肾上皮样血管平滑肌脂肪瘤的CT表现

CT features of renal epithelioid angiomyolipomas

目的 探讨肾上皮样血管平滑肌脂肪瘤（EAML）的CT表现.方法 回顾性分析经手术病理证实的10例EAML患者的临床资料及CT图像,10例均行平扫及增强检查,观察影像表现特征.结果 肿瘤平扫呈相对高密度、向肾外突出、乏脂肪;增强明显不均性强化（快进慢出）、瘤体较大但无分叶、包膜完整,多与肾分界清晰;其内常有轻度变性坏死区.镜下见密集分布的上皮样细胞;免疫组织化学示黑色素瘤相关抗原（HMB45）均为阳性、上皮膜抗原（EMA）均为阴性.结论 EAML的CT表现有一定的有助于定性诊断的特点,与病理结构明显相关.

Objective To explore the CT and pathological features of renal epithelioid angiomyolipoma （EAML）. Methods Clinical data and CT images from ten cases with EAML proved by surgery and pathology were retrospectively analyzed. All cases were performed with plain and contrast enhanced CT scans. Results CT features： higher pre-contrasted density than kidney, bulging from kidney,absent of fat, markedly heterogeneous enhancement （ quick wash-in and slow wash-out）, big size without lobular sign, complete capsule with clear margin and mild necrostic area. Pathological features： diffuse sheets of epithelioid cells were found under microscopy with immunohistochemistrical findings including positivity for HMB-45 and negativity for EMA. Conclusion Some specific CT features, which is correlated well with the pathological findings, provide helpful information in the primary diagnosis of EAML.