急速な経過をたどったベリニ管癌の1例

A CASE OF BELLINI DUCT CARCINOMA SHOWING A RAPID COURSE OF DEATH AFTER THE OPERATION

　症例は57歳，男性。右側腹部痛，発熱を主訴に当科を受診し，腹部CTにて右腎に内部構造を有する嚢胞性病変が認められ入院した。RPで腎盂腎杯の不整がみられ，腎盂腫瘍の診断で腎・尿管全摘除術を施行した。摘出標本で腎髄質から皮質にわたって結節状に増殖する充実性の腫瘍を認め，免疫染色を含む病理組織学検索にてベリニ管癌（乳頭状腺管型）と診断された。術後1か月に後頸部リンパ節転移出現，4か月後に癌性胸腹膜炎を併発し癌死した。

A 57-year old male was admitted to our clinic with the chief complaints of right flank pain and repetition of fever attacks. A cystic lesion including the internal mass structure in the right kidney was detected by abdominal computed tomography. Because retrograde pyelography showed renal pelvis deformity suggesting renal pelvic tumor, nephroureterectomy was performed. Macroscopic examination of the extirpated kidney revealed a nodulous tumor, growing from the renal medulla into the cortex. Histopathological diagnosis with immunohistostaining examinations was Bellini duct carcinoma of papillary tubular type.