腎盂外自然溢流をきたした尿管Fibroepithelial polypの1例

Abstract

右腰背部仙痛を呈した26歳女で, 逆行性腎盂造影で右腎盂からの造影剤溢流, 及び尿管口の近位側4.5cmの右尿管に陰影欠損を認めた.尿細胞診は悪性陰性であった.右尿管部分切除術及び膀胱尿管新吻合術を行った.切除遠位側尿管に灰白色の表面平滑な3mmのポリープ及びポリープの直ぐ遠位側に長さ2cmの尿管狭窄を認めた.病理診断は線維上皮性ポリープであった

A 26-year-old woman presented with a colicky right flank pain. Retrograde pyelogram showed extravasation of the contrast medium from the right renal pelvis and a filling defect in the right ureter 4.5 cm proximal to the ureteral orifice. Urinary cytology was negative for malignancy. A partial ureterectomy with a vesicoureteroneostomy was performed. Gross inspection of the resected distal ureter revealed a 3-mm polyp with a grayish-white smooth surface as well as a ureteral stenosis of 2 cm in length just distal to the polyp. Pathological diagnosis was a fibroepithelial polyp. In our case, urinary extravasation probably resulted from an impacted polyp in the stenotic ureter.