腎血管造影後に発症し救命しえた肺塞栓症

A CASE OF PULMONARY EMBOLISM AFTER ANGIOGRAPHY FOR RENAL CELL CARCINOMA

　61歳，女性。右腎腫瘍の診断で血管造影を施行。検査翌日に圧迫および安静解除したところ，突然呼吸困難，ショック症状を呈し，肺血流シンチグラフィーなどにより，肺塞栓症と診断された。ただちにSwan-Ganzカテーテルを挿入し，肺動脈への選択的ウロキナーゼ投与を行い救命し得た。発症より40日後，根治的右腎摘除術を施行。病理学的診断は腎細胞癌，胞巣型，淡明細胞亜型，Gl＞G2,pT2であった。

Angiography was performed in a 61-year old female patient for the renal tumor. On the next day, dyspnea and shock developed suddenly and pulmonary embolism was suspected from lung perfusion scintigram. She was treat-ed by thrombolytic and anti-coagulant therapy using Swan-Ganz catheter, and became completely recovered. 40 days after angiography, right radical nephrectomy was done. Pathological diagnosis was renal cell carcinoma, alveolar type, clear cell subtype,G1＞G2, pT2.