無尿を契機に発見された悪性リンパ腫

A CASE REPORT OF MALIGNANT LYMPHOMA REVEALED BY ANURIA

　72歳，男性。無尿と顔面の浮腫を主訴に当科で受診。超音波検査とCT検査で傍大動脈リンパ節から膀胱内に連続する腫瘤を認めたため，腎後性腎不全を考え，左腎瘻造設術を施行した。経尿道的生検の病理組織学的診断は悪性リンパ腫であった。CHOP療法3コース終了後に腎瘻も抜去でき，さらに3コース追加後，残存腫瘤に対して60Gyの放射線療法を行った。無尿を主訴とする悪性リンパ腫は，自験例を含めて本邦では4例のみであった。

A 72-year-old man was admitted to our hospital with the chief complaint of anuria and edema in his face. Bilateral hydronephrosis and a tumor in the bladder were found on ultrasonography. Computed tomography revealed a bilat-eral ureteral obstruction by the swelling of the retroper-itoneal swollen lymphnodes. Vesical tumor was his-topathologially diagnosed as malignant lymphoma of the diffuse large cell type. After relieving his delirium by hemodialysis, percutaneous nephrostomy was performed to improve renal function.