaginally at 38 weeks and 5days of gestation.
He was referred to our hospital for further examination 7 days after birth because a lateral ventricular dilatation was detected on ultrasonography at 33 weeks' gestation.
A Toxoplasma gondii-specific IgM antibody was positive in his peripheral blood.
Computed tomography showed hydrocephalus with intracranial calcification.
Our diagnosis was congenital toxoplasmosis.
Oral administration of pyrimethamine, sulfadoxine, and folic acid started when the patient was 16 days old.
Ventriculo-peritoneal shunting was performed at 27 days of age and the boy was 42 days of age with no complications.
This treatment continued until he was 1 year old.
At that age he was also diagnosed with chorioretinal atrophy.
Except for this, his physical and mental development are now(at age 3)normal.
《13》胎盤より確定診断し得た先天性トキソプラズマ症の1例
A case of congenital toxoplasmosis confirmed by detection of toxoplasma gondii in placenta
脳と発達Vol.30(1998)No.5p411-416
https://www.jstage.jst.go.jp/article/ojjscn1969/30/5/30_5_411/_pdf
We report a case of congenital toxoplasmosis with a prenatal diagnosis of fetal hydrocephalus.
A CT scan performed at birth revealed ventricular dilatation with calcification.
The serum and CSF Toxoplasma specific IgM were elevated.
The diagnosis was confirmed by the presence of Toxoplasma cysts in the placenta, and detection of the Toxoplasma SAG1 gene by a polymerase chain reaction (PCR) (placenta, positive; CSF, negative).
Signs of active central nervous system infection, such as the decreased CSF glucose, and elevated CSF protein, neuron specific enolase and LDH, resolved after initiation of treatment with pyrimethamine and sulfazoxine.
A PCR test using the placental tissue may be useful for the rapid diagnosis of congenital toxoplasmosis
《14》トキソプラズマ症による頸部リンパ節腫脹の1例
Toxoplasmic lymphadenopathy‐Report of a case‐
耳鼻と臨床Vol.46(2000)No.6p456-460
https://www.jstage.jst.go.jp/article/jibi1954/46/6/46_456/_pdf
We report a case of cervical lymphadenopathy caused by toxoplasmosis.
The patient was a 26-year-old female and visited our clinic because of multiple right neck lymphadenopathy.
A CT scan showed multiple right posterior cervical lymphadenopathy.
The results of fine needle aspiration cytology showed class II disease.
Histologically, the excised lymph node was characterized by follicular hyperplasia with clusters of epithelioid histocytes.
The serological titer against toxoplasma was high.
Based on these results, we diagnosed this lymphadenopathy to be toxoplasmosis.
After treating the patient with acetylspiramycin for 4 weeks, the lymphadenopathy disappeared.
Toxoplasmosis is a disease caused by an infection with the obligate intracellular parasite Toxoplasma gondii.
An acute infection acquired after birth is asymptomatic but frequently results in the chronic persistence of cysts within the tissues of the host.
Toxoplasmosis has many clinical subtypes: lymphadenopathy, encephalitis, chorioretinitis, dissemeinated toxoplasmosis and congenital toxoplasmosis, etc.
Toxoplasmic lymphadenitis generally involves the lymph node in the head and neck regions without any systemic symptoms.
There are various diseases which present with an enlargement of the cervical lymph nodes including benign or malignant tumors, infectious diseases and sarcoidosis.
Therefore, a careful and definite differential diagnosis must always be done in such cases.
･･････････････････
《15》RSウィルス感染症と喘鳴・喘息
Respiratory syncytial virus infection and wheezing/asthma
小児耳鼻咽喉科Vol.31(2010)No.3p.248-252
https://www.jstage.jst.go.jp/article/shonijibi/31/3/31_248/_pdf
《16》RSウイルス迅速診断の有用性と問題点
‐定量的リアルタイムPCR 法をスタンダードとした検討‐
Usefulness and problems of rapid antigen test for respiratory syncytial virus detection
小児感染免疫Vol.22(2010)No.4
http://www.jspid.jp/journal/full/02204/022040337.pdf
At present, the rapid respiratory syncytial virus（RSV）antigen detection kit is common and
easily controlled in clinical use. In this study we demonstrated the effectiveness and problems
of the rapid RSV antigen detection kits.
