急性腎不全で発症し診断困難であった腫瘤形成性急性骨髄性白血病の1例

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  • A Case of Tumor-Forming Acute Myelogenous Leukemia with an Initial Manifestation of Acute Renal Failure
  • 急性腎不全で発症し診断困難であった腫瘤形成性骨髄性白血病の1例
  • キュウセイ ジンフゼン デ ハッショウシ シンダン コンナン デ アッタ シュ

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A 54 year-old male was admitted to our hospital with acute renal failure. He had severe oliguria. Physical examination showed edema in face and bilateral lower limbs. No lymphadenopathy, hepatosplenomegaly and hemorrhagic diathesis were noted.<br>Laboratory data showed a slight normocytic, normochromic anemia with normal leucocyte and platelet count. Differentials of peripheral leucocytes were normal. Blood urea nitrogen, serum creatinine and potassium level were all markedly elevated.<br>Digital examination of rectum revealed a presence of hard tumorous resistence at the place of prostatic gland. Intravenous pyelography showed hydronephrosis of left kidney. Aortography demonstrated a stenosis above the bilateral iliac arteries. Diagnosis of the acute renal failure by an intrapelvic or retroperitoneal tumor was made.<br>The patient had been treated with peritoneal dialysis. His oliguria, however continued. After an administration of massive dosis of corticosteroid, remarkable urinary discharge had occurred.<br>But this effect of corticosteroid diminished gradually.<br>Fifteen days prior to his death, the patient had hematemesis and abrupt drop of platelet counts were noticed. Bone marrow aspiration performed on that day showed the picture of acute myelogenous leukemia. DCMP therapy started immediately. But his general condition took a turn for worse. The patient died on the 70th day of the admission.<br>Autopsy showed leukemic infiltration with tumor formation between bladder and rectum. Because of the unusual initial manifestation of the leukemic tumor, this case was considered worth reporting.

収録刊行物

  • 臨床血液

    臨床血液 18 (11), 1363-1369, 1977

    一般社団法人 日本血液学会

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