肾嗜酸细胞腺瘤诊治分析

肾嗜酸细胞腺瘤诊治分析
迟强;于满;王志勇;辛立升;张学军;傅华;李剑;周逢海;王养民
【期刊名称】《中国全科医学》
【年(卷),期】2011(014)035
【摘要】Objective To explore the diagnosis and treatment of renal oncocytoma. Methods Clinical features, radiological and pathological manifestations, treatment and prognosis of 23 cases of renal oncocytoma were retrospectively analyzed with related literature reviewed. Results Of the 23 patients, 15 were males and 8 were females ( aged from 52 to 73 years ). All lesions were unilateral, of which 13 located in the right side and 10 in the left side, with diameters ranged from 2 cm to 17 cm. Eleven cases were with symptoms with flank pain the main complaint among these patients. Abdominal mass were found in 5 patients. The other 7 patients were detected by ultrasonography on routine examinations. B -ultrasonic findings showed homogeneous echoes with clear edges. Renal oncocytoma was characterized by homogeneous attenuation with a central, margined stellate area on CT scan. Immunohistochemical staining results were positive for cytokeratin and negative for vimentin. All patients underwent open surgery, of them 12 received radical nephrectomy and 11 received nephron sparing surgery. After the operation, 18 of the cases were followed up for 2 to 62 months and no tumor recurrence or metastasis was reported. Conclusion Integration of imaging examinations
and medical history characteristics indicate the existence of renal oncocytoma, the definite diagnosis of which depends on pathological results after open operation. Nephron sparing surgery is the first choice for renal oncocytoma treat-%目的探讨肾嗜酸细胞腺瘤的诊断和治疗的方法.方法回顾性分析23例肾嗜酸细胞腺瘤患者的临床特征、影像学、病理学表现,治疗及预后,并复习相关文献.结果 23例患者,男15例,女8例;年龄52～73岁.病变均为单侧,左侧10例,右侧13例.直径2～17 cm.有症状者11例,主要表现为患侧腰部胀痛不适;有体征者5例,均表现为腹部包块;另7例体检时行超声检查发现.B超均表现为质均、边界清楚的实性回声;CT表现为肿瘤密度均匀,瘤体中央有星状结构.行根治性肾切除术12例,肾部分切除术11例.免疫组化染色重组人细胞角蛋白
18(CK18)强阳性、波形蛋白(Vimentin)阴性.术后病理回报均为肾嗜酸细胞腺瘤.18例患者随访2～62个月无肿瘤复发或转移.结论综合病史及影像学检查特点可考虑肾嗜酸细胞腺瘤的诊断,确诊靠术后病理.选择保留肾单位的肿瘤切除术是其首选治疗方法.
【总页数】3页(P4088-4090)
【作者】迟强;于满;王志勇;辛立升;张学军;傅华;李剑;周逢海;王养民
【作者单位】067000,河北省承德市,承德医学院附属医院泌尿外科;067000,河北省承德市,承德医学院附属医院泌尿外科;067000,河北省承德市,承德医学院附属医院泌尿外科;067000,河北省承德市,承德医学院附属医院泌尿外科;067000,河北省承德市,承德医学院附属医院普外一科;067000,河北省承德市,承德医学院附属医院普外一科;067000,河北省承德市,承德医学院附属医院普外一科;兰州军区兰州总医院全军泌尿外科中心;兰州军区兰州总医院全军泌尿外科中心
【正文语种】中文
【中图分类】R737.11
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