周期的な右季肋部痛を呈した肝子宮内膜症の1例
症例は44歳，女性．主訴は周期的な右季肋部痛．腹部MRIで肝周囲に多発性の嚢胞性病変を認め，子宮内膜症に特徴的なshadingの所見（T1強調像で高信号，T2強調像で高信号から低信号が混在）より肝子宮内膜症と診断した．GnRHアナログによるホルモン療法を施行し右季肋部痛は消失，病変の縮小も得られた．肝子宮内膜症は稀な疾患であるが，その診断には痛みと月経周期との関連を聴取すること，およびMRIによる画像診断が有用である．...
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| Published in | 日本内科学会雑誌 Vol. 101; no. 11; pp. 3233 - 3235 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本内科学会
2012
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5384 1883-2083 |
| DOI | 10.2169/naika.101.3233 |
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| Abstract | 症例は44歳，女性．主訴は周期的な右季肋部痛．腹部MRIで肝周囲に多発性の嚢胞性病変を認め，子宮内膜症に特徴的なshadingの所見（T1強調像で高信号，T2強調像で高信号から低信号が混在）より肝子宮内膜症と診断した．GnRHアナログによるホルモン療法を施行し右季肋部痛は消失，病変の縮小も得られた．肝子宮内膜症は稀な疾患であるが，その診断には痛みと月経周期との関連を聴取すること，およびMRIによる画像診断が有用である． |
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| AbstractList | 症例は44歳，女性．主訴は周期的な右季肋部痛．腹部MRIで肝周囲に多発性の嚢胞性病変を認め，子宮内膜症に特徴的なshadingの所見（T1強調像で高信号，T2強調像で高信号から低信号が混在）より肝子宮内膜症と診断した．GnRHアナログによるホルモン療法を施行し右季肋部痛は消失，病変の縮小も得られた．肝子宮内膜症は稀な疾患であるが，その診断には痛みと月経周期との関連を聴取すること，およびMRIによる画像診断が有用である． |
| Author | 嶋田, 豊 柴原, 直利 引網, 宏彰 藤本, 誠 渡り, 英俊 海老澤, 茂 野上, 達也 |
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| References | 2) Schuld J, et al: Bronchobiliary fistula: a rare complication of hepatic endometriosis. Fertil Steril 95: 804. e15-18, 2011. 7) Chung CC, et al: Endometriosis of the liver. Surgery 123: 106-108, 1998. 3) Goldsmith PJ, et al: Case hepatic endometriosis: a continuing diagnostic dilemma. HPB Surg 2009: 407206, 2009. 4) Huang WT, et al: Endometrial cyst of the liver: a case report and review of the literature. J Clin Pathol 55: 715-717, 2002. 5) Khan AW, et al: Liver tumours due to endometriosis and endometrial stromal sarcoma. HPB 4: 43-45, 2002. 10) Rovati V, et al: Endometrioma of the liver. Am J Obstet Gynecol 163: 1490-1492, 1990. 6) Inal M, et al: Hepatic endometrioma: a case report and review of the literature. Eur Radiol 10: 431-434, 2000. 9) Verbeke C, et al: Cystic endometriosis of the upper abdominal organs: report on three cases and review of the literature. Pathol Res Pract 192: 300-304, 1996. 1) Roesch-Dietlen F, et al: Hepatic endometriosis. Ann Hepatol 10: 347-348, 2011. 8) Cravello L, et al: Hepatic endometriosis: a case report. Fertil Steril 66: 657-659, 1996. |
| References_xml | – reference: 1) Roesch-Dietlen F, et al: Hepatic endometriosis. Ann Hepatol 10: 347-348, 2011. – reference: 5) Khan AW, et al: Liver tumours due to endometriosis and endometrial stromal sarcoma. HPB 4: 43-45, 2002. – reference: 7) Chung CC, et al: Endometriosis of the liver. Surgery 123: 106-108, 1998. – reference: 10) Rovati V, et al: Endometrioma of the liver. Am J Obstet Gynecol 163: 1490-1492, 1990. – reference: 2) Schuld J, et al: Bronchobiliary fistula: a rare complication of hepatic endometriosis. Fertil Steril 95: 804. e15-18, 2011. – reference: 3) Goldsmith PJ, et al: Case hepatic endometriosis: a continuing diagnostic dilemma. HPB Surg 2009: 407206, 2009. – reference: 6) Inal M, et al: Hepatic endometrioma: a case report and review of the literature. Eur Radiol 10: 431-434, 2000. – reference: 9) Verbeke C, et al: Cystic endometriosis of the upper abdominal organs: report on three cases and review of the literature. Pathol Res Pract 192: 300-304, 1996. – reference: 8) Cravello L, et al: Hepatic endometriosis: a case report. Fertil Steril 66: 657-659, 1996. – reference: 4) Huang WT, et al: Endometrial cyst of the liver: a case report and review of the literature. J Clin Pathol 55: 715-717, 2002. |
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| Title | 周期的な右季肋部痛を呈した肝子宮内膜症の1例 |
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