南 雅人¹, 桑口 愛¹, 竹中 清悟¹, 落合 健², 前倉 俊治², 能勢 和宏³, 西岡 伯³

Masahito MINAMI¹, Ai KUWAGUCHI¹, Kiyonori TAKENAKA¹, Ken OCHIAI², Syunji MAEKURA², Kazuhiro NOSE³, Tsukasa NISHIOKA³

¹近畿大学医学部堺病院臨床検査部, ²近畿大学医学部堺病院病理診断科, ³近畿大学医学部堺病院泌尿器科

¹Department of Clinical Laboratory, Kinki University Sakai Hospital, ²Department of Pathology, Kinki University Sakai Hospital, ³Department of Urology, Kinki University Sakai Hospital

キーワード : papillary renal cell carcinoma, Sonazoid, hypovascular renal tumor, contrast-enhanced ultrasonography

Sonazoid^®造影超音波検査により，微小血流診断が可能であった乏血性腎腫瘍の1例を報告する．症例は75歳男性．近医に腎機能障害で通院中，腹部超音波検査・MRI検査にて左腎腫瘤を指摘された．当院で単純CT検査でも同部位に腫瘤を認めた．腎機能障害があるため造影CT検査を施行できず，Sonazoid^®造影超音波検査を施行したところ腫瘍辺縁部から内部への染影を認めた．悪性を疑い経腰的左腎部分切除術を施行したところ，病理組織検査で乳頭状腎細胞癌と診断された．本例の様に，造影CT検査が禁忌になる症例において，腎腫瘤の微小血流診断に，Sonazoid^®造影超音波検査が有用となり得ると考えられた．

We herein report a case of hypovascular renal tumor in which microvascular blood flow diagnosis by Sonazoid^®-enhanced ultrasonography was possible. Abdominal ultrasonography (US) and magnetic resonance imaging (MRI) performed at another institution detected a left renal mass in a 75-year-old man with renal dysfunction. At our hospital, non-contrast computed tomography (CT) detected a mass at the same site. Staining was seen from the tumor margin to the interior of the tumor on contrast-enhanced ultrasonography using Sonazoid^®. Therefore, malignancy was suspected, and translumbar partial nephrectomy was performed. The tumor was diagnosed as a papillary renal cell carcinoma based on histopathologic examination. In cases such as this in which contrast-enhanced CT is contraindicated, Sonazoid^®-enhanced ultrasonography is useful for microvascular blood flow diagnosis of renal masses.