血中CA19-9が高値を示した水腎症

A Case of Hydronephrosis Presented High Serum CA19-9

　53歳の男性が，検査にて血中CA19-9が306.6U／mlと高値を示し，消化器系に異常はなく右腎に嚢胞状病変を発見された。この病変は腎嚢胞か水腎症か鑑別が困難であった。病変部の穿刺液中CA19-9は220×10⁴U／mlと異常高値で，ミノサイクリンの注入にて血中CA19-9は正常値となった。しかし嚢胞状病変の再発とCA19-9の再上昇，さらに右背部の圧迫感も出現したため腎摘出術を行い，水腎症と判明した。CA19-9免疫染色にて腎盂粘膜は強く染色された。今までに血中CA19-9が高値を示した水腎症は5例報告されており，検討を加えた。

53 year-o1d male with high serum CA19-9 level had a cystic lesion in right kidney and his digestive organs were demonstrated normal.It was difficult to differentiate renal cyst from hydronephrosis. The puncture of this cystic le-sion was carried out and CA19-9 in the fluid was 220×10⁴U/ml. Serum CA19-9 became normal after injection of minocycline into this lesion. Cystic lesion however returned immediately to preoperative size with elevation of serum CA19-9. The patient underwent right nephrec-tomy, which disclosed cystic lesion was hydronephrosis.Renal pelvic mucosa was strongly stained on immunostain-ing.