精索結核の1例

Abstract

65歳男.患者は左鼠径部に無痛性の腫瘤を自覚し, 1ヵ月後, 増大していた.胸部X線写真にて, 右上肺野に陳旧性肺結核病巣を認め, 左精索腫瘍の診断にて, 手術が行われた.腫瘤は精巣上体に接して精索内に存在し, 精索血管と強固に癒着していた.腫瘤のみを摘出することは困難であると判断し, 左高位精巣摘除術が施行された.精索結核と診断し, Ziehl-Neelsen染色を行ったが結核菌は確認できなかった.ツベルクリン反応は中等度陽性であった.抗核療法を6ヵ月間の予定で開始し, 術後2ヵ月経過現在, 新たな局所再発は認められていない

A 65-year-old man visited our hospital with a complaint of a left inguinal mass. He had had a past history of tuberculosis. A left spermatic cord tumor was suspected. Left high orchiectomy was performed. The mass did not connect with the testis or epididymis. The removed mass measured 4 x 2 x 1.5 cm in size. Microscopic examination showed a granulomatous lesion with Langhans giant cells. Tuberculin skin test was moderately positive. From these findings we diagnosed the patient with tuberculosis in spermatic cord. Antituberculous chemotherapy was subsequently initiated. Two months after surgery, recurrence has not been found.