G-CSF産生ベリニ管癌の1例

Abstract

75歳女.食欲不振があり, 超音波検査を施行したところ, 左腎盂腫瘍を疑い入院した.生検の結果は炎症性黄色腫であった.画像所見からは左腎盂腫瘍が疑われたが, 炎症性変化も否定できない為, 左腎尿管全摘除術とリンパ節郭清術を施行した.摘出標本の病理組織学的所見からベリニ管癌と診断した.又, 抗G-CSF抗体による免疫染色で濃染されたことからG-CSF産生ベリニ管癌と診断した.術後経過は良好で第28病日に退院した.その後, 左上肺野へ新たな転移が認められた.M-VACを施行して肺転移の縮小が認められたが, 新たに脳転移をきたして死亡した

A case of Bellini duct carcinoma producing granulocyte colony-stimulating factor (G-CSF) is reported. The patient was a 75-year-old female with the chief complaint of appetite loss. Abdominal ultrasonography and abdominal computed tomography revealed left renal pelvic tumor. Left radical nephrouretrectomy was performed. The histopathological report showed Bellini duct carcinoma. Immunohistochemical staining using the anti-G-CSF antibody showed positive staining in the cancer cells. Preoperatively, the white blood cell count and serum G-CSF concentration were elevated to 34, 100/microliter and 334 pg/ml respectively. After operation these values became normal. However, these values were elevated again and CT scan revealed a left pulmonary metastasis 3 months after the operation. In spite of chemotherapy, she died of brain metastases 7 months after the operation.