common disease22

【臨床症状】50代 左MMK 全身精査

【問題】どんな正常変異がある?

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    ▶答えはこちら
    • 内臓逆位を認める
    • 左乳腺には既知の乳癌の所見は認めない
    • また腋窩リンパ節腫大や遠隔転移も認めない

    【内臓逆位】

    ・内臓逆位は3,000~5,000人に1人の割合で認める解剖学的変異

    ・全てが反転している場合を完全内臓逆位と呼び、一部の臓器のみ反転する部分内臓逆位に分類される

    ・4:1の割合で完全内臓逆の方が頻度は多い

    ・内臓が反転しているだけなら病的意義は無いが、血管奇形を伴う場合も多いので注意が必要

    ・慢性副鼻腔炎、気管支拡張症、内臓逆位の3徴を認める場合は、Kartagener症候群と呼ばれる

    ・内臓が左右対称に形成されるのは内臓錯位と呼び、無脾症、多脾症を伴う

    ・内臓錯位は心機能不全など重篤な症状や血管奇形を伴う事もあり、5歳まで生存できるのは5~13%とも言われている

    参考文献:ジェネラリストを目指す人のための画像診断パワフルガイド 第2版
         金子唯 澤田傑 他:全内臓逆位症と腸回転異常を合併したS状結腸癌の1例 日消外会誌
         松川啓義 八木孝仁 他:Kartageber症候群を伴う完全内臓逆位症に対して肝切除を施行した1例 日消外会誌