We compared the specificity and sensitivity of six test kits available in Japan using a real-time polymerase chain reaction（PCR）.
Nasopharyngeal aspiration samples were obtained from children with lower respiratory tract infections caused by RSV who were hospitalized in Soma General Hospital using both rapid RSV antigen detection tests and a real-time PCR.
Based on the results of real-time PCR, all of the kits had high specificity and few false positive.
However, kit sensitivities varied from 32％ to 79％.
Negative results were obtained from all rapid tests in nasopharyngeal samples containing lower viral loads.
It should be considered that the false negatives are attributable to the binding affinity of the monoclonal antibody to the antigen.
Rapid RSV antigen detection kits contribute to controlling RSV infection by using a sample containing sufficient viral load and a kit with high sensitivity and specificity.
《17》RSウィルス 国立感染症研究所
http://www0.nih.go.jp/niid/reference/RS-manual.pdf
Color doppler ultrasound images and their types liver tumors
肝臓Vol.30(1998)No.11p1637-1638
https://www.jstage.jst.go.jp/article/kanzo1960/30/11/30_11_1637/_pdf
《2》肝血管腫のエコーパターンと病理所見との対比検討
Comparative study between ultrasonographic and pathologic findings in hemangioma of the liver
日本臨床外科学会誌Vol.43(1982)No.11p.1202-1208
https://www.jstage.jst.go.jp/article/ringe1963/43/11/43_11_1202/_pdf
《3》A-Pシャントにより非典型的画像所見を呈し肝細胞癌との鑑別を要した肝血管腫の1例
A case of liver hemangioma with arterioportal shunt presenting atypical manifestation mimicking hepatocellular carcinoma
肝臓Vol.36(1995)No.3p158-161
https://www.jstage.jst.go.jp/article/kanzo1960/36/3/36_3_158/_pdf
A 65-year-old man with a history of C viral liver cirrhosis was pointed out 15mm space occupying lesion in the S8 segment of the liver on dynamic CT, demonstrating rapid disappearance associated with arterioportal shunt, which is commonly regarded as a pathognomonic sign of hepatocellular carcinoma.
However hepatic angiography showed pooling appearance in the S8 segment compatible with liver hemangioma, which atypically associated with arterioportal shunt.
To our knowledge, such an atypical liver hemangioma with arterioportal shunt mimicking hepatocellular carcinoma on dynamic CT is rare in the literature.
《4》A-Pshuntを伴い特殊な病理組織像を呈した肝血管腫の1例
A case of hepatic hemangioma with arterial-portal shunting
肝臓Vol.36(1995)No.7p441-447
https://www.jstage.jst.go.jp/article/kanzo1960/36/7/36_7_441/_pdf
A 57-year-old female was admitted to our hospital because of epigastralgia.
Dynamic CT revealed an enhaced area occupying the left lobe of the liver, but a part of it was not enhanced.
Angiography showed a hypervascular lesion with arterial-portal shunting in the left lobe.
At laparotomy the left lobe was atrophic and a white solid mass was located in the lateral segment.
Left lobectomy was performed.
Histopathologically the white mass consisted of fibrous tissue and thickend fiber of smooth muscle, at the edge of it typical cavernous hemangioma existed, and among the normal liver tissue surrounding it small multiple hemangioma spread.
《5》肝血管腫の自然破裂の一例
A case of spontaneous rupture of a hepatic hemangioma
日本臨床外科学会誌Vol.74(2013)No.6p.1650-1654
https://www.jstage.jst.go.jp/article/jjsa/74/6/74_1650/_pdf
A 52-year-old male was admitted to our emergency room with the sudden onset of right upper abdominal pain.
