感染を伴った副腎嚢腫

A CASE OF ADRENAL CYST WITH INFECTION

　45歳の糖尿病を有する女性。主訴は発熱，上腹部不快感。逆行性腎盂造影，CT等にて，左副腎嚢腫と診断。種々の抗生剤投与に抵抗する発熱を繰り返し，発熱は嚢腫の感染によるものと思われたため，嚢腫摘出術を施行。嚢腫は重さ1,300g，大きさ16×12×12cmで，比較的厚い被膜からなり，内容液は混濁した褐色の液だった。病理組織学的には，嚢腫壁は細胞浸潤を伴う肉芽形成が著明だった。術後，発熱はみられていない。

A 45-year-old woman visited our hospital with the chief complaints of high fever and abdominal discomfort. She had been sufferring from diabetes mellitus for several years which was not well con-trolled. By physical examination a large cystic mass was palpated with tenderness in the left upper quadrant of the abdomen. The diagnosis of the left adrenal cyst was established by ultra-sonography, CT-scan and retrograde pyelography. High fever was resist and to various antibiotics administration.