M蛋白血症を伴った腎癌の1例 -腎癌の血清蛋白像のパターンを中心に-

Abstract

Renal cell carcinoma is said to be occasionally associated with dysproteinemia. Here reported is a case of renal cell carcinoma associated with M-proteinemia of IgG (L-type) which is known to be quite rare. A 59-year-old man complained of a painless hypochondrial mass on the left side. At some surgical clinic, he had excision of the mass which was proved to be clear cell carcinoma. He was transfered to us for investigation of the original site of the tumor. He showed no renal or extrarenal symptoms. Various examinations disclosed no abnormalities except for M-peak in the beta fraction on the cellulose acetate electrophoresis of serum protein as well as the M-bow in the beta area on the immunoelectrophoresis. The patient showed normal erythrocyte sedimentation rate and no toxic signs such as anemia, pyrexia, elevated alpha-2 globulin and hepatic disorder. All other tests or examinations on urine, blood and bone marrow showed no abnormalities. The clinical features of this case was obviously different from those of multiple myeloma and interpreted as compatible with idiopathic benign M-proteinemia of Waldenstrom. According to our conventional classification of seven serum protein patterns in renal cell carcinoma, this case belongs to the sixth. At this opportunity, 65 renal cell carcinomas were studied with emphasis on the clinical features and serum protein patterns. The patients of renal cell carcinoma could be divided into two types, dysproteinemic type and non-dysproteinemic type; and each showed different clinical features.