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2312
2313
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2319
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2321
2322
2323
2324
2325
2326
2327
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2330
2331
2332
2333
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2335
2336
2337
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2346
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4
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20
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85.1%10
2.
1
IIIIIa,IIb,IIc)III
2
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XCT,MRI
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IIa,IIb
IIaIIb
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1090
11.1%I
112
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7
-
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1 20
1 727
11:00 21F
12:00
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12:30 III 2F
15:00 III
I
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16:30 I
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2 728)
08:10 A,B,C)
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08:30 II 2F
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08:30-09:30 A B C
10)
09:40-10:40 D A B C
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10:50-11:50 C D A B
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13:00 II
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(100)180(60)
IIc ) 20 5146)
III) 1 180
2-4710
150 150
(2138) 4A,B,C,D) 15
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IIIc
15
1
A,B,C,D,E4
4.
48III
III
1)
:57 :
:1) 2)
:
:
:20
5256
:
:9
20001237
2001338
312
321
322
CT
328
49
331
42
30
428
1a,b
522
2a,b
515MRITh11L1
sIL2R,beta2-GM,LDH,CRP
CHOP-E
LDH
405,000CHOP-E3
810
920
925
CHOP-E;1 g1
60 mg11 mg190 mg
5100 mg5
9
3
I IIaIIb IIc
2 3 0 5
1 1 0 2
3 2 2 7
4 8 1 13
1 2 2 5
1 2 1 4
3 2 0 5
0 1 2 3
1 5 2 7
0 4 1 5
2 4 2 8
3 3 2 8
3 1 0 4
5 0 5 10
1 2 0 3
30 40 20 90
-
10
4 I
No.
I-1 3 Lewy 4.67
I-2 3 d) ( 4.43
I-3 3 Inflammatory fibroid tumor 4.08
I-4 2 Germinoma 3.05
I-5 4 lambliasis 3.16
I-6 3 Solid-pseudopapillary tumor 4.08
I-7 3 Gastrinoma(endocrine carcinoma),gastrin 3.41
I-8 2 2.87
I-9 21EM Dense deposit disease 1.37
I-10 2 2.44
I-11 2 3.23
I-12 2 Juvenile xanthogranuloma 2.48
I-13 2 c) ( 2.93
I-14 6 3.79
I-15 2 b) ( 2.93
I-16 2 2.22
I-17 4 4.38
I-18 3 Wegenerb) (c-ANCA) 4.63
I-19 1 4.17
I-20 2 PAS/Grocott 4.97
I-21 2 Endometrial stromal nodule 1.06
I-22 3 1.77
I-23 2 Tumoral calcinosis 1.67
I-24 2 pemphigus vulgaris 1.36
I-25 4 4.40
I-26 3 2.70
I-27 2 Ameloblastoma,plexiform type 4.09
I-28 2 e) ( 4.37
I-29 2 e) ( 3.74
I-30 2 a) ( 4.43
-
:
1)
2)
3)
4)
5)
2) )
3) :247()
4) :
1:
(a.:H-Eb.:Elastica-
van Gieson)
2:a.Giemsab.
H-E
11
5 I
No.
I-46
1.00
I-47
0.98
I-48 DOA(death on arrival)
0.98
I-49
0.95
I-50 Creutzfeldt-Jakob (CJD)20
0.99
I-51
1.00
I-5295
0.93
I-53
0.94
I-54
0.56
I-55
0.91
I-56
1.00
I-57DAB(3,3-diamino
benzidine
1.00-
I-58
1.00
I-59
0.97
I-60
0.98
I-61
0.95
I-62 HIV44
0.93
I-63
1.00
I-64
0.99
I-65
1.00
6 IIa
No.
