腎動静脈瘻を伴つた腎細胞癌—CTによる診断の評価

CT EVALUATION OF RENAL ARTERIOVENOUS FISTULA ASSOCIATED WITH RENAL CELL CARCINOMA

緒言

　Computed tomography（CT）は腎細胞癌の静脈内浸潤の診断に有用であることが認められている。われわれは最近CTで腎静脈および下大静脈の拡張がみられたため，静脈内の腫瘍血栓を疑つたが，手術的に腫瘍血栓を認めず，CTでみられた腎静脈と下大静脈の拡張は，腫瘍に合併した動静脈瘻によるものと診断された腎細胞癌の1例を経験したので報告する。

The patient was 49-year-old woman. She visited us on March 12, 1979, complaining gross hematuria and left renal pain. Renal mass was palpated and hypertension was observed. Engorgement of superi-ficial abdominal vein and edema of lower extremities were not observed. Excretory pyelography revealed that the pelvis and calyces of the left kidney were compressed toward inner side with deformity. By CT, this mass was diagnosed as a tumor. However, since the left renal vein and inferior vena cava showed enlargement with their diameters of 3.8cm and 3.2cm, respectively, tumor thrombus was suspected.