肾嗜酸细胞瘤.pptVIP

Case discussion by abdomen group 2012-3-14 History Female 63y get wound in a fall 1 month ago USG:solid mass lesion of left kidney SPECT：high perfusion in the mass lesion of left kidney Operation：left kidney radical correction Pathology ：Renal oncocytoma DDX Renal oncocytoma ,RO Renal oncocytoma Renal oncocytomas are benign,rare, solid tumours of the kidney,derived renal cortex epithelium of proximal convoluted tubule.，comprising 3–7% of all renal tumors Occur in all ages, the most in about 50y，generally men more than women ,M:F 1. 5～1. 7 :1 Most is solitary ,can also be complicated with Polycystic kidney , renal angiomyolipomas , renal cancer usually asymptomatic and discovered incidentally Renal oncocytoma CT scanner A well-defined margin Central stellate scar d 3cm, homogeneous, rare scar d≥3cm,with volume become larger,central or eccentrical scar will be occurred follower calcification Cystic or necrosis rarely Renal oncocytoma CT enhancement： Cortical period or Medulla period :substantial part improved obviously and homogeneously, the degree of enhancement is larger than or equal to the cortex in the same period Discharge period :enhanced degree reduce , below the renal parenchyma density , higher than muscle density A centrally placed non-enhancing area,likely representing a fibrous scar Spoke-wheel-like enhancement Part of the coating can be seen in rough vessels 右肾嗜酸细胞瘤 Differential Diagnosis renal angiomyolipoma renal chromophobe cell carcinoma,RCCC renal clear cell carcinoma renal clear cell carcinoma Diagnostic point Located in the cortex，inordinance shape, irregular margin cystic or necrosis is common，density nonuniform in the plain scan renal pelvis and renal calyx be destroyed, easy to transfer rich blood supply for tumor, the degree of enhancement is greater than or equal to the cortex of the same period in the cortical period, CT100HU, CT value fell rapidly in the medulla period, “Quick in quick out” Renal chromophobe cell