There was no history of trauma.
The general condition of the patient was stable, but an abdominal CT scan revealed hemoperitoneum and an enhanced tumor in the left lateral segment of the liver, 7 cm in diameter, associated with extravasation of the contrast medium.
Spontaneous rupture of a hepatic hemangioma was diagnosed and transcatheter arterial embolization (TAE) was performed.
In order to avoid the risk of re-bleeding, lateral segmentectomy of the liver was performed 21 days after TAE.
Histological findings were compatible with cavernous hemangiomas.
The postoperative course was uneventful and the patient was discharged from the hospital 13 days after the operation.
Spontaneous rupture of a hepatic hemangioma is very rare, but could be associated with the mortality of 3％.
Ruptured hemangioma should be treated with TAE to achieve hemostasis followed by elective hepatectomy
《6》肝悪性腫瘍との鑑別が困難であったsclerosed hemangiomaの1症例
A sclerosed hemangioma of the liver
肝臓Vol.39(1998)No.9p638-642
https://www.jstage.jst.go.jp/article/kanzo1960/39/9/39_9_638/_pdf
《7》腫瘍内フィブリノーゲン消費を示した巨大な肝血管腫の1治験例
Giant cavernous hemangioma of the liver associated with consumption of the fibrinogen in the tumor‐report a case‐
肝臓Vol.22(1981)No.4p587-592
https://www.jstage.jst.go.jp/article/kanzo1960/22/4/22_4_587/_pdf
A 51-year-old woman with a cavernous hemangioma of the liver and hypofibrinogenemia was presented.
Measurements of the plasma coagulation factor revealed a decreased fibrinogen concentration and an increase of fibrinogen degradation products.
Platelet count and prothrombin time were within normal limit.
Fibrinogen concentration and FDP were improved slightly by the heparinization.
131I-Fibrinogen was accumulated at the site of the tumor on the liver scintigram, this accumulation corresponded with defect of the liver scintigram with 99mTc-phytate.
A consumption of fibrinogen in the hemangioma was considered.
The resected tumor by extended right lobectomy of the liver was 2500g. in weight and 17×15×16cm in size.
Fibrin was histopathologically proved in the section of the tumor by phosphotangstic acid hematoxylin staining.
Fibrinogen concentration and FDP was normalized respectively after the surgery.
《8》肝切除術後もDICが遷延し死亡した巨大肝血管腫によるKasabach-Merritt症候群の1例
A case of kasabach-Merritt syndrome died to massive hepatic necrosis caused by prolonged disseminated intravascular coagulation after the resection of a giant hepatic hemangioma
肝臓Vol.45(2004)No.1p39-45
https://www.jstage.jst.go.jp/article/kanzo1960/45/1/45_1_39/_pdf
《9》腫瘍内で局所的な凝固線溶系の亢進を認めた肝細胞癌の1例
日内会誌Vol.83(1994)No.11p1982-1983
https://www.jstage.jst.go.jp/article/naika1913/83/11/83_11_1982/_pdf
《10》肝細胞癌との鑑別に難渋した右尾状葉原発肝血管腫の1切除例
A resected case of cavernous hemangioma situated in the right caudate lobe of the liver difficult to differentiate from hepatoma
日本臨床外科医学会誌Vol.49(1988)No.2p344-349
https://www.jstage.jst.go.jp/article/ringe1963/49/2/49_2_344/_pdf
A 56-year-old female complaining of macrohematuria was accidentally found to have a liver tumor by ultrasonography.
Selective celiac angiography showed a hypervascular hepatic lesion with haphazard marked neovascularity, dilated feeding artery and mottled tumor stain, 90 mm in diameter, in the middle and cranial portion of the liver.
