To differentiate renal oncocytoma from renal carcinoma, the clinical data of four patients with incidentally found renal oncocytomas were studied in this report. And additional Immunohistochemistry examinations were d...To differentiate renal oncocytoma from renal carcinoma, the clinical data of four patients with incidentally found renal oncocytomas were studied in this report. And additional Immunohistochemistry examinations were done to confirm diagnosis. Renal oncocytomas were found incidentally in four patients during medical examination. No characteristic changes were found in laboratory tests. Radiology examination provided the location and possibility of renal oncocytoma. History, laboratory test and radiology exanimation indicated the diagnosis of renal oncocytoma, but the final identify of renal oncocytoma need pathology examination.展开更多
Introduction: The gold of this work was to study the clinical and therapeutic management aspects of renal oncocytoma in our settings. Our Observations: Case 1: there was a 44-year-old patient being followed up for a u...Introduction: The gold of this work was to study the clinical and therapeutic management aspects of renal oncocytoma in our settings. Our Observations: Case 1: there was a 44-year-old patient being followed up for a urinary tract infection due to Escherichia coli. The urological CT-scan showed a tumor-like process on a horseshoe kidney. Radical nephrectomy was performed and the histology report confirmed renal oncocytoma;Case 2: it involved a 62-year-old hypertensive patient. Clinical examination revealed a grade II cystocele and medical imaging showed a tumor-like mass at the lower pole of the right kidney. Radical nephrectomy was performed and histology was concluded in favor of renal oncocytoma;Case 3: there was a 64-year-old patient monitored for chronic renal failure and on dialysis for 6 months. Imaging showed a heterogeneous mass developing from the kidney. Histology and immunohistochemistry confirmed renal oncocytoma. Conclusion: Imaging could contribute greatly to preoperative diagnosis. However, there is a need to think about renal oncocytoma when evaluating kidney tissue masses.展开更多
Background：The difference between renal oncocytomas （RO） and renal clear cell carcinomas （RCCs） presents the greatest diagnostic challenge.The aim of this study was to retrospectively determine ifRO and RCCs coul...Background：The difference between renal oncocytomas （RO） and renal clear cell carcinomas （RCCs） presents the greatest diagnostic challenge.The aim of this study was to retrospectively determine ifRO and RCCs could be differentiated on computed tomography （CT） images on the basis of their enhancement patterns with a new enhancement correcting method.Methods：Forty-six patients with a solitary renal mass who underwent total or partial nephrectomy were included in this study.Fourteen of those were RO and 32 were RCCs.All patients were examined with contrast-enhanced CT.The pattern and degree of enhancement were evaluated.We selected the area that demonstrated the greatest degree of enhancement of the renal lesion in the corticomedullary nephrographic and excretory phase images.Regions of interest （ROI） were also placed in adjacent normal renal cortex for normalization.We used the values of the normal renal cortex that were measured at the same time as divisors.The ratios of lesion-to-renal cortex enhancement were calculated for all three phases.The Student＆#39;s t-test and Pearson＆#39;s Chi-square test were used for statistical analyses.Results：All RCCs masses showed contrast that appeared to be better enhanced than RO on all contrast-enhanced phases of CT imaging,but there was no significant difference in absolute attenuation values between these two diseases （P 〉 0.05）.The ratio of lesion-to-cortex attenuation in the corticomedullary phase showed significantly different values between RO and RCCs.The degree of contrast enhancement in RCCs was equal to or greater than that of the normal renal cortex,but it was less than that of the normal cortex in RO in the corticomedullary phase.The ratio of lesion-to-cortex attenuation in the corticomedullary phase was higher than the cut off value of 1.0 in most RCCs （84%,27/32） and lower than 1.0 in most RO （93%,13/14） （P 〈 0.05）.In the nephrographic phase,the ratio of lesion-to-cortex attenuation was higher than that in the corticomedullary phase in most RO （71%,10/14）,showing a prolonged enhancement pattern; and was lower than that in most RCCs （97%,31/32）,showing an early washout pattern （P 〈 0.05）.In the differentiation of RO from RCCs,the sensitivity was 93%,specificity 84%,positive predictive value 72%,negative predictive value 84%,and accuracy for RO was 87,if the ratio of lesion-to-cortex attenuation in a cortex phase was lower than the cutoff value of 1.0.The sensitivity was 71%,specificity was 97%,positive predictive value was 91%,negative predictive value was 91%,and accuracy for RO was 89%,if the ratio of lesion-to-cortex attenuation in nephrographic phase was higher than that in the corticomedullary phase.Conclusions：The ratios of renal lesion-to-cortex attenuation ratios may be helpful in differentiating RO from RCCs.展开更多
Contrast enhanced ultrasound(CEUS) has gained clinical importance over the last years for the characterization of hepatic masses.Its role in extrahepatic indications has been investigated repeatedly but has been less ...Contrast enhanced ultrasound(CEUS