腎カルチノイド腫瘍の1例

Abstract

症例は44歳の女性で, 健康診断の超音波検査で右腎腫瘤を指摘され精査目的で入院した.腎超音波検査では右腎中部に径3cmの高エコーの充実性腫瘤を認め, カラードップラーエコーで腫瘤内に血流は認めなかった.針生検により高分化な腎細胞癌が疑われ右腎摘出術を行った.組織学的検索において, 特徴的な細胞形態及び配列, Grimelius染色強陽性であること, 更に電子顕微鏡にて神経分泌顆粒を認めたことにより腎カルチノイド腫瘍と診断した

The patient was a 44-year-old woman in whom a mass of the right kidney was found when she underwent abdominal ultrasonography in a physical checkup. The computed tomography of abdomen and the magnetic resonance imaging of abdomen revealed a 3 x 3 cm solid mass at the right kidney. Excretory urograms showed a deformity of the right collecting system due to a mass lesion. The specimen of the resected tumor showed a cellular arrangement specific to carcinoid tumor and positive reaction of Grimelius stain. Electron microscopy confirmed the presence of dense-core granules in the tumor cells. Gastrointestinal investigation after the operation revealed no particular findings suggesting a carcinoid syndrome. No evidence of metastasis or recurrence was noted for 5 months after the operation. This was a very rare case of primary renal carcinoid tumor, representing the 12th case in the literature in Japan.