コレステリン肉芽腫の病態

乳突蜂巣粘膜の電子顕微鏡による観察

抄録

Cholesterol granulomas of six patients were investigated electron-micloscopically. Non-ciliated cells in cholesterol granuloma had a round surface and they formed mulitiple layers. Some small pores were seen between cell membranes, and there were numerous lipoid granules in cytoplasm of the mucosa and in subcutaneous tissue. Lipid granules were secreted at the cell membrane surface with apocrine secretion or were seen escaping from the small pores between cells due to laceration. These lipid substances accumulated together in the mastoid air cells and formed cholesterol crystals. This phenomenon was observed especially around microvessels. Ciliated cells had degenerated and their cilia had decreased in number. Shorter and adherent of cilia were also found.
These observations lead us to conclude that cholesterol granulomas caused by pathological changes in the mucosa of the mastoid air cell system. It also seemed apparent that reducing pathological mucosa in the mastoid portion is very important in clinical therapy.