我院近3年收治以肾病综合征为首发症状的恶性肿瘤3例。3例病人首次查24小时尿蛋白定量分别为4.5克、7.8克、及9.7克。血清白蛋白分别为24g/L、18g/L、及15g/L伴有水肿及高脂血症。均无糖尿病、高血压及肝炎病史。无肝功能损害,尿素氮、肌酐均正常。双肾B超示:双肾形态及大小正常,未发现占位性病变。1.病例介绍 例1:男,56岁。水肿,蛋白尿1个月。查体除水肿外无其他阳性体征。入院查便潜血阴性。胃肠钡餐透视示食管下段管壁僵硬。胃镜:进镜3厘米处有不规则小溃疡面,组织脆,活检示食管鳞癌。肾活检:示膜性肾病。经对症及支持治疗后转外科手术。术后蛋白尿消失,痊愈出院。 In our hospital for the past 3 years, 3 cases of malignant tumors with nephrotic syndrome as the first symptom were treated. For the first time, the quantitation of 24-hour urinary protein was 4.5 g, 7.8 g, and 9.7 g for 3 patients. Serum albumin was 24g/L, 18g/L, and 15g/L with edema and hyperlipidemia. No history of diabetes, hypertension, and hepatitis. No liver damage, urea nitrogen, creatinine were normal. Kidney B ultrasound showed: The kidneys were normal in shape and size and no lesions were found. 1. Case Introduction Example 1: Male, 56 years old. Edema, proteinuria for 1 month. There were no other positive signs except edema. Admission examination was occult blood negative. Gastrointestinal barium meal perspective shows the stiffness of the lower esophageal wall. Gastroscope: There is an irregular small ulcer 3 cm into the mirror, the organization is brittle, and biopsy shows esophageal squamous cell carcinoma. Renal biopsy: showing membranous nephropathy. After symptomatic and supportive treatment, the surgery was changed. Proteinuria disappeared after surgery and he was discharged from the hospital.