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英文誌(2004-)

Journal of Medical Ultrasonics

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1996 - Vol.23

Vol.23 No.11

Case Report(症例報告)

(0797 - 0801)

シュードキドニーサインを呈した悪性空腸平滑筋芽細胞腫の1例

A Case of Malignant Jejunal Leiomyoblastoma With Pseudo-Kidney Sign

石田 誠1, 岩田 康義1, 稲田 俊雄1, 塩見 勝彦1, 吉永 浩明1, 菅 敬彦1, 中村 之信1, 児島 完治2, 呉羽 晃徳3, 溝渕 光一4

Makoto ISHIDA1, Yasuyoshi IWATA1, Toshio INADA1, Katsuhiko SHIOMI1, Hiroaki YOSHINAGA1, Toshihiko KAN1, Yukinobu NAKAMURA1, Kanji KOJIMA2, Akinori KUREHA3, Kohichi MIZOBUCHI4

1香川労災病院内科, 2香川労災病院放射線科, 3香川労災病院臨床検査部, 4香川労災病院病理科

1Department of Internal Medicine, Kagawa Rosai Hospital, 2Department of Radiology, Kagawa Rosai Hospital, 3Department of Clinical Laboratory, Kagawa Rosai Hospital, 4Department of Pathology, Kagawa Rosai Hospital

キーワード : CT, Malignant leiomyoblastoma, Pseudo-kidney sign, Small intestine, Ultrasound

We encountered a rare case of malignant jejunal leiomyoblastoma with a pseudo-kidney sign in a 46-year-old man who visited our institution because of upper abdominal discomfort and anemia. He had previously had cervical lymphadenopathy, which had metastasized from malignant leiomyoblastoma that was proven by lymph-node biopsy. The abdominal echogram showed a tumor with a diameter of about 12×7 cm, a so-called pseudo-kidney sign, consisting of a thickened low-echoic wall that measured about 3 cm across and an internal heterogeneous high-echoic area. Barium examination showed a tumor about 14 cm long with irregular intestinal mucosa 20 cm distal from the ligament of Treiz. CT scan demonstrated marked thickening of the intestinal wall, similar to that of carcinoma of gastrointestinal tract. The tumor was resected because of intestinal bleeding and was found to be soft and fragile. A specimen of the tumor showed expansive growth around the jejunal wall, but the intestinal lumen was maintained. This rare pattern of growth for an intestinal leiomyogenic tumor would appear to explain the appearance of the pseudo-kidney sign in this case.