顆粒球コロニー刺激因子（G-CSF）を産生した膀胱腫瘍

A case of G-CSF producting bladder tumor

　症例は83歳，女性。肉眼的血尿を認め当科を受診した。膀胱鏡で後壁に非乳頭状と乳頭状腫瘍を認めた。TURBTによる組織診断は，移行上皮癌，肉腫様変化，G3であった。術後CRPの上昇を伴わない白血球増多症および血中G-CSF：420pg/mlを認め，腫瘍組織は抗G-CSF抗体を用いた免疫染色で強陽性を示したことより，G-CSF産生膀胱腫瘍と診断した。予後不良で比較的稀な腫瘍として知られており，本症例はわれわれの調べ得た限りでは本邦51例目と思われる。

　An 83-year-old woman was referred to our hospital because of macrohematuria. Cystoscopy showed non-papillary tumor at the posterior wall with papillary daughter tumors, and histologic findings were grade 3 TCC with sarcomatoid changes. Since leukocytosis without positive CRP and elevated value of G-CSF（420pg/ml）in serum were recognized in post-TURBT period, diagnosis of G-CSF producting bladder tumor was established. The tumor tissue obtained by surgery demonstrated a positive staining of the immunohistochemistry using an anti G-CSF antibody. This case, to our knowledge seemed to be the 51st case reported in Japanese literatures.

（Rinsho Hinyokika 61：1011-1014, 2007）