Yoshii Takahiko, Horiguchi Akio, Shirotake Suguru, Tobe Musashi, Hayakawa Masamichi, Sumitomo Makoto, Asano Tomohiko
The Department of Urology, National Defense Medical College, Japan.
Hinyokika Kiyo. 2010 Nov;56(11):639-43.
We report a rare case in which upper ureteral rupture was the primary symptom of malignant lymphoma. A 74-year-old female visited our hospital with left flank pain. Computed tomography showed urinoma around the left kidney and retrograde pyelography showed a diffuse filling defect in the left ureter and a rupture of the upper portion of that ureter. A urine cytology specimen from the left ureter was class V, suggesting undifferentiated carcinoma or malignant lymphoma. An open laparotomy revealed a nodule on the omentum and diffuse fibrosis around both ureters, and the histopathological diagnosis was diffuse large B-cell lymphoma. The patient' s ureteral stenosis disappeared after she received six cycles of R-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone and rituximab) chemotherapy. We should be aware that malignant lymphoma can be the cause of a spontaneous ureteral rupture.
我们报告了一例罕见病例，其中输尿管上段破裂是恶性淋巴瘤的主要症状。一名74岁女性因左侧腰痛前来我院就诊。计算机断层扫描显示左肾周围有尿囊肿，逆行肾盂造影显示左输尿管弥漫性充盈缺损及输尿管上段破裂。左侧输尿管的尿液细胞学标本为V级，提示未分化癌或恶性淋巴瘤。剖腹探查发现大网膜上有一个结节，双侧输尿管周围弥漫性纤维化，组织病理学诊断为弥漫性大B细胞淋巴瘤。该患者接受六个周期的R-CHOP（环磷酰胺、阿霉素、长春新碱、泼尼松龙和利妥昔单抗）化疗后，输尿管狭窄消失。我们应该意识到恶性淋巴瘤可能是自发性输尿管破裂的原因。
