尿管閉塞を契機に診断された悪性リンパ腫

URETERAL OBSTRUCTION AS THE FIRST SIGN OF MALIGNANT LYMPHOMA: A CASE REPORT

　68歳，女性。主訴は下肢の浮腫，無尿。腹部超音波検査にて水腎を認めたため，腎後性腎不全と考え，エコーガイド下に経皮的腎瘻術を施行した。CT，リンバ系撮影，リンパ節生検などにより，無尿の原因は後腹膜腔の悪性リンパ腫の圧迫による両側尿管閉塞と考えられた。腎機能改善後に施行した化学療法によって尿管閉塞は解除され，15ヵ月が経過した現在，再閉塞の兆候はない。

A 68-year-old woman was admitted to our hospital with a chief complaint of anuria and edema in her legs. Hydronephrosis was found on the ultrasonogram, and percutaneous nephrostomy was per-formed. It was proved by CT scan and lymphography that a bilateral ureteral obstruction was caused by the swelling of the retroperitoneal lymphnode. Lymphnode biopsy was done and the pathological diagnosis was malignant lymphoma of the diffuse medium cell type. After her renal function was im-proved, chemotherapy (CHOP-B regimen) was done, which was successful, resulting the disappearance of ureteral obstruction.