両側腎盂偽リンパ腫により水腎症をきたしたシェーグレン症候群の1例

Abstract

52歳女.口渇感を主訴とし, 唾液腺機能低下を認めシェーグレン症候群と診断された.両側腎盂の病変による悪性リンパ腫と診断し, 試験開放右腎盂生検を施行した.腎盂は周囲脂肪組織と激しく癒着しており, 腎盂壁表面および断面は白色均一でび漫性に肥厚していた.病理検査によりシェーグレン症候群に伴う偽リンパ腫と診断された.ステロイド療法を開始し, CRPおよびIgGは正常化し, 3ヵ月後には腎盂腫瘤は縮小して水腎症は改善した

We report a case of bilateral hydronephrosis caused by pseudolymphoma of bilateral renal pelves. A 52-year-old woman with Sjogren's syndrome and bronchial asthma was found to have bilateral hydronephrosis. Abdominal plain computerized tomography showed an irregular thickening of the bilateral renal pelves with moderate hydronephrosis. The gallium scintigraphy revealed intense tracer uptake in bilateral renal pelves. Open biopsy of the right renal pelvis was performed under the diagnosis of malignant lymphoma. The pathologic diagnosis was pseudolymphoma of the renal pelvis. Steroid therapy dramatically improved pseudolymphoma and hydronephrosis within a month. There were no signs of recurrence.