IIa-1 Hemangioblastoma 3.71
IIa-2 1) Central neurocytoma
2) synaptophysin
2.36
IIa-3 Angiofibroma 3.26
IIa-4 Carcinoid tumor 4.40
IIa-5 Gastric cancer;por 4.36
IIa-6 Peutz-Jeghers syndrome 4.28
IIa-7 Serrated adenoma 4.49
IIa-8 Ganglioneuroma 3.97
IIa-9 M i x e d h e p a t o c e l l u l a r a n d
cholangiocellular carcinoma
3.39
IIa-10 Subacute thyroiditis 4.31
IIa-11 Urothelial (Transitional cell)carcinoma,G3,with muscular
invasion
4.47
IIa-12 Yolk sac tumor 4.39
IIa-13 Clear cell carcinoma 4.08
IIa-14 Adenoma of the nipple 3.95
IIa-15 I n v a s i v e d u c t a l c a r c i n o m a;apocrine carcinoma
2.84
IIa-16 Castlemans disease 4.38
IIa-17 1) Tuberculous lymphadenitis
2) Ziehl-Neelsen
4.30
IIa-18 Spitz nevus 4.01
IIa-19 Granuloma annulare 1.82
IIa-20 Embryonal rhabdomyosarcoma 2.86
-
3:
4:
5:;a.b.
6:
7:
8:
9:;
13
5) :
#1 H-E
#2 H-E
#3 H-E
#4 H-E
#5 H-E
#6 PAS
#7 H-E
#8 H-E
#9 H-E
#10 H-E
#11 PAS
#12 H-E
#13 H-E
#14 Th11-12 H-E
#15 Th11-12 K-B
#16 L2-3 H-E
#17 L2-3 K-B
#18 H-E
18
6)
1.
12
7 IIb
No.
IIb-1 1) Pilocytic astrocytoma
2) Rosenthal fiber
2.93
IIb-2 Cardiac myxoma 4.92
IIb-3 Amyloid tumor 1.94
IIb-4 MALT type lymphoma 2.48
IIb-5 Papilloma 4.70
IIb-6 X a n t h o g r a n u l o m a t o u s c h o l e c y s
titis
3.82-
IIb-7 Malignant melanoma 2.01
IIb-8 Gonadoblastoma 0.80
IIb-9 Gangrenous appendicitis with en
dometriosis
2.82-
IIb-10 Oncocytoma 3.01
IIb-11 Germ cell tumor;EC S im
mature teratoma
2.70-
IIb-12 Adenomatoid tumor 3.22
IIb-13 1) Partial hydatidiform mole
2) HCG
4.92
IIb-14 1) Phyllodes tumor
2) lactating state
3.59
IIb-15 I n v a s i v e d u c t a l c a r c i n o m a;mucinous carcinoma
2.36
IIb-16 1) Toxoplasmic lymphadenitis
2)
1.94
IIb-17 Anaplastic large cell lymphoma 1.62
IIb-18 Merkel cell carcinoma 3.10
IIb-19 Giant cell reparative granuloma 1.69
IIb-20 Mucoepidermoid carcinoma 0.29
8 IIc
No.
IIc-01 c) Dirofilariasis 4.25
IIc-02 Cryptococcosis 1.98
IIc-03 Thymoma 4.53
IIc-04 Cytomegalovirus infection 1.17
IIc-05 (H-E,AZAN) CCHA2,F2 3.86
IIc-06 Primary biliary cirrhosis 4.54
IIc-07 Follicular carcinoma 4.43
IIc-08 Absence of germ cells(Ser
toli cell only syndrome)
3.34-
IIc-09 Prostatic ade n o c a r c i n o m a,Gleason score 6(33)
4.01
IIc-10 K o i l o c y t o t i c a t y p i a/m i l d
dysplasia
2.77
IIc-11 Blue nevus of the uterine
cervix
2.40
IIc-12 ()S o-c a l l e d m a s t o p a t h y(sclerosing adenosis)
3.86
IIc-13 Malignant lymphoma,fol
licular,small cleaved(grade
1)
3.92-
IIc-14 Angiosarcoma 2.89
IIc-15 Leukocytoclastic vasculi t i s(Anaphylactoid purpura)
3.98
IIc-16 b) 4.25
IIc-17 c) 3.56
IIc-18 b) 3.68
IIc-19 d) 4.60
IIc-20 ) c) 3.51
-
2.15
3.
