術前診断に尿細胞診が有用であった上部尿路の腫瘍性および炎症性病変の6例

Abstract

上部尿路腫瘍の術前診断において, 画像のみでの診断が困難であり, 尿細胞診が診断の決め手となった6症例を提示するとともに, 総合的な診断過程における尿細胞診の位置づけを検討し, 尿細胞診の有用性を述べた

We present six cases of upper urinary tract diseases including tumors and inflammatory lesions in which the urine cytology rather than the radiological examinations was useful for their preoperative diagnoses. Three of the six cases had malignant diseases and the others had benign diseases. In all cases preoperative results of urine cytology were identical to histopathological findings of resected specimens; the cases with positive findings in urine cytology had ureter cancers and those with negative findings had benign diseases. Primary CIS of upper urinary tract was found in two of six cases, which is still uncommon in Japan. Since it is very difficult to make a preoperative diagnosis of primary CIS by radiological examinations, the present study showed that urine cytology is useful for its preoperative diagnosis. Recently endoscopic techniques for the diagnosis of upper urinary tract tumors are in clinical use. The ureteroscopic biopsy is recommended for the case in which the diagnosis using urine cytology is difficult.