Nakaya Izaya, Iwata Yasunori, Abe Toshio, Yokoyama Hitoshi, Oda Yoshio, Nomura Gakuji
Department of Internal Medicine, Kanazawa Municipal Hospital, Kanazawa.
Intern Med. 2004 Feb;43(2):102-5. doi: 10.2169/internalmedicine.43.102.
A 69-year-old man was admitted with a large elastic mass in the upper abdomen. Computed tomography revealed a massive tumor in contact with the liver and gastrointestinal endoscopy revealed a gastric adenocarcinoma. He developed acute renal failure with massive proteinuria and died with a marked enlargement of the tumor. Autopsy revealed a tumor located in the lesser omentum. The tumor was considered to be a Gastrointestinal Stromal Tumor (GIST) because it was positive for c-kit. In addition, crescent formations and immune complexes in glomeruli were observed. We report the first case of GIST complicated by rapidly progressive glomerulonephritis and gastric carcinoma.
一名69岁男性因上腹部有一个巨大的弹性肿块入院。计算机断层扫描显示有一个与肝脏相连的巨大肿瘤,胃肠内镜检查显示为胃腺癌。他出现了伴有大量蛋白尿的急性肾衰竭,并因肿瘤明显增大而死亡。尸检发现肿瘤位于小网膜。该肿瘤被认为是胃肠道间质瘤(GIST),因为它对c-kit呈阳性。此外,在肾小球中观察到新月体形成和免疫复合物。我们报告了首例GIST并发快速进行性肾小球肾炎和胃癌的病例。