坏死性肌病作为胃癌伴桥本甲状腺炎的远隔效应。

Necrotizing myopathy as a remote effect of gastric cancer accompanied with Hashimoto's thyroiditis.

作者信息

Yutani C, Matsuda Y, Murao S, Kamo Y, Yoshida H, Nakajima T

出版信息

Acta Pathol Jpn. 1978 Jan;28(1):165-74. doi: 10.1111/j.1440-1827.1978.tb01257.x.

DOI:10.1111/j.1440-1827.1978.tb01257.x

Abstract

An autopsy case of a 74-year-old male who had shown clinically hypothyroidism due to chronic atrophic thyroiditis (Hashimoto's thyroiditis), and pathologically necrotizing myopathy as a remote effect of gastric cancer was reported. Morphological features of this necrotizing myopathy was those of carcinomatous myopathy rather than those of hypothyroid or diabetic myopathy. As for the pathogenesis of the necrotizing myopathy (as a Group IV of polymyositis of Walton and Adams), the malignancy might have played an important role as a trigger of the secondary immunological abnormality upon a pre-existing longstranding immune disorder of Hashimoto's thyroiditis. Pseudomembranous colitis, which was thought to be related to antibiotics. (Lincomycin), was also briefly discussed.

摘要

报告了一例74岁男性尸检病例，该患者因慢性萎缩性甲状腺炎（桥本甲状腺炎）临床上表现为甲状腺功能减退，病理上表现为胃癌远隔效应所致的坏死性肌病。这种坏死性肌病的形态学特征是癌性肌病的特征，而非甲状腺功能减退或糖尿病性肌病的特征。至于坏死性肌病（作为Walton和Adams多肌炎的IV组）的发病机制，在桥本甲状腺炎长期存在的免疫紊乱基础上，恶性肿瘤可能作为继发性免疫异常的触发因素发挥了重要作用。还简要讨论了与抗生素（林可霉素）相关的假膜性结肠炎。