尿管移行上皮内癌の１例

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  • Transitional cell carcinoma in situ arising in the middle ureter. A case report.

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Background: Renal pelvic and ureteral lesions are difficult to diagnose because of technical difficulties in obtaining tissue specimens. We reported a case of transitional cell carcinoma in situ (CIS) in the right ureter suspected preoperatively from radiographic and cytological examinations.<BR>Case: A 70-year-old man diagnosed with transitional cell carcinoma (Grade 3) in the urinary bladder in 1989 underwent chemotherapy alone and the tumor decreased in size. Four years later, in 1993, the tumor relapsed in to the urinary bladder, necessithting transurethral tumor resection and spell out (BCG) therapy. A follow-up urinary examination disclosed hematuria on November 1999. Retrograde pyelography showed an irregularity of the right ureteral wall. Atypical transitional cells with increased nuclear chromatin and distinct nucleoli were seen in urinary cytology from the right lower ureter and vesical washing solution, suggesting malignancy. Right ureteronephrectomy was done in February 2000. CIS in the right lower ureter was diagnosed on histological examination.<BR>Conclusion: Cytological examination is useful for evaluating ureteral lesions.

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