On angio-CT, dense accumulation of contrast material near the periphery of the lesion in early contrast scan, accumulation spreading toward the center of the tumor with time, and marked reduction of the low density area in the late scan were recognized.
The lesion was diagnosed as hepatoma as a result of the findings on angiography, although hemangioma was strongly suggested by angio-CT.
At laparotomy the tumor was found in the right caudate lobe, and extended medial segmentectomy (caudate, middle and right anterosuperior segments) was performed.
The cut surface of the resected specimen was spongy and dark red in color except for a whitish area at the center of the tumor.
Histologically it was liver cavernous hemangioma without malignancy.
The fact that many abnormal arteries were recognized near the capsul of the tumor reflected the findings of neovascularity on angiography.
We should pay careful attention to differential diagnosis between hepatoma and hemangioma with neovascularity on angiography
《11》肝嚢胞に隣接して発生し嚢胞内容液と血清CEAが異常高値を示したS状結腸癌肝転移の1例
A case of hepatic metastasis from the sigmoid colon cancer growing around the hepatic cyst with high CEA value in both serum and cystic fluid
日消外会誌35(1):49-53,2002
https://www.jstage.jst.go.jp/article/jjgs1969/35/1/35_1_49/_pdf
A 73-year-old woman underwent a sigmoidectomy April 30, 1999, after being diagnosed with sigmoid colon cancer.
The histopathological diagnosis was moderately differentiated adenocarcinoma（se,INFβ,ly2,v1,n0）.
After the first operation, the serum CEA value increased a second time, and a tumor to the cranial side of a hepatic cyst with a diameter of 10 cm and transformation around the cyst was observed by CT in January 2000.
An exploratory aspiration and biopsy of the tumor showed a high CEA value in the cystic fluid（38,900ng/ml）and a moderately differentiated adenocarcinoma was identified.
A right lobectomy, including the hepatic cyst, was performed on March 25.
Macroscopically, the tumor measured 6×5cm and was located in segment8.
It pressed against the hepatic cyst.
Microscopically, the cancer cells had infiltrated the tissue near the cystic
wall but were not found inside the cyst.
The serum CEA value decreased to 3.7ng/ml six months after the second operation, and no signs of recurrence have been observed.
The relation between serum and hepatic cyst CEA values may be of interest in cases of hepatic metastasis of colon cancer.
･･････････････････
《12》重症先天性トキソプラズマ症の一例
A case of a neonate with severe congenital toxoplasmosis
福岡大学医紀:39(3/4),257-261,2012
http://www.adm.fukuoka-u.ac.jp/fu844/home2/Ronso/Igakubu/v39-34/v39-34-04.pdf
A 3,372-gram male neonate was delivered transvaginally at 38 weeks and 5days of gestation.
He was referred to our hospital for further examination 7 days after birth because a lateral ventricular dilatation was detected on ultrasonography at 33 weeks' gestation.
A Toxoplasma gondii-specific IgM antibody was positive in his peripheral blood.
Computed tomography showed hydrocephalus with intracranial calcification.
Our diagnosis was congenital toxoplasmosis.
Oral administration of pyrimethamine, sulfadoxine, and folic acid started when the patient was 16 days old.
Ventriculo-peritoneal shunting was performed at 27 days of age and the boy was 42 days of age with no complications.
This treatment continued until he was 1 year old.
At that age he was also diagnosed with chorioretinal atrophy.
Except for this, his physical and mental development are now(at age 3)normal.
《13》胎盤より確定診断し得た先天性トキソプラズマ症の1例
A case of congenital toxoplasmosis confirmed by detection of toxoplasma gondii in placenta
脳と発達Vol.30(1998)No.5p411-416
https://www.jstage.jst.go.jp/article/ojjscn1969/30/5/30_5_411/_pdf
We report a case of congenital toxoplasmosis with a prenatal diagnosis of fetal hydrocephalus.
A CT scan performed at birth revealed ventricular dilatation with calcification.
