無カタラーゼ血液症に出現した口腔壊疽についての臨床的研究

Abstract

About one half of acatalasemia cases showed the specific oral gangrene, and two cases of them had unilateral tonsillar gangrene furthermore. The author conducted clinical observations on this gingival gangrene and tonsillar gangrene, and at the same time made a comparative study of these two types of gangrene histopathologically.As for the peculiarities of the gingival gangrene the following may be pointed out.1. These cases can be divided into three groups by the degree of the progress in symptoms. Namely, the minimal type of an extremely early stage, showing a highly advanced alveolar pyorrhea accompanied by ulcer of the gingiva; the moderately advanced type with the atrophy and sinking of the gingival bone and the spontaneous falling off of teeth due to the still further advanced gangrene; and the severe type presenting a progressive gangrene in the superior maxillary or the inferior maxillary bone, and or in the mucous membrane tissue of tongue base and cheek due to a still more violent advance.2. As for the histopathological characteristics the cell infiltration is slight in despite of the tissue necrosis is vigorous. The boundary of the tissue necrosis is distinct and the infiltration of eosinophilis can be recognized around the boundary line.Next, as for the characteristics of tonsillar gangrene, the following results have been obtained.1. Macroscopically the inflammatory reaction is slight, and ulceration tends to start from the tonsillar lacuna and spread from there, and the area surrounding the lesion is like sawteeth and undermined but not so deep, presenting the shape like a sack.2. Histopathologically lacunar tonsillitis and the necrosis commencing from tonsillar lacuna can be observed. The boundary line of the necrotic region is clear-cut, and the infiltration of eosinophilis can be seen around the necrosis. In addition, marked changes can be recognized in the wall of the blood vessels and muscle surrounding the necrosis.