再生不良性貧血に続発し，男性ホルモン誘発性の肝腺腫を伴ったMyeloproliferative disorderの1剖検例

抄録

A boy, born in 1961, was first admitted in 1967 and a diagnosis of aplastic anemia was made. He was on androgenic steroids for five and a half years and was re-admitted in November 1973, because of severe anemia and a 12×9 cm mass in the left upper abdominal quadrant. Liver scan demonstrated hepatomegaly with a large filling defect. HBs-Ag and α₁-fetoprotein were not detected. Bone marrow examination revealed normoblastic hyperplasia with many ringed sideroblasts. A diagnosis of sideroblastic anemia was made. Chromosome examination revealed aneuploidy in 50% of the analysed cells (44, X-Y, -21/ 45XY, -21/ 46XY lq⁺). He was treated with vitamine B₆ and the response was not sufficient. He died in July 1976 suddenly. On autopsy, a single, well circumscribed 11.8×8 cm tumor was found in the left lobe of the liver. Histologically, the tumor was well differentiated liver cell adenoma. There was a hypercellular marrow with myeloid cells, but no increase of the atypical cells. This is the first case of hepatocellular adenoma induced by long-term androgenic steroids reported in the Japanese literature. Discussion was made on an association between the aplastic anemia and sideroblastic anemia terminating as myeloproliferative disorder.