《腎嗜酸細(xì)胞瘤》教學(xué)課件

Casediscussion

byabdomengroup2012-3-14Casediscussion1HistoryFemale63ygetwoundinafall1monthagoUSG:solidmasslesionofleftkidneySPECT：highperfusioninthemasslesionofleftkidneyHistoryFemale63y2Corticalperiod（CTvalue:110HU;36HU)Corticalperiod（CTvalue:110H3Medullaperiod（CTvalue:180HU;62HU)Medullaperiod（CTvalue:180HU;4Dischargeperiod（CTvalue:107HU;57HU)Dischargeperiod（CTvalue:107H5《腎嗜酸細(xì)胞瘤》教學(xué)課件6VRVR7Operation：leftkidneyradicalcorrectionPathology：RenaloncocytomaOperation：leftkidneyradical8DDXRenaloncocytoma,RODDXRenaloncocytoma,RO9RenaloncocytomaRenaloncocytomasarebenign,rare,solidtumoursofthekidney,derivedrenalcortexepitheliumofproximalconvolutedtubule.，comprising3–7%ofallrenaltumors

Occurinallages,themostinabout50y，generallymenmorethanwomen,M:F1.5～1.7:1Mostissolitary,canalsobecomplicatedwithPolycystickidney,renalangiomyolipomas,renalcancerusuallyasymptomaticanddiscoveredincidentallyRenaloncocytomaRenaloncocyto10RenaloncocytomaCTscannerAwell-definedmarginCentralstellatescard<3cm,homogeneous,

rare

scard≥3cm,withvolumebecomelarger,centraloreccentricalscarwillbeoccurredfollower

calcification

CysticornecrosisrarelyRenaloncocytomaCTscanner11RenaloncocytomaCTenhancement：Corticalperiod

orMedullaperiod:substantialpartimprovedobviouslyandhomogeneously,thedegreeofenhancementislargerthanorequaltothecortexinthesameperiodDischargeperiod

:enhanceddegreereduce,belowtherenalparenchymadensity,higherthanmuscledensityAcentrallyplacednon-enhancingarea,likelyrepresentingafibrousscarSpoke-wheel-likeenhancementPartofthecoatingcanbeseeninroughvesselsRenaloncocytomaCTenhancement12plainscancorticalperiodMedullaperiodDischargeperiodL-ROplainscancorticalperiodMedul13plainscanDorticalperiodDischargeperiodL-ROplainscanDorticalperiodDisch14雙腎嗜酸細(xì)胞瘤伴鈣化雙腎嗜酸細(xì)胞瘤15雙腎嗜酸細(xì)胞瘤雙腎嗜酸細(xì)胞瘤16右腎嗜酸細(xì)胞瘤右腎嗜酸細(xì)胞瘤17DifferentialDiagnosisrenalangiomyolipomarenalchromophobecellcarcinoma,RCCCrenalclearcellcarcinomaDifferentialDiagnosisrenalan18renalclearcellcarcinomaDiagnosticpointLocatedinthecortex，inordinanceshape,irregularmargincysticornecrosisiscommon，densitynonuniformintheplainscanrenalpelvisandrenalcalyxbedestroyed,easytotransferrichbloodsupplyfortumor,thedegreeofenhancementisgreaterthanorequaltothecortexofthesameperiodinthecorticalperiod,CT>100HU,CTvaluefellrapidlyinthemedullaperiod,“Quickinquickout”renalclearcellcarcinomaDiag19Renalchromophobecellcarcinoma

(RCCC)DiagnosticpointLocatedinthemedullary,expansiongrowthtorenalsinusandrenalcortical,tumorsizelarger,onthesurroundingrenalorganizationperformancefortheonlysignsofoppressionEnhancedscanning:Lighttomoderate,homogeneousstrengtheningofthetumor,changeofdensityisnotobviousineachperiod,AndthereisnoclinicalsymptomsandtransferofthepatientsRCCCcanalsoseescar,butlessthantheROCysticornecrosisrarelyIdentifypoints：Theenhanced,almostthestrengtheningoftheROsignificantlyhigherthanRCCC,butsometimesROandRCCCperformancehasacross,thereforeneedtopathologicaldiagnosisRenalchromophobecellcarcino20Thankyou??！Thankyou！！21

Casediscussion

byabdomengroup2012-3-14Casediscussion22HistoryFemale63ygetwoundinafall1monthagoUSG:solidmasslesionofleftkidneySPECT：highperfusioninthemasslesionofleftkidneyHistoryFemale63y23Corticalperiod（CTvalue:110HU;36HU)Corticalperiod（CTvalue:110H24Medullaperiod（CTvalue:180HU;62HU)Medullaperiod（CTvalue:180HU;25Dischargeperiod（CTvalue:107HU;57HU)Dischargeperiod（CTvalue:107H26《腎嗜酸細(xì)胞瘤》教學(xué)課件27VRVR28Operation：leftkidneyradicalcorrectionPathology：RenaloncocytomaOperation：leftkidneyradical29DDXRenaloncocytoma,RODDXRenaloncocytoma,RO30RenaloncocytomaRenaloncocytomasarebenign,rare,solidtumoursofthekidney,derivedrenalcortexepitheliumofproximalconvolutedtubule.，comprising3–7%ofallrenaltumors

Occurinallages,themostinabout50y，generallymenmorethanwomen,M:F1.5～1.7:1Mostissolitary,canalsobecomplicatedwithPolycystickidney,renalangiomyolipomas,renalcancerusuallyasymptomaticanddiscoveredincidentallyRenaloncocytomaRenaloncocyto31RenaloncocytomaCTscannerAwell-definedmarginCentralstellatescard<3cm,homogeneous,

rare

scard≥3cm,withvolumebecomelarger,centraloreccentricalscarwillbeoccurredfollower

calcification

CysticornecrosisrarelyRenaloncocytomaCTscanner32RenaloncocytomaCTenhancement：Corticalperiod

orMedullaperiod:substantialpartimprovedobviouslyandhomogeneously,thedegreeofenhancementislargerthanorequaltothecortexinthesameperiodDischargeperiod

:enhanceddegreereduce,belowtherenalparenchymadensity,higherthanmuscledensityAcentrallyplacednon-enhancingarea,likelyrepresentingafibrousscarSpoke-wheel-likeenhancementPartofthecoatingcanbeseeninroughvesselsRenaloncocytomaCTenhancement33plainscancorticalperiodMedullaperiodDischargeperiodL-ROplainscancorticalperiodMedul34plainscanDorticalperiodDischargeperiodL-ROplainscanDorticalperiodDisch35雙腎嗜酸細(xì)胞瘤伴鈣化雙腎嗜酸細(xì)胞瘤36雙腎嗜酸細(xì)胞瘤雙腎嗜酸細(xì)胞瘤37右腎嗜酸細(xì)胞瘤右腎嗜酸細(xì)胞瘤38DifferentialDiagnosisrenalangiomyolipomarenalchromophobecellcarcinoma,RCCCrenalclearcellcarcinomaDifferentialDiagnosisrenalan39renalclearcellcarcinomaDiagnosticpointLocatedinthecortex，inordinanceshape,irregularmargincysticornecrosisiscommon，densitynonuniformintheplainscanrenalpelvisandrenalcalyxbedestroyed,easytotransferrichbloodsupplyfortumor,thedegreeofenhancementisgreaterthanorequaltothecortexofthesameperiodinthecorticalperiod,CT>100HU,CTvaluefellrapidlyinthemedullaperiod,“Quickinquickout”renalclearcellcarcinomaDiag40Renalchromophobecellcarcinoma

(RCCC)Diagnosticpoi