保存的治療が可能であった腎盂炎症性偽腫瘍の1例

Abstract

20歳女.主訴は発熱及び腰痛.腹部単純CTで右腎盂に腎実質とほぼ等吸収域を示す2.5×2.0cm大の腫瘤状陰影を認めた.腎臓超音波検査では腎内に直径2.5cmの境界明瞭で内部不均一な腫瘤を認めた.抗生剤の点滴加療を施行し, 症状が改善したため軽快退院となった.退院30日後, 再度腹部CT施行したところ右腎盂の腫瘤性病変は消失していた.又, 静脈性尿路造影でも右腎盂に陰影欠損は認めなかった.以上の臨床経過及び画像診断より腎盂に発生した炎症性偽腫瘍と考えられた

A 20-year-old woman was admitted with chief complaints of high fever and right lumbago. Abdominal computed tomography (CT) and ultrasonography revealed a right renal pelvic tumor 25 mm in diameter. Although malignancy could not be confirmed by the scan, we administered antibiotics based on a diagnosis of inflammatory pseudotumor of the renal pelvis. After treatment, no tumor was detected. In such cases, because diagnosis is generally difficult, surgery is usually performed. However, in this case, the patient showed a complete response to antibiotics.