Oberholzer C, Sawatzki M, Rothermundt C
Medizinische Poliklinik, Onkologie, Universitätsspital Basel.
Praxis (Bern 1994). 2007 Nov 28;96(48):1911-4. doi: 10.1024/1661-8157.96.48.1911.
A 52-year-old patient presented himself with weight loss and night sweats. Laboratory analyses revealed a high sedimentation rate, elevated immunoglobulines and anaemia with sludge phenomenon. Differential diagnoses included Multiple Myeloma and Lymphoma. Having a risk constellation for HIV infection and just having recovered from oral thrush also made this diagnosis possible. Urinary analysis and chest x-ray were normal; however, CT-scan detected renal cell cancer with pulmonary metastases. Renal cell cancer is heterogeneous in presentation, symptoms are unspecific, therefore they are often discovered late when they have already metastasized. Paraneoplastic syndromes, e.g. hypercalcaemia or hypertension are not infrequent in renal cell cancer.
一名52岁患者出现体重减轻和盗汗症状。实验室分析显示血沉加快、免疫球蛋白升高以及伴有红细胞缗钱状现象的贫血。鉴别诊断包括多发性骨髓瘤和淋巴瘤。鉴于该患者有HIV感染的风险因素且刚从口腔念珠菌病中康复，这也使得这种诊断成为可能。尿液分析和胸部X光检查均正常；然而，CT扫描检测到肾细胞癌伴肺转移。肾细胞癌的表现具有异质性，症状不具特异性，因此往往在已经发生转移时才被发现。副肿瘤综合征，如高钙血症或高血压，在肾细胞癌中并不罕见。
