Murata Tadashi, Noda Masatoshi
Department of Urology, Himeji Saint Maria Hospital.
Hinyokika Kiyo. 2004 Oct;50(10):699-702.
We report a case of Bellini duct carcinoma with giant hydronephrosis. A 56-year-old man was referred with the chief complaint of gross hematuria. The intravenous pyelography showed a huge right renal contour and non-functioning kidney. The abdominal computed tomographic scan and magnetic resonance imaging demonstrated giant hydronephrosis. Percutaneous urinary cytology obtained in the direct pyelography was class V. Right total nephro-ureterectomy was performed. Punctured fluid volume was 1,010 ml during the operation. Histological and immunohistochemical analysis revealed the collecting duct carcinoma of the kidney. Three months later, multiple bone metastases had appeared. He was treated by the combination chemotherapy of gemcitabine and paclitaxel, but lung and liver metastases developed. The patient died of cancer 12 months later. This case was considered to be Bellini's duct carcinoma as its features had poor prognosis and image findings infiltrating from medulla to cortex with the total enlargement of the kidney. To our knowledge there has been no case found like these atypical imaging findings.
我们报道一例伴有巨大肾积水的肾集合管癌。一名56岁男性因肉眼血尿为主诉前来就诊。静脉肾盂造影显示右肾轮廓巨大且肾脏无功能。腹部计算机断层扫描和磁共振成像显示为巨大肾积水。在直接肾盂造影时获取的经皮尿液细胞学检查结果为V级。遂行右侧全肾输尿管切除术。术中穿刺出的液体量为1010毫升。组织学和免疫组化分析显示为肾集合管癌。三个月后，出现了多发骨转移。他接受了吉西他滨和紫杉醇联合化疗，但出现了肺和肝转移。12个月后患者死于癌症。该病例因其预后不良且影像表现为从髓质浸润至皮质并伴有整个肾脏增大，故被认为是肾集合管癌。据我们所知，尚未发现有类似这些非典型影像表现的病例。