4.1a,b
1:80
:Intravascular(large B-cell)lymphoma
A) :
1)
(
)()
2) hemophagocy-
tosis)
3)
radiculomyelopathy)
gliosis
4)
B) :
1) 220:240 g
2) 740:840 g)
1
3) 1,570 g
4) 5
5) 5100
g
6) 400 g)
7) 1,500 g)
8) 15.9 g)9.5:9.0 g
0.6 g
9)
10)
2-1:intravascular lymphoma
large B-cell lymphoma
10
2-2:Hemophagocytic syndrome
CMVEBVherpes group
T-cell
typeleukemialymphoma
T-cell
cytokinemacrophage
hemophagocytosis
Hemophago-
cytosispancytopenia
CMVEBVB-
cell lymphomahemophagocytosis
hemophagocytosis
10
13
-
2-3:
radiculomyelopathy
intravascular lymphoma
paraneoplastic necrotizing
myelopathy(PNM
PNM
14
1. III 2. III
9
M
SD
M-SD
I 150 98.86 18.26 80.60 140 59
I 20 19.06 1.02 18.04 20 15
I 170 117.92 18.35 99.57 159 79
IIa 100 75.87 10.51 65.37 92 44
IIb 100 54.86 13.00 41.86 79 21
IIc 100 71.53 11.02 60.51 91 49
II 300 202.26 28.58 173.69 259 124
III 470 320.18 42.78 277.40 418 222
III 150 103.87 26.30 77.57 147 20
620 424.06 59.92 304.21 565 285
50 37.99 8.23 29.76 50 20
10
1 S58(83) 36 31 86.1
2 S59(84) 43 36 83.7
3 S60(85) 48 39 81.3
4 S61(86) 67 59 88.1
5 S62(87) 97 81 83.5
6 S63(88) 63 56 88.9 7:138,1989
7 H1(89) 68 56 82.4 8:1331990
8 H2(90) 70 63 90.0 9:1291991
9 H3(91) 69 62 90.0 10:1231992
10 H4(92) 65 56 86.1 11:1091993
11 H5(93) 80 69 86.3 12:1311994
12 H6(94) 70 58 82.9 13:1131995
13 H7(95) 75 61 81.3 Pathol Int 46:(5)7,1996
14 H8(96) 97 79 81.4 46:(1031996
15 H9(97) 77 69 89.6 47:(1271997
16 H10(98) 86 72 83.7 48:(1151998
17 H11(99) 88 73 83.0 49:(1051999
18 H12(00) 87 73 83.9 50:(1052000
19 H13(01) 75 61 81.3 51:(972001
20 H14(02) 87 74 85.1 52:(10)72002
-
cytotoxic factor
(10)
2-4:
(10)
2-5:
15
11
1:
3:
5:
) I
) I
) IIa,b
) IIc
) III
3.325)
2.515)
3.625)
3.425)
4.125)
1:
3:
5:
) I
) I
) IIa,b
) IIc
) III
3.615)
3.725)
3.525)
3.525)
3.215)
1:
3:
5:
) I
) I
) IIa,b
) IIc
) III
2.914)
3.025)
2.714)
2.714)
2.214)
1:
3:
5:
IIIc 3.115
1:
3:
5:
IIIc 3.025
1:
3:
5:
) I
) I
) I1
) III
) III
) III
3.015)
3.515)
3.615)
3.215)
3.525)
3.415)
1:
3:
5:
IIIIII 3.115)
1:
3:
5:
3.815)
1:
3:
5:
3.615
1:
3:
5:
3.715
-
(10)
3:intravascular large B-
cell lymphomaleuko-
cyte common antigen(LCA),B-cell marker(CD20,
MB1),T-cell marker(CD45RO,MT1
10
4:
caliber persistent artery
(Dieulafoys lesion(10)
5.
