早期腎腫瘍の発見におけるCT検査の重要性

Abstract

Our experience of finding a small renal cell carcinoma by CT suggested the diagnostic importance of CT in the early stage of the tumor. The patient was a forty-year-old woman who had suffered several times from pyelonephritis. She consulted us for detailed examination. IVP showed only slight deformity like a calyceal diverticulum at the upper pole of the left kidney. Ultrasonic tomography failed to expose the region. Enhanced CT revealed a small space occupying lesion like a simple renal cyst at the region, though plain CT revealed no abnormal findings. From the comparison of these two CT, she was diagnosed to have renal cell carcinoma which was confirmed by renal arteriography. Subsequently, transabdominal left nephrectomy was performed. Pathological diagnosis was renal cell carcinoma (clear cell type). The tumor size was very small, 1.5 cm in diameter. Comparison of plain and enhanced CT were considered important to diagnose a small tumor, and CT is now the most useful examination to detect early stage renal cell carcinoma.