肾癌胆囊瘤转移的CT表现(3例病例报告及文献复习)

CT Manifestations of Gallbladder Metastasis from Renal Cell Carcinoma:Report of 3 Cases with Literature Review

目的探讨肾癌胆囊转移瘤的CT表现,以提高对该病的认识和诊断水平。方法回顾性分析3例肾癌胆囊转移患者的临床和CT资料。结果所有病例均行腹部CT平扫和增强扫描,3例肾癌胆囊转移瘤均为单发,2例为实性,平扫为稍高密度,增强病灶明显强化;1例为囊实性,平扫为等低混杂密度,增强病灶呈环形明显强化;所有病灶均伴有胆囊外转移。结论肾癌胆囊转移瘤少见,常为单发病灶及胆囊外转移,CT主要表现为稍高密度、动脉期强化明显,病灶可有囊变坏死,结合原发病史可作出准确诊断。

Objective To analyze CT characteristics of gallbladder metastasis from renal cell carcinoma in order to improve its recognition and diagnosis. Methods The clinical data and CT findings of 3 cases with gallbladder metastasis from renal cell carcinoma were retrospectively analyzed. Results Both plain and enhanced CT scans of abdomen were performed in all 3 cases. The lesion of gallbladder metastasis was single in all 3 patients. The lesion was solid in 2 patients, which showed slightly high-density on plain scan and obvious enhancement on enhanced scan. In one patient the metastasis was a cyst-solid lesion, which showed iso-density and low-density on plain CT scan, and displayed obvious ringlike enhancement after contrast injection. Other metastases outside gallbladder were detected in all 3 patients. Conclusion Clinically, gallbladder metastasis from renal cell carcinoma is rare. The gallbladder metastasis is usually single, and concomitant metastasis outside gallbladder is often present. The main CT findings include slight high-density shadow, obvious enhancement during arterial phase, cystic degeneration and necrosis within the lesion, etc. Correct diagnosis can usually be made when the presence of renal cell carcinoma is taken into consideration.