腎嗜酸細(xì)胞瘤

1、Case discussion,by abdomen group2012-3-14,History,Female 63yget wound in a fall 1 month agoUSG:solid mass lesion of left kidneySPECT：high perfusion in the mass lesion of left kidney,,,Cortical period（CT value: 110HU

2、;36HU),Medulla period（CT value:180HU;62HU),Discharge period（CT value:107HU;57HU),VR,,Operation：left kidney radical correction Pathology ：Renal oncocytoma,DDX,Renal oncocytoma ,RO,Renal oncocytoma,Renal oncocytomas are be

3、nign,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～

4、1. 7 :1Most is solitary ,can also be complicated with Polycystic kidney , renal angiomyolipomas , renal cancer usually asymptomatic and discovered incidentally,Renal oncocytoma,CT scannerA well-defined marginCentral

5、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：Corti

6、cal 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 t

7、he renal parenchyma density , higher than muscle density A centrally placed non-enhancing area,likely representing a fibrous scar Spoke-wheel-like enhancementPart of the coating can be seen in rough vessels,plain scan

8、,cortical period,Medulla period,,Discharge period,L-RO,plain scan,Dortical period,Discharge period,L-RO,,雙腎嗜酸細(xì)胞瘤伴鈣化,雙腎嗜酸細(xì)胞瘤,右腎嗜酸細(xì)胞瘤,Differential Diagnosis,renal angiomyolipomarenal chromophobe cell carcinoma,RCCCrenal

9、 clear cell carcinoma,renal clear cell carcinoma,Diagnostic pointLocated in the cortex，inordinance shape, irregular margin cystic or necrosis is common，density nonuniform in the plain scanrenal pelvis and renal calyx

10、 be destroyed, easy to transferrich blood supply for tumor, the degree of enhancement is greater than or equal to the cortex of the same period in the cortical period, CT>100HU, CT value fell rapidly in the medulla p

11、eriod, “Quick in quick out”,Renal chromophobe cell carcinoma(RCCC),Diagnostic pointLocated in the medullary , expansion growth to renal sinus and renal cortical , tumor size larger , on the surrounding renal organizati

12、on performance for the only signs of oppression Enhanced scanning: Light to moderate , homogeneous strengthening of the tumor, change of density is not obvious in each period, And there is no clinical symptoms and tran

13、sfer of the patients RCCC can also see scar, but less than the RO Cystic or necrosis rarelyIdentify points：The enhanced, almost the strengthening of the RO significantly higher than RCCC , but sometimes RO and RCCC p