Tsuji Takayuki, Ohtake Takayasu, Yonemura Katsuhiko, Sudoko Hiroshi, Komiyama Akira, Seki Akihiko, Kato Akihiko, Hishida Akira
First Department of Medicine, Hamamatsu University School of Medicine.
Intern Med. 2007;46(12):879-82. doi: 10.2169/internalmedicine.46.1885. Epub 2007 Jun 15.
We encountered a 49-year-old Japanese man in whom tumor-like renal lesions developed as a result of chronic Staphylococcus aureus pyelonephritis. The patient complained of general fatigue, weight loss, and anorexia for 6 months. Contrast-enhanced computed tomography (CT) of the abdomen revealed multiple low-density lesions in both kidneys and paraaortic lymphadenopathy. A strong uptake of Ga67 citrate in the lesions and elevation of serum soluble interleukin-2 receptor and thymidine kinase activity were strongly suggestive of primary renal lymphoma; however, histologic examination of renal biopsy specimens revealed severe tubulointerstitial change, consistent with chronic pyelonephritis. Following systemic antibiotic treatment, multiple tumor-like lesions regressed 4 months later. This case suggested that chronic pyelonephritis could present as bilateral renal tumors.
我们遇到一名49岁的日本男性，其因慢性金黄色葡萄球菌肾盂肾炎而出现肿瘤样肾病变。患者主诉全身乏力、体重减轻和食欲不振6个月。腹部增强计算机断层扫描（CT）显示双肾多发低密度病变及主动脉旁淋巴结肿大。病变部位对柠檬酸镓67摄取强烈，血清可溶性白细胞介素-2受体和胸苷激酶活性升高，强烈提示原发性肾淋巴瘤；然而，肾活检标本的组织学检查显示严重的肾小管间质改变，符合慢性肾盂肾炎。全身抗生素治疗后，4个月后多个肿瘤样病变消退。该病例提示慢性肾盂肾炎可表现为双侧肾肿瘤。
