肾嗜酸细胞腺瘤的诊疗分析

Diagnosis and treatment of renal oncocytoma

目的：探讨肾嗜酸细胞腺瘤的临床及病理特点，提高临床诊治水平。方法：回顾性分析11例肾嗜酸细胞腺瘤患者的临床资料。肿瘤直径为2．5～7cm，平均4．2cm，分别位于左肾5例、右肾6例，肾上极4例、肾下极5例、肾中极2例。术前均诊断为肾癌而行肾癌根治术。结果：术后病理证实均为肾嗜酸细胞腺瘤。大体观察肿瘤包膜完整，切面呈淡黄或棕黄色，质地均匀，2例肿瘤中央可见白色星芒状瘢痕样病灶，未见明显出血坏死灶。结论：肾嗜酸细胞腺瘤是一种较少见的良性肾脏肿瘤，常易被误诊为肾癌。其CT影像特征有助于术前诊断，确诊有赖于病理组织学和免疫组化。保留肾单位手术为首选治疗方法，其预后良好，但应密切随访。

Objective To improve the diagnosis and treatment of renal oncocytoma. Methods Clinical data of 11 patients with renal oncocytoma were retrospectively analyzed. The diameter of the tumor was from 2.5 to 7 cm, and 4.2 cm in average. There were 5 cases on the left kidney and 6 cases on the right. Radical nephreetomy was performed in all cases. Results All cases were proved renal oneocytoma by postoperative pathology. All cases had pseudocapsule, cross-section was yellow or brown, and homogenous. Two cases had central margined stellate area, and had no necrosis and hemorrhage. Conclusion Renal oncocytoma is a rare type of benign tumor, and has no specific clinical feature. Diagnosis depends on pathology and immunohistochemical methods. Nephron-sparing surgery should be the first choice. The prognosis of renal oncocytoma is well and regular follow-up should be taken.