肾血管平滑肌脂肪瘤误诊4例分析并文献复习

Renal Angiomyolipoma:Report of 4 Misdiagnosed Cases and Literature Review

目的 :分析肾血管平滑肌脂肪瘤 (RAML )影像学及病理的误诊原因 ,探讨避免误诊的措施。方法 :分析 4例 RAML的影像和病理资料 ,进行免疫组织化学标记检测。结果 :影像学误诊为肾癌 3例 ,病理 HE染色误诊为平滑肌肉瘤 1例。结论 :影像学及病理的 HE染色诊断均可发生误诊。应用彩色多普勒血流显像技术造影及双期螺旋 CT增强扫描 ,可以提高部分不典型 RAML影像学确诊率。免疫组织化学标记 HMB- 4 5对于

Objective:To analyze the misdiagnostic causes of renal angiomyolipoma (RAML) in the aspects of the image and pathology , and to investigate the measure to avoid the misdiagnosis.Methods:The images and pathologic data of 4 cases of renal angiomyolipoma were analyzed and determined by immunohistochemical staining.Results:The images of 3 cases were misdiagnosed as renal cell carcinoma,and 1 as Leiomyosarcoma by HE staining.Conclusion:The diagnose by image and the pathological HE staining might result in misdiagnosis. The application of Colour Doppler flow imaging (CDFI) and dual phase contrast enhanced spiral CT could raise the rate of diagnose in some atypical renal angiomyolipoma . Applying immunohistochemical marking of HMB-45 was highly specific to the differential diagnose of RAML.