儿童肾脏非Wilms瘤原发性恶性肿瘤临床表现及腹部CT特征分析

Clinical manifestations and CT features of the abdomen of primary malignant non-Wilms'renal tumors in children

目的探讨儿童肾脏非Wilms瘤原发性恶性肿瘤的临床表现与腹部CT特征,提高对儿童肾脏非Wilms瘤原发性恶性肿瘤的认识。方法回顾性分析2012年3月至2018年9月苏州大学附属儿童医院11例经病理证实,并且具有完整腹部CT影像资料的儿童肾脏非Wilms瘤原发性恶性肿瘤病儿的临床资料,分析其临床特点、腹部CT影像表现以及与Wilms瘤的鉴别要点。结果本研究11例病儿中,肾恶性横纹肌样瘤3例,腹部CT示病灶均为实性肿块,可见融冰征、肾周积液、包膜下积液,1例合并中枢神经系统肿瘤,1例出现两肺转移;肾透明细胞肉瘤2例,腹部CT示病灶均为实性肿块,均可见大片坏死,CT增强扫描均可见瘤体内多发扭曲的细小血管,可见“虎斑样”改变,所有病例均未见瘤栓,未见骨骼转移。肾细胞癌6例,3例出现血尿,腹部CT示病灶为实性肿块,4例可见钙化。结论儿童肾脏非Wilms瘤原发性恶性肿瘤的临床表现与腹部CT有一定的特征,有助于诊断。

Objective To investigate the clinical manifestations and abdominal CT features of primary malignant non-Wilms'renal tumors in children.Methods The clinical data of 11 cases of pathologically confirmed primary malignant non-Wilms'renal tumors in children in the Children's Hospital of Soochow University from March 2012 to September 2018.were retrospectively reviewed.The clinical features and the abdominal CT imagings of all cases were analysised.Results Among the 11 cases,3 cases were malignant renal rhabdomyoid tumor.Abdominal CT showed that the lesions were solid masses with melting ice sign,perirenal effusion and subcapsular effusion,1 case was complicated with central nervous system tumor,and 1 case had metastasis to both lungs;Two cases of clear cell sarcoma manifested large necrosis and multiple distorted small blood vessels in the tumors;1 case showed"tabby cat striation"change.The renal cell carchinomas(n=6)showed calcification in 4 cases and hematuria were find in 3 cases.Conclusion The clinical manifestations and abdominal CT images are useful in the diagnosis of primary malignant non-Wilms'renal tumors in children.