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63歳の主婦が無症候性肉眼的血尿を主訴に受診した。膀胱鏡で左尿管からの血尿が認められ,左腎盂洗浄液の細胞診がclass 5であつた。左腎尿管全摘出術を施行したが肉眼的に明らかな腫瘍は認められず,組織学的分布図で上皮内癌とdysplasiaが腎盂全体と集合管の一部に広がつており,原発性腎盂上皮内癌と確定した。原発性上部尿路上皮内癌は上部尿路尿細胞診で診断しうるが,多発性尿路再発のおそれがある重要な疾患である。
A 63-year-old female visited the Niigata University hospital with a complaint of macrohematuria on April 19,1985. Cystoscopy revealed hematuria flowing out from the left ureteral orifice. A 1 cm-sized mass was found in the left upper calyx by secretory urography, CT, and left retrograde pyelography. Voided urine, irrigation samples from the bladder, urine from the left renal pelvis and irrigation samples from the left renal pelvis were diagnosed cytologically class 1, class 1, class 3 and class 5, respectively. Left total nephroureterectomy was performed on June 19, 1985.
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