腎門部リンパ節にも病変のみられた腎血管筋脂肪腫

REGIONAL LYMPH NODE INVOLVEMENT IN RENAL ANGIOMYOLIPOMA

　53歳女性。主訴は微熱，全身倦怠感で来院。CT，血管造影で腎血管筋脂肪腫，脂肪肉腫が疑われ，術前検査でLDH高値，血沈亢進が認められたため，悪性腫瘍も否定できず，左腎摘出術を施行。病理組織診では，腎血管筋脂肪腫で腎門部リンパ節にも同様病変を認めた。LDH，血沈は術後7ヵ月では正常であった。従来の報告では，リンパ節に病変を認めても予後良好であるとのことであるが，今後長期的な観察が必要と考えている。

A case of angiomyolipoma of the kidney with renal hilus lymph node involvement is reported. Patient was 53-year-old woman with complaints of slight fever and general fatigue. Preoperative diagnosis was renal angiomyolipoma or liposarcoma by computed tomography and angiography. High LDH and ESR values were also noticed. Therefore left nephrectomy and lymph node biopsy were performed. Histo-logical examination of the tumor revealed angiomyolipoma with same changes in regional lymph node. Preoperative high LDH and ESR returned normal at 7 month after surgery.