悪性リンパ腫との鑑別に難渋した特発性後腹膜線維症の１例

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  • A Case of Idiopathic Retroperitoneal Fibrosis Mimicking Malignant Lymphoma.

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We report a case of idiopathic retroperitoneal fibrosis mimicking malignant lymphoma, which was successfully treated with prednisolone. A 65-year-old man was seen at the hospital because of a swelling of the left lower extremity. A venography of the left lower extremity venography disclosed no abnormalities around the iliac vein from the femoral vein. Pelvic enhanced computed tomography (CT) demonstrated a tumor in the front of the sacrum, which penetrated by some blood vessels. Gallium scintigraphy demonstrated abnormal accumulation in the same region. The level of serum soluble IL-2 receptor was high. Therefore, a laparotomy was performed to biopsy the tumor on suspicion of malignant lymphoma. But the pathological diagnosis was idiopathic retroperitoneal fibrosis because fibrous connective tissue increased diffusely with inflammatory cellular infiltration. We began steroid therapy with prednisolone, and it was very effective for the idiopathic retroperitoneal fibrosis. The patient is strictly followed in the out patient clinic and no signs of recurrence have been observed. It is necessary to consider idiopathic retroperitoneal fibrosis in case of a localized retroperitoneal mass.

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