嫌色素性腎細胞癌を合併した黄色肉芽腫性腎盂腎炎の一例  [in Japanese] A CASE OF XANTHOGRANULOMATOUS PYELONEPHRITIS ASSOCIATED WITH CHROMOPHOBE RENAL CELL CARCINOMA  [in Japanese]

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Abstract

<p>症例は,39歳女性.甲状腺眼症のため当院眼科でステロイドパルス療法を施行されていたが,突然の左下腹部痛が出現し,発熱も伴った.発熱・疼痛は一過性であり鎮痛薬で軽快し,他の症状は認めなかった.造影CT,MRI,ドップラーエコーで,左腎上極に40mm大の囊胞内出血などの良性病変が疑われたが,悪性を否定できないため,手術の方針となった.</p><p>左腎腫瘤に対し,経腰式左腎部分切除術を施行した.検体は肉眼的に褐色調充実性の病変で,組織学的には30mm大の黄色肉芽腫性腎盂腎炎に隣接して5mm大の嫌色素性腎癌がみられた.術後は順調な経過であり,9カ月時点で炎症所見や腫瘍再発は認めていない.黄色肉腫性腎盂腎炎に腎癌が併存した症例は極めて稀であり,嫌色素性腎癌は調べ得た限りではこれまでに報告例はなく,文献的考察を加えて報告する.</p>

<p>Xanthogranulomatous pyelonephritis (XGP) is a type of chronic suppurative renal inflammation. We present an extremely rare case of XGP concomitant with chromophobe renal cell carcinoma (RCC). A-39-year-old woman presented with transient fever and left lower abdominal pain during steroid pulse therapy for thyroid eye disease. Imaging studies including contrast-enhanced computed tomography, magnetic resonance imaging, and doppler ultrasonography, showed a 40 mm unusual mass lesion in the upper pole of the left kidney, and we could not rule out the possibility of malignancy.</p><p>A left open partial nephrectomy for the renal mass was performed. Pathological examination revealed a 5 mm chromophobe RCC located beside a 30 mm XGP. The patient presented a favorable course without inflammatory episodes or tumor recurrence during the 9-month follow-up. This is the first case report of the coexistent XGP and chromophobe RCC.</p>

Journal

  • The Japanese Journal of Urology

    The Japanese Journal of Urology 108(3), 154-157, 2017

    THE JAPANESE UROLOGICAL ASSOCIATION

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