顆粒球コロニー刺激因子産生腎盂移行上皮癌

A CASA OF G-CSF-PRODUCING RENAL PELVIC TUMOR

　症例は61歳，男性。主訴は肉眼的血尿，発熱，全身倦怠感。精査により右腎盂腫瘍と診断し，右腎尿管全摘術およびリンパ節郭清を施行した。病理組織学的診断は移行上皮癌，Grade 3,pT₄　pN₂　M₀であった。術前高値であった白血球数は再上昇し，血清顆粒球コロニー刺激因子の高値と，腫瘍組織に顆粒球コロニー刺激因子産生が証明された。肺，骨転移がみられ，術後31日目に死亡した。

A 61-year-old man was admitted to the hospital com-plaining of asymptomatic macroscopic hematuria, high fever and general fatigue. Labolatory deta showed marked leukocytosis and increased CRP. Computed tomography revealed right renal pelvic tumor and lymph node adenopathy. Total nephroureterectomy and lymphadectomy were performed and the pathological diagnosis was transitional cell carcinoma (Grade 3). After the operation, marked leukocytosis recurred again with increased serum G-CSF, and immnohistochemical staining with anti-G-CSF antibody showed positive in the cancer cells.