30例肾嗜酸细胞瘤的临床诊疗分析

发布时间：2018-06-28 21:23

本文选题：肾嗜酸细胞瘤 + 良性肾肿瘤　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:通过分析和探讨肾嗜酸细胞瘤的临床表现、影像学和病理学特点、治疗方法,提高对肾嗜酸细胞瘤的诊断和治疗水平。方法:收集吉林大学第一医院2011年6月至2016年6月(共5年)期间,经病理学检查证实的30例肾嗜酸细胞瘤病人的临床资料。结合文献回顾性分析肾嗜酸细胞瘤的临床表现、影像学和病理学特点以及治疗方法和预后。结果:符合纳入标准的病人共30例,男10例,女20例。患病年龄32~76岁,平均57.8±10.4岁。肿瘤位于左侧12例,右侧17例,双侧1例。肿瘤最大径2.2~13cm,平均4.81±2.46cm;肿瘤最小经1.2~8.0cm,平均3.26±1.27cm。无不适症状17人,腰腹部疼痛7人,肉眼血尿3人,高血压、消瘦、腹胀各1人。所有病人均行泌尿系统彩超及肾脏CT检查,1例行肾脏MRI检查,仅1例术前考虑为肾嗜酸细胞瘤。30例病人中有12例可完整收集原始影像学资料,其中66.7%(8/12)的病例可见中央星状瘢痕,41.7%(5/12)的病例可观察到节段性增强反转。所有病人均接受手术治疗,根治性肾切除术22例,肾部分切除术8例。开放手术1例(根治性肾切除术),其余均为腹腔镜手术。所有病人术后病理均诊断为肾嗜酸细胞(腺)瘤。术后随访时间8~68个月,未见肿瘤复发和转移。结论:肾嗜酸细胞瘤是一种少见的良性肾肿瘤,约占所有肾实性肿瘤的3.2%。当影像学检查发现有中央星状瘢痕、节段性增强反转等特征的肾肿瘤时,应考虑到肾嗜酸细胞瘤的诊断。经皮肾穿刺活检是术前确诊肾嗜酸细胞瘤的唯一方式。保留肾单位手术是肾嗜酸细胞瘤主要的治疗方式。
[Abstract]:Objective: to improve the diagnosis and treatment of renal eosinophils by analyzing and discussing the clinical manifestations, imaging and pathological features, and treatment methods of renal eosinophils. Methods: the clinical data of 30 patients with renal eosinophils confirmed by pathological examination from June 2011 to June 2016 (5 years) in the first Hospital of Jilin University were collected. The clinical manifestations, imaging and pathological features, treatment and prognosis of renal eosinophils were analyzed retrospectively. Results: a total of 30 patients, 10 males and 20 females, met the inclusion criteria. The age of disease was 32 to 76 years (mean 57.8 卤10.4 years). The tumor was located on the left in 12 cases, on the right in 17 cases and on both sides in 1 case. The maximum diameter of tumor was 2.2 ~ 13cm with an average of 4.81 卤2.46cm, and the minimum diameter of tumor was 1.2cm. with an average of 3.26 卤1.27cm. There were 17 cases without discomfort, 7 cases with waist abdominal pain, 3 cases with naked hematuria, 1 case with high blood pressure, 1 case with weight loss and 1 case with abdominal distension. All the patients underwent urography and renal CT examination. Renal MRI was performed in 1 patient, and 12 of 30 patients with renal eosinophils were considered as renal eosinophils before operation. Among them, 66.7% (8 / 12) cases showed central stellate scar 41.7% (5 / 12) with segmental enhancement inversion observed. All patients received surgical treatment, radical nephrectomy 22 cases, partial nephrectomy 8 cases. Open surgery (radical nephrectomy) was performed in 1 case, and laparoscopic surgery was performed in the rest. All patients were pathologically diagnosed as renal eosinophils (adenoma). The follow-up time was 8 ~ 68 months. No tumor recurrence or metastasis was found. Conclusion: renal eosinophil tumor is a rare benign renal tumor, accounting for about 3.2% of all renal solid tumors. The diagnosis of renal eosinophils should be taken into account when central stellate scar and segmental enhancement inversion are found in imaging examination. Percutaneous renal biopsy is the only way to diagnose renal eosinophils before operation. Nephron-sparing surgery is the main treatment for renal eosinophils.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.11

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