XP11.2易位/TFE3基因融合相关性肾癌的CT诊断及鉴别诊断

The CT features and the differential diagnosis of the renal cell carcinoma associated with XP11.2translocation/TFE3 gene fusions

目的：探讨 XP11．2易位／TFE3基因融合相关性肾癌 CT 表现及鉴别诊断，以提高对该病的认识。方法搜集本院2009年3月～2013年6月6例经手术病理证实的6例 Xp11．2易位性肾癌患者，分析其好发部位、大小、包膜等CT 特点以及与其它类型肾癌的鉴别诊断。结果4例肿瘤局限于肾髓质，另2例位于髓质累及肾盂，肾皮质被压迫，并可见破坏。肿瘤均呈实性肿块，类圆形5例，不规则形1例。平扫时3例病灶为稍高密度，1例为等密度灶，1例稍低密度，边缘光滑，境界清晰，4例瘤内可见点状钙化，未见明显坏死囊变。增强扫描肿瘤皮质、髓质期病灶均呈中度强化，强化不均匀，但强化程度低于肾皮质。结论 XP11．2易位／TFE3基因融合相关性肾癌 CT 表现有一定的特点，与其它类型肾癌可作鉴别，综合分析该肿瘤的 CT 特征，有助于提高对该病的诊断正确率。

Objective To investigate the CT features and the differential diagnosis of the renal cell carcinoma associated with XPl1 .2 tranaloecation TFE3 gene fusions so as to improve the recognition of this disease .Methods We collected 6 patients with Xp11 .2 translocation renal cancer confirmed by surgery pathology from March 2009 to June 2013 in our hos‐pital ,analyzed its CT features ,such as location ,size ,envelope ,and analyzed the types of the differential diagnosis of re‐nal cancer with it .Results 4 cases of tumors confined in the renal medulla ,and the other 2 cases located in the medulla in‐volvement of the renal pelvis ,renal cortex was oppressed and visible damage .Tumors were solid lump and circle in 5 ca‐ses ,irregular in 1 case .Plain scan showed 3 cases of lesion were slightly high density ,1 case was equal density ,1 case was lower density ,edge was smooth and clear .Punctate calcifcation can be seen in 4 cases of tumors but the necrosis ca‐paule was not seen clearly .Enhanced scanning showed tumor cortex and medulla period lesions were moderate strengthe‐ning ,strengthening was uneven ,but ,the level of strergthening was below the renal cortex .Conclusion XP11 .2‐TFE3 Ca has certain characteristic in CT features .Comprehensive analysis of its CT features may help for improving the diagno‐sis .