小児黄色肉芽腫性腎盂腎炎の1例

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A 3-year-old boy with the complaints of progressive abdominal distension and emaciation was transfered to our hospital on Jan. 24, 1979. Physical examination revealed a right abdominal mass and hepatosplenomegaly. Severe anemia, r-globulinemia and acceleration of BSR were detected by hematology. Urinalysis revealed mild infection and positive VMA spot test. Radiologically, right non-functioning kidney with a calculus was disclosed. Aortogram showed stretching of right renal arteries. Based on these findings, diagnosis of neuroblastoma involving right kidney was made. Blood transfusion and intravenous hyperalimentation were performed to improve his condition, followed by chemotherapy of James' regimen. Abdominal mass was resected under retroperitoneal approach on March 1. Resected specimen weighed 520 gm and was found to be right kidney itself. On cut surface, renal capsule was slightly thickened, calyces were dilated and the parenchyma was replaced by yellowish tissue, confirming xanthogranulomatous pyelonephritis histologically. Postoperative course is uneventful except for transient liver dysfunction accompanied with jaundice. Our case is the 7th case of infantile xanthogranulomatous pyelonephritis reported in Japan.
泌尿器科紀要刊行会の論文