9
I7II
IIaIIbIIc19III14
III
I
II1
III
IIIIII
730
III270III
70
D
8774
85.1%
10
3
6.
100%11
4147.1%)21
24.1%)1719.5%)
66.9%)
11%
7990%5101015
6152020
1
III
I
I
7.
12
16
12 20
20:
:
:
:
-
102002
10
1.
10200214
72728
20(
)
3
2.
312
21
115202
510
3.
III230
I7015)IIa
60IIb60IIc60
4.
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15
15
24HE
1
30
154530
1530
20
II IIa,IIb,IIc10
10IIc
3
IIaIIb
III
19
1
2
1154
3
III
III
5.
IIIaIIbIIc1,2IIaIIb
IIc
17
-
3
IIIa
8
4
18
1. 102002I
I-16.Ependymoma
I-17.Mycotic endocarditis,Candidosis
I-18.Wegeners granulomatosis,b)
I-19.Lymphangitis carcinomatosa
I-20.Esophagomycosis,Candidosis,PAS/grocott stain
I-21.Endometrial stromal nodule
I-22.Malignant lymphoma,lymphobalstoma
I-23.Tumoral calcinosis
I-24.Pemphigus vulgais
I-25.Chondrosarcoma
I-26.Osteosarcoma
I-27.Ameloblastoma,plexiform type
I-28.e)
I-29.e)
I-30.a)
I-31.Incisive canal cyst
I-32.Adenoid cystic carcinoma
I-33.basal cell adenocarcinoma
I-34.Cavernous hemangioma
I-35.Mucous membrane pemphigoid
I-36.Denture fibroma
I-37.Complex adontoma
I-38.Cemento-osseous dysplasia,mandible
I-39.Odontogenic myxoma
I-40.Sequestrum
I-41.Odontogenic fibroma
I-42.Cemento-osseous fibroma
I-43.Inverted papilloma
I-44.Salivary duct carcinoma
I-45.b)
2. 102002II
IIa-01.Angiofibroma
IIa-02.Carcinoid tumor
IIa-03.Gastric cancer;por
IIa-04.Urothelial(transitional cell)carcinoma
IIa-05.Yolk sac tumor
IIa-06.Apocrine carcinoma
IIa-07.Castlemans disease
IIa-08.Tuberculous lymphadenitis,Zeehl Neelsen
IIa-09.Spitz nevus
IIa-10.Embryonal rhabdomyosarcoma
IIa-11.Schwannoma Neurofibroma,Neurilemoma
IIa-12.Thyroglossal duct cyst
IIa-13.Calcifying epithelioma of Malherbe,Pilomatricoma
IIa-14.Ameloblastic fibro-odontoma
IIa-15.Verrucous carcinoma
IIa-16.Myeoepithelioma
IIa-17.Calcifying epithelial odontogenic tumor
IIa-18.Mucous granuloma,mucocele
IIa-19.Epulis osterplastica
IIa-20.Calcifying odontogenic cyst
IIb-01.Amyloid tumor
IIb-02.MALT type lymphoma
IIb-03.Papillary carcinoma,thyroid
IIb-04.Papilloma
IIb-05.Malignant melanoma
IIb-06.Gangrenous appendicitiswith endometriosis
IIb-07.Oncocytoma
IIb-08.Partial hydatidiform mole,HCG
IIb-09.Phyllodes tumor
IIb-10.Giant cell reparative granuloma
IIb-11.Mucoepidermoid carcinoma
IIb-12.Adenomatoid odntogenic tumor
IIb-13.Spindle cell carcinoma
IIb-14.Squamous cell carcinoma
IIb-15.Carcinoma in pleomorphic adenoma
IIb-16.Chroncic sclerosing sialoadenitis
IIb-17.Epithelial-myoepithelial carcinoma
IIb-18.Adenosquamous carcinoma
IIb-19.Leiomyosarcoma
IIb-20.Hodgkins lymphoma
IIc-01.1.Squamous cell carcinoma 2.Dysplasia
IIc-02.
