Retroperitoneal fibrosis: report of two cases

24歳男と74歳女の後腹膜線維症の2例について報告した.症例1は24歳男で, 肉眼的血尿, 左腰背部痛を主訴とし, 左下腹部に可動性のない腫瘤を触知した.腹部骨盤CTにて左腎静脈を上縁として後腹膜腔に辺縁不整な腫瘤性病変を認めた.経皮的腫瘍針生検術を施行した結果, 繊維化を認めるのみで悪性所見は認めなかった.プレドニゾロン投与により, 徐々に疼痛は軽減した.10ヵ月を経過した現在, プレドニゾロン5mgの維持療法を施行中である.症例2は74歳女で, 右下腹部痛を主訴とし, 両側水腎症による腎後性腎不全と診断した.後腹膜鏡下生検術を施行した結果, 線維性結合織を豊富に認め, 形質細胞, リンパ球浸潤からなる慢性炎症が認められたが, 悪性所見は認められなかった.プレドニゾロン5mgの維持療法を施行中であり, 腎機能も正常であったIn case 1, a 24-year-old man was admitted with left lumbago. Abdominal computed tomographic (CT) scan showed the huge mass (8 x 10 x 13 cm in diameter) in the left retroperitoneal space, which lack enhancement and had a irregular margin. Percutaneous needle biopsy guided by ultrasonography was performed. In case 2, a 74-year-old woman was admitted with right lower abdominal pain. Laboratory data showed the renal failure. Imaging study revealed bilateral hydronephroses and bilateral masses at both common iliac vessels. A retroperitoneoscopic biopsy was performed. We diagnosed both cases as retroperitoneal fibrosis and administered prednisolone for 10 months. The masses decreased in size and the symptoms disappeared in both cases