Shiota Masaki, Tokuda Noriaki, Kanou Takehiro, Yamasaki Humio
Department of Urology and Pathology, Saga Prefectural Hospital, Koseikan, Saga, Japan.
J Nippon Med Sch. 2007 Aug;74(4):306-8. doi: 10.1272/jnms.74.306.
Although injection-site granulomas caused by leuprorelin acetate have been reported, there have been no reports of granulomas caused by both leuprorelin acetate and goserelin acetate. An 81-year-old man presented with subcutaneous nodules of the abdominal wall and upper arm, where 11.25 mg of leuprorelin acetate had been injected for the treatment of prostate cancer. Because of these nodules, treatment was changed to goserelin acetate. Nevertheless, he presented with another subcutaneous nodule at the injection site. Histological examination showed that these nodules consisted of numerous giant cells that were CD3-positive T lymphocytes and CD68-positive histiocytes associated with granulomatous changes. The granulomas had likely been caused by delayed-type hypersensitivity to leuprorelin acetate injection. The granuloma that formed after goserelin acetate injection might thus have developed owing to the immunogenicity of the previous leuprorelin acetate injections. The patient underwent surgical castration. The present case suggests that both leuprorelin acetate and goserelin acetate can cause injection-site disorders.
虽然已有醋酸亮丙瑞林引起注射部位肉芽肿的报道，但尚无醋酸亮丙瑞林和醋酸戈舍瑞林二者均引起肉芽肿的报道。一名81岁男性因前列腺癌接受治疗，在腹壁和上臂注射了11.25mg醋酸亮丙瑞林后出现皮下结节。由于这些结节，治疗改为醋酸戈舍瑞林。然而，他在注射部位又出现了一个皮下结节。组织学检查显示，这些结节由大量巨细胞组成，这些巨细胞为CD3阳性T淋巴细胞和CD68阳性组织细胞，并伴有肉芽肿性改变。这些肉芽肿可能是由对醋酸亮丙瑞林注射的迟发型超敏反应引起的。因此，醋酸戈舍瑞林注射后形成的肉芽肿可能是由于先前醋酸亮丙瑞林注射的免疫原性所致。该患者接受了手术去势。本病例提示醋酸亮丙瑞林和醋酸戈舍瑞林均可引起注射部位疾病。
