若年性高血圧症に見られた多発性腎内動脈瘤の1例

概要

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The early diagnosis of intra-ureteral tumor is yet difficult. To approach this clinical problem, a new method of intra-ureteral biopsy was attempted. Under sacral block, a Dormia stone basket is passed up through the site of the lesion and manipulated. On withdrawing the basket from the ureter, it would pick up a small fragment of tumor tissue or sometimes blood clot. It was noted that satisfactory intra-ureteral biopsies were obtained in each of three cases of ureteral or pelvi-ureteral cancer, without particular difficulty and without ill-effect upon the patient. In all cases, the accuracy of the biopsy including Broders' cellular classification was confirmed by subsequent operation. Even when a piece of tumor fails to be picked up, a blood clot was also diagnostic because of the presence of clusters of atypical cells in it. The purpose of such biopsy is not only to make a conclusive diagnosis of ureteral tumor even at an early stage and to differentiate it from other causes of filling defects but to choose an adequate opetation on microscopic cellular grading. Application of the method should improve the percentage of correct preoperative diagnosis of ureteral tumors which has been unsatisfactory in the past.