著者

金沢 浩吉

出版者

The Medical Society of Kansai Medical University

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.21, no.4, pp.79-93, 1969

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While 196 autopsy cases pre8enting alveolar macrophages containing. brown pigment such as hemosiderin, were examined, it was found that 148 cases, that is,75.52 of all the cases revealed the presence of so-called heart failure cells yielding a positive 'mercuryaffinity reaction.<BR>And among these cases the strong mercury-affinity reaction-positive cases presenting an iron reaction-negative or a weak iron reaction-positive pigment in alveolar macrophages, accounted for 44. cases (about 30% of 148 cases), of which 33 cases (75% of 44 cases)were found to have malignant tumors accompanied by cachexia.<BR>The remaining II cases had suffered from consum p tive diseases accompanied by an evident cachekia. Moreov er, according to the author's detailed histochemica, observations of 44 cases demonstrating the so-called heart failure cells, it has been manifested that congestive lung edema., probably due to cachexia is usually present, and that the, appearance of these, cells is ncit directly related to intraalveolar -hemorrhage and destruction of red corpuscles due to severe lung congestion, a factor which had been regarded as essential conditions for the appearance of heart failure cells.<BR>Thus, taking the above re sults into account, - the occurrence of ceroid-like -pigment 'in the so-called heart failure cells in ' autopsy cases of cachexia accompanying malignant tumors or consumptive diseases, appears to be closely related to alteration of the components of plasma protein, that is an increase in plasma protein fractions (&alpha;-globulin or glycoprotein) due to a probable 'consumption of tissue proteins and can be possibl y attributed to a phagocytosis of those, proteins carried out by macrophages.<BR>It seems reasonable to assume that the above findings pre s uppose the existence of cachectic lung edema accompanied by congestion in the so-called heart failute cell pigmentpositive cases and that origin of ceroid-like pigment in the so-called heart failure cells may be attributable to the edematous' protein-rich fluid which may contain the abnormal proteins mentioned above.