IIc-03.d
IIc-04.d
IIc-05.No metastasis to lymph node
IIc-06.
IIc-07.
IIc-08.Fordyces spot
IIc-09.Adenoid cystic carcinoma
IIc-10.Thyroid carcinoma,papillary adenocarcinoma
IIc-11.Cytomegalovirus infection
IIc-12.Primary biliary cirrhosis
IIc-13.Absence of germ cells
IIc-14.Prostatic adenocarcinoma
IIc-15.Koilocytic atypis/mild dyslasia
IIc-16.So-calledmastopathy(sclerosing adenosis)
IIc-17.Malignant lymphoma,follcular,small cela v e d(grade 1)
IIc-18.b)
IIc-19.b)
IIc-20.Cryptococcosis
-
6.
5
I
IIa/IIb
IIc6
III
3
III
60
3
7.
63
IIcIIII
IIIcIII
IIIIIc
8.
10
19
3. 102002
I IIab IIc
1 1
2 2 2 6
3(1) 2 5
2 2
1 1
2 4 3 9
1 6 1 8
1 1
1 1 2
2 2
2 2
1 1
0
1 2 3
1 1 2
3(1) 2(0)
15(3) 20(2) 10 45(5)
4. 102002
I IIab IIc
/ 2 4 2 7(1)10(1)
/ 2 1 1 2 1
/ 1 3 1 3 1 6/ 1 2
/ 5 4 9 1 15/ 2 5
/ 3(1) 2 1(1) 6(2 1(1)7(3)
/
/ 3 1 4 1 6/ 1 1
/ 1 1 1
1 1
/ 1 3(1) 4(1)4(1)
/
15(1) 20 10(2) 45(4) 5(1) 50(5)
15 20 10 45
15(3) 20(2) 10 45(5)
30 40 20 90
%60 55 50 56
(
5. 102002
M
SD
M-SD
I 75 44.7 5.1 39.6 66 41
I 75 65.7 5.1 60.6 75 59
I 20 19.3 1.2 18.1 19 12
IIa 50 44.3 3.8 40.5 38 13
IIa 50 46.3 7.8 38.5 50 45
IIb 50 34.5 1.5 33.0 45 28
IIb 50 48.0 2.1 45.9 50 45
IIc 50 31.5 3.1 28.4 40 28
IIc 50 35.8 2.9 32.9 39 28
III 190 129.0 23.3 105.7 148 110
660 499.1 55.9 443.2 570 409
(%) 75.6 86.4 62.0
-
3
9.
7
III
20
6. 102002
1 2 3 4 5
1.
I 1 1 1
I 2
IIab 1 2
IIc 1 2
III 1 5
2.
I 1 2
I 1 2
IIab 1 1 1
IIc 1 2
III 2 1
3.
I 2 1
I 1 2
IIab 2 1
IIc 1 1 1
III 1 2
4.
1 2
2 1
5.
I 2 1
I 1 1 1
I1 1 2
III 1 2
III 2 1
III 3
6. 1 1 1
7. 2 1
8. 1 2
9. 1 2
11/42/5/8/9436/7
51/42/5/8/9436/7
7. 92001
1.
2.
-
200211
9417
9417
1.
2. 174165
3.
4. 151
152
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E-mail FAX TE L
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A
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B
(1) :A
(2) :
800
(3) :AB
(4) :A
49AB152
:TEL 03-5684-6886 FAX 03-5684-6936
:TEL 03-3547-5241 FAX 03-3248-0326()
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1411
14
331340
1.
2. 15120
3.
4. 10
5.
(
:113-0033 2-40-9
4F
TEL:03-5684-6886 FAX:03-5684-6936
E-mail:jspma.kcom.ne.jp