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66歳,男性.主訴は尿閉と肉眼的血尿.腹部超音波検査時,右腎中央部に直径4cm大の腫瘤を認め,右腎細胞癌の術前診断にて,根治的右腎摘除術を施行した.術前に高アミラーゼ血症を呈していたが,術後その値は低下した.高アミラーゼ血症は,酵素免疫固定法の結果から,IgG・IgA-κλ型結合マクロアミラーゼが原因と考えられた.腎細胞癌に合併したマクロアミラーゼ症例はめずらしく,欧米の文献でI例報告されているのみである.
A 66-year-old male was admitted to the hospital on July 2, 1990, with the complaint of urinary retentionand gross hematuria. Abdominal ultrasonography and CT scan indicated a right renal tumor. A right radicalnephrectomy was performed. The level of the preoperative serum amylase was elevated, however, itdecreased gradually after the operation. Gel exclusion chromatography of the serum revealed that theelevated amylase was due to macroamylase which consisted of a complex of amylase, IgG lambda and IgAlambda. Renal cell carcinoma associated with macroamylasemia is rare.
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