総合健診受診者にみられた腎腫瘍,膀胱腫瘍の検討

Abstract

東海大学病院健診センターにおける自動化総合健診中にみられた腎腫瘍と膀胱腫瘍につき症例の概要を報告した.総合健診が腎腫瘍, 膀胱腫瘍の早期発見に対して果たす役割につき考察した.腎腫瘍の早期発見のためには, 総合健診への腎USの導入が必要であるとともに, 顕微血尿の精査際にもUSは必須の検査法であることを述べた.膀胱腫瘍の発見については, 肉眼血尿の既往を重視し, 血尿に対する啓蒙の必要性があり, 顕微血尿からの発見という点からは, 受診者の性, 年齢を考慮し, 静脈性腎盂造影や尿細胞診を利用したうえ, 膀胱鏡検査をタイミング良く行うことであると考えた

From June 1975 through December 1983, 48, 604 individuals consisting of 34, 535 males and 14, 069 females underwent health examinations at the Automated Multiphasic Health Testing and Services (AMHTS) Center in Tokai University Hospital. There were five patients with renal cell carcinoma and three with bladder cancer. We reviewed the clinical courses of these patients and discussed the early detection of urological cancers in AMHTS. Patients with renal cell carcinoma were brought to the urology department with various findings in AMHTS. A 44-year-old male was referred to us for the investigation of multiple metastatic shadows in the chest X-P and left renal tumor was diagnosed by intravenous pyelography (IVP) and computed tomography (CT). Renal tumor of a 57-year-old male was diagnosed by the investigations of abnormal renal calcifications found in AMHTS. A 39-year-old female had undergone health check-ups several times but was not found to have a renal tumor. The diagnosis of left renal tumor was made by the abdominal CT carried out after the operation on cerebellar hemangioblastoma. The fourth patient was a 60-year-old female with microscopic hematuria found in AMHTS and the diagnosis was confirmed by calyceal deformity shown in IVP. The last patient was a 64-year-old male and was accidentally demonstrated to have a right renal mass by ultrasonography when he was reexamined for the hepatic abnormality found in AMHTS. He showed microscopic hematuria in the AMHTS urinalysis. The diagnosis was confirmed by IVP, CT and renal angiography.(ABSTRACT TRUNCATED AT 250 WORDS)