血清CA19-9値が高値を示した左高度水腎水尿管症

A CASE OF SEVERE HYDRONEPHROSIS WITH SIGNIFICANTLY ELEVATED SERUM CA19-9

　45歳，男性，健診にて血清CA19-9値の異常高値と左水腎症を指摘された。画像所見では左高度水腎水尿管症と左尿管下端の結石を認めるのみで，肝，胆，膵には異常を認めなかった。左腎尿管摘除術を施行し，病理所見では悪性像はみられなかった。腎盂内容液の尿細胞診はclass 1であった。腎盂，尿管粘膜はCA19-9で陽性に染色された。術後1か月後の血清CA19-9値は22U／mlと正常域まで下降した。

A 45-year-old man presented with significantly elevated serum CA19-9 and severe left hydronephrosis. Physical examination was normal except for left hydrocele. Laboratory data were within normal range. Urine cytology was class I . Computerized tomography showed severe left hydronephrosis and hydroureter with a ureter stone in the lower edge of ureter. The patient underwent left nephroureterectomy. Pathological exami-nation revealed no malignant tumor. The cytology of fluid of hydronephrosis was class I .