腎盂腫瘍との鑑別を要したIgG4関連疾患

IgG4-related disease mimicking renal pelvic tumor : A case report

　75歳男性．左腎盂癌の疑いで，精査加療目的にて当科を受診した．CT検査では両側腎病変が認められたため，腎盂癌よりも全身性疾患の可能性が考えられた．腎実質病変に対して経皮的針生検を施行し，IgG4関連疾患の診断を得た．ステロイド治療を行うことで，病変は著明に縮小した．IgG4関連疾患は他臓器病変を有さず，腎尿路を唯一の病巣として発症することがありうることを認識しておくことが重要である．

Abstract

A 75-year-old man visited our hospital for the purpose of the further examination and the treatment of cancer suspicious lesion of left renal pelvis. Because reevaluation by computed tomography revealed multiple parenchymal lesions in bilateral kidneys, systemic disease rather than renal pelvic cancer was suspected. Percutaneous needle biopsy of the parenchymal lesion was carried out and through the histopathological examination the patient was diagnosed as IgG4-related disease. The patient was treated with predonisolone, and the lesion markedly decreased in size. It is important for urologists to recognize that IgG4-related disease presenting as urological involvements without lesions of any other organs (Rinsho Hinyokika 72 : 939-943, 2018).