腎盂癌が合併した多房性腎嚢胞

MULTILOCULAR RENAL CYST AND TRANSITIONAL CELL CARCINOMA OF THE RENAL PELVIS COEXISTING IN THE SAME KIDNEY: A CASE REPORT

　67歳，女性．主訴は左側腹部痛と肉眼的血尿であった．初診時の排泄性腎盂撮影で左無機能腎がみられ，超音波診断法では左腎に水腎症と下極の嚢胞性腫瘤がみられた．経皮的腎痩を造設し，その腎痩造影では嚢胞性腫瘤より離れた上部腎杯に不整な陰影欠損がみられた．尿細胞では悪性細胞が認められた．左腎尿管全摘除術を施行した．組織学的所見では腎盂移行上皮癌と多房性腎嚢胞が別個にみられ，後者には悪性変化は認められなかった．

A 67-year-old female was admitted to our clinic with the chief complaints of left flank pain andmacroscopic hematuria of sudden onset. Excretory pyelography showed left nonvisualizing kidney, andultrasonography disclosed hydronephrosis and multicystic lesion occupying the lower pole of the left kidney.Percutaneous nephrostomy was carried out, and nephrostography showed an irregular filling defect in theupper calyx apart from the cystic mass. Urine cytology was positive for malignancy. Left nephroureter-ectomy was performed.