Pharmacoangiographyで異常血管を描出しえた乳頭状腎細胞癌の1例

Abstract

右腎腫瘤の精検の為に紹介された64歳男で, CT上, 造影剤による増強はみられず, MRIのT1強調像では腫瘤は低信号画像, T2強調像では高信号画像として現れた.血管造影では血管過小腫瘤を示したが, エピネフリン併用の薬理学的血管造影上, 腫瘤血管は血管収縮反応を示さなかった.根治的右腎摘出術を行った.腫瘤は大部分が壊死性で, 厚い被膜を有していた.組織学的に乳頭状腺癌と診断された

A 64-year-old man with a right renal mass was referred to our hospital for further examination. The tumor demonstrated no dye enhancement of the computerized tomography (CT) scan. The tumor appeared as a low signal intensity image on the T1 weighted magnetic resonance imaging (MRI) and as a high signal intensity image on the T2 weighted MRI. Angiography revealed as hypovascular mass, however, the vessels in the tumor appeared on pharmacoangiography due to the absence of vasconstrictive response. A right radical nephrectomy was thus performed. The tumor was mostly necrotic and had a thick capsule. The histopathological findings indicated the tumor to be papillary adenocarcinoma.