結石を伴つた海綿腎の2例

Abstract

The report discribed two cases of the SPONGE K I D NEY, which were both associated with multiple renal calculi and ureteral calculus. The patient of the first case was a m a n 41 years old, whose chief complaint was a dull pain in left renal region ; and the second, a man 32 years old, who complained a history of several passages of small calculi with renal colic. Blood chemical studies and renal funct i on tests of both cases were almost within normal limits. A p l a in roentgenogram of the first case showed multiple small calculi in both kidneys and left ureteral calculus, and of the second showed multiple small calculi in left kidney and right ureteral calculus. Intravenous pye l o gram of both cases showed numerous small cystic cavities and multiple small calculi contained in cavities at tips of all calyces and formed a typical "grape-like cluster" picture which identified the SPONGE KIDNEY. The SPONGEK IDNEY is usually diagnosed b y specific figures of the intravenous pyelogram. Therefore in a case associated with the calculous hydronephrosis, it is necessary to examine the intravenous pyelography after the improved renal function following a lithotomy as in the first case of above. The SPONGE KIDN E Y, which is associated with multiple renal calculi, manifests the figure of the nephrocalcinosis roentgenologically, hence differential diagnosis must be made to find the nephrocalcinosis caused if by hyperparathyroidism, renal acidosis, chronic pyelonephritis, milk-alkaline syndrome, multiple myeloma, metastatic myeloma, idiopathic hypercalcemia, idiopathic hypercalcinuria, hypervitaminosis D and others .