原発性上部尿路扁平上皮化生—尿路白板症症例

SQUAMOUS METAPLASIA OF THE URETER

緒言

　上部尿路に結石や結核などの疾患を伴うことなく扁平上皮化生の起きることは少ない。扁平上皮化生が角化を伴つていれば完全型白板症（leuko-plakia）と呼び，角化物が重積して腫瘤を形成していれば真珠腫（cholestcatoma）と呼ぶが，neo-plasmでないものに"腫"という名称をつけるのは不適当であるという考え，また扁平上皮化生をただちに白板症と呼び，前癌状態と定義するのは適当でないという主張がみられるようになつている。そのような観点から角化を伴う原因不明の尿管扁平上皮化生の1例を報告し，本邦例を集計し，考察を加えたい。

A case of squamous metaplasia with keratinization of the ureter was reported. A 37-year-old male had passed "stone-like" masses for a period of nine years. The excreted mass was identified as keratin. No episode of pyelonephritis was revealed. Right kidney was not visualized on an intravenous pyelo-gram. Retrograde pyelography resulted in uncontrolable pyelonephritis and right nephroureterectomy was performed.

Out of reported cases of leukoplakia of the pelvis and ureter in Japan, 38 cases who had no primary lesions such as stone, tuberculosis and others were collected and reviewed.