The serum and CSF Toxoplasma specific IgM were elevated.
The diagnosis was confirmed by the presence of Toxoplasma cysts in the placenta, and detection of the Toxoplasma SAG1 gene by a polymerase chain reaction (PCR) (placenta, positive; CSF, negative).
Signs of active central nervous system infection, such as the decreased CSF glucose, and elevated CSF protein, neuron specific enolase and LDH, resolved after initiation of treatment with pyrimethamine and sulfazoxine.
A PCR test using the placental tissue may be useful for the rapid diagnosis of congenital toxoplasmosis
《14》トキソプラズマ症による頸部リンパ節腫脹の1例
Toxoplasmic lymphadenopathy‐Report of a case‐
耳鼻と臨床Vol.46(2000)No.6p456-460
https://www.jstage.jst.go.jp/article/jibi1954/46/6/46_456/_pdf
We report a case of cervical lymphadenopathy caused by toxoplasmosis.
The patient was a 26-year-old female and visited our clinic because of multiple right neck lymphadenopathy.
A CT scan showed multiple right posterior cervical lymphadenopathy.
The results of fine needle aspiration cytology showed class II disease.
Histologically, the excised lymph node was characterized by follicular hyperplasia with clusters of epithelioid histocytes.
The serological titer against toxoplasma was high.
Based on these results, we diagnosed this lymphadenopathy to be toxoplasmosis.
After treating the patient with acetylspiramycin for 4 weeks, the lymphadenopathy disappeared.
Toxoplasmosis is a disease caused by an infection with the obligate intracellular parasite Toxoplasma gondii.
An acute infection acquired after birth is asymptomatic but frequently results in the chronic persistence of cysts within the tissues of the host.
Toxoplasmosis has many clinical subtypes: lymphadenopathy, encephalitis, chorioretinitis, dissemeinated toxoplasmosis and congenital toxoplasmosis, etc.
Toxoplasmic lymphadenitis generally involves the lymph node in the head and neck regions without any systemic symptoms.
There are various diseases which present with an enlargement of the cervical lymph nodes including benign or malignant tumors, infectious diseases and sarcoidosis.
Therefore, a careful and definite differential diagnosis must always be done in such cases.
･･････････････････
《15》RSウィルス感染症と喘鳴・喘息
Respiratory syncytial virus infection and wheezing/asthma
小児耳鼻咽喉科Vol.31(2010)No.3p.248-252
https://www.jstage.jst.go.jp/article/shonijibi/31/3/31_248/_pdf
《16》RSウイルス迅速診断の有用性と問題点
‐定量的リアルタイムPCR 法をスタンダードとした検討‐
Usefulness and problems of rapid antigen test for respiratory syncytial virus detection
小児感染免疫Vol.22(2010)No.4
http://www.jspid.jp/journal/full/02204/022040337.pdf
At present, the rapid respiratory syncytial virus（RSV）antigen detection kit is common and
easily controlled in clinical use. In this study we demonstrated the effectiveness and problems
of the rapid RSV antigen detection kits.
We compared the specificity and sensitivity of six test kits available in Japan using a real-time polymerase chain reaction（PCR）.
Nasopharyngeal aspiration samples were obtained from children with lower respiratory tract infections caused by RSV who were hospitalized in Soma General Hospital using both rapid RSV antigen detection tests and a real-time PCR.
Based on the results of real-time PCR, all of the kits had high specificity and few false positive.
However, kit sensitivities varied from 32％ to 79％.
Negative results were obtained from all rapid tests in nasopharyngeal samples containing lower viral loads.
It should be considered that the false negatives are attributable to the binding affinity of the monoclonal antibody to the antigen.
Rapid RSV antigen detection kits contribute to controlling RSV infection by using a sample containing sufficient viral load and a kit with high sensitivity and specificity.
《17》RSウィルス 国立感染症研究所
http://www0.nih.go.jp/niid/reference/RS-manual.pdf