Haitani Takao, Shimizu Yosuke, Inoue Takahiro, Okubo Kazutoshi, Watanabe Jun, Kamba Tomomi, Yoshimura Koji, Kanematsu Akihiro, Nishiyama Hiroyuki, Ogawa Osamu, Sumiyoshi Shinji, Mikami Yoshiki, Nishikori Momoko
The Department of Urology, Kyoto University.
Hinyokika Kiyo. 2012 Apr;58(4):209-13.
A 59-year-old man was referred to our hospital with right hydronephrosis, which was diagnosed from a medical examination. On imaging studies, he had concentric thickness of the right ureteral wall, and retroperitoneal and mesenteric lymphadenopathy. Urine cytology was negative, and an ureteroscopic biopsy showed no malignancy. We performed laparoscopic biopsy of the retroperitoneal lymphadenopathy, and the histopathological diagnosis was B-cell follicular lymphoma. The patient received four cycles of RCVP (rituximab, cyclophosphamide, vincristine, prednisolone) chemotherapy and four cycles of rituximab monotherapy and then he obtained complete remission. If concentric thickness of the ureteral wall is found, physicians should be aware of the possibility of malignant lymphoma and should consider laparoscopic biopsy for diagnosis.
一名59岁男性因右侧肾积水被转诊至我院，该肾积水通过体检诊断得出。影像学检查显示，他右侧输尿管壁呈同心性增厚，伴有腹膜后及肠系膜淋巴结病。尿液细胞学检查为阴性，输尿管镜活检未发现恶性病变。我们对腹膜后淋巴结病进行了腹腔镜活检，组织病理学诊断为B细胞滤泡性淋巴瘤。该患者接受了四个周期的RCVP（利妥昔单抗、环磷酰胺、长春新碱、泼尼松龙）化疗以及四个周期的利妥昔单抗单药治疗，随后实现完全缓解。如果发现输尿管壁同心性增厚，医生应意识到恶性淋巴瘤的可能性，并应考虑进行腹腔镜活检以明确诊断。
