所属リンパ節に同一病変を認めた腎血管筋脂肪腫

A CASE OF RENAL ANGIOMYOLIPOMA WITH REGIONAL LYMPH NODE INVOLVEMENT

　72歳，女性。体重減少と心窩部圧迫感を主訴に来院し，CTなど画像検査の結果，右腎下極に腎外性に発育する腫瘍を認めた。右根治的腎摘除術を施行し，病理診断は腎血管筋脂肪腫で，所属リンパ節にも同様の病変を認めた。リンパ節の病変を原発巣の転移と考えるか，多中心性発生と考えるかが問題で，一般的には後者を支持する意見が多い。まだ症例も少なく，十分な経過観察が必要と思われる。

A 72 year-old woman was admitted with complaints of weight loss and abdominal discomfort. Adiagnosis of a right extrarenal tumor was made by ultrasonography, CT scan, and angiography. Right radicalnephrectomy and regional lymph node dissection were performed under general anesthesia. Pathologicaldiagnosis was renal angiomyolipoma with regional lymph node involvement. It was concluded that theselymph node changes were not lymph metastasis of renal angiomyolipoma but simultaneously occurred lymphnode angiolopoma. However, few cases have yet been reported and thus we believe that a long term followup of patients is required.