Takada Hideaki, Nagahama Kanji, Nakashima Yoshiharu, Yoshimura Koji, Nishio Yasunori, Matsuo Ken, Mori Noriko
The Department of Urology, Shizuoka General Hospital.
The Department of Nephrology, Shizuoka General Hospital.
Hinyokika Kiyo. 2017 Feb;63(2):81-85. doi: 10.14989/ActaUrolJap_63_2_81.
Patients with renal insufficiency receiving long-term hemodialysis often develop so-called hemodialysis amyloidosis characterized by systemic β 2-microglobulin amyloid lesions, while patients with renal cell carcinoma may develop amyloid A(AA) amyloidosis. Herein, we present a 67-year-old man on thirty-yearlong hemodialysis who was diagnosed to have left renal cell carcinoma coincident with a large spaceoccupying lesion adjacent to the psoas muscle in the pelvic cavity. An ultrasound-guided percutaneous needle biopsy was performed at the time of laparoscopic radical nephrectomy. The pathological work-up on the needle biopsy specimen revealed that the lesion was not an AA amyloidoma but a β2-microglobulin amyloidoma, which is a rare manifestation of hemodialysis amyloidosis.
接受长期血液透析的肾功能不全患者常发生所谓的血液透析淀粉样变性,其特征为全身性β2-微球蛋白淀粉样病变,而肾细胞癌患者可能发生淀粉样A(AA)淀粉样变性。在此,我们报告一名67岁男性,他接受了30年的血液透析,被诊断为左肾细胞癌,同时在盆腔腰大肌附近有一个大的占位性病变。在腹腔镜根治性肾切除术时进行了超声引导下经皮穿刺活检。对穿刺活检标本的病理检查显示,该病变不是AA淀粉样瘤,而是β2-微球蛋白淀粉样瘤,这是血液透析淀粉样变性的一种罕见表现。