摘要
目的探讨透明细胞乳头状肾细胞癌(CCPRCC)的计算机断层扫描(CT)特征。方法回顾性分析6例透明细胞乳头状肾细胞癌的CT表现,观察肿瘤的大小、部位、生长方式、形态、质地、钙化、坏死、出血、CT值、增强扫描的强化形式、强化程度以及肾脏周围淋巴结等情况。结果6例CCPRCC均为单发病灶,位于左肾3例、右肾3例。肿瘤直径1.5-4.0cm。4例肿瘤边界规则,2例肿瘤边界不规则。肿瘤均呈膨胀性生长,无浸润改变,其中3例为内生型,3例为外生型。肿瘤质地除1例呈囊性外,其余5例均为实性。所有肿瘤均未及钙化、坏死及出血性改变。平扫期肿瘤的CT值为31.2-42.5HU;增强CT时,5例呈明显强化,1例呈中度强化,皮髓质期肿瘤的CT值为75.1-150.1HU;在肾实质期时,除1例强化程度继续增强外,其余5例强化程度减弱,肿瘤的CT值为73.3-102.2HU;在排泄期时,6例肿瘤强化程度均减弱,其CT值为52.6-79.1HU。在肿瘤强化形式方面,除1例显示强化均匀外,其余5例均显示强化不均匀。此外,所有患者肾脏周围未及肿大淋巴结,未及肾静脉受侵或癌栓形成。结论透明细胞乳头状。肾细胞癌有着相对特异性的CT表现,易与乳头状肾细胞癌和嫌色细胞肾细胞癌进行区分;但是对于早期透明细胞肾细胞癌,两者之间鉴别诊断比较困难。
Objective To investigate the computed tomography (CT) features of clear cell papilla- ry renal cell carcinoma (CCPRCC). Methods The CT features of 6 patients with CCPRCC were analyzed retrospectively. The size, location, growth pattern, shape, texture, calcification, necrosis, hemorrhage, CT value, enhancement form and enhancement degree of the tumor and perirenal lymph nodes were ob- served. Results All 6 cases of CCPRCC were solitary lesions, of which 3 were located in the left kidney and 3 in the right kidney. Maximum tumor diameter ranged from 1.5 cm to 4. 0 cm. The tumor margin was well-defined in 4 cases and ill-defined in two cases. All tumors showed expansive growth without invasion. There were three cases of endophytie growth and three cases of exophytic growth. Regarding tumor composi- tion, only one case was cystic and the other five cases were solid. No calcification, necrosis and hemorrhage occurred in all the tumors. The CT value of tumors in unenhanced phase ranged from 31.2 HU to 42. 5 HU. During the enhanced CT scan, 5 cases showed highly enhancement and 1 case showed moderate enhance-ment. The CT value of tumors in corticomedullary phase ranged from 75.1 HU to 150. 1 HU. In nephro- graphic phase, the enhancement degree in 1 case continued to increase, but it decreased in the other 5 ca- ses. The CT value ranged from 73.3 HU to 102. 2 HU. The enhancement degree in all 6 cases decreased in excretory phase and the CT value ranged from 52. 6 HU to 79. 1 HU. In the aspect of tumor enhancement form, only one case showed homogeneous enhancement and the other five cases showed heterogeneous en- hancement. In addition, the peripheral renal lymph nodes were not enlarged in all patients, and no tumor invasion or tumor thrombus formation occurred in the renal vein. Conelusions CCPRCC has a relatively specific CT features that are easily distinguished from papillary renal cell carcinoma or chromophobe renal cell carcinoma, but it is difficult to identify from early-stage clear cell renal cell carcinoma.
出处
《中国医师杂志》
CAS
2017年第10期1488-1491,1495,共5页
Journal of Chinese Physician
基金
国家自然科学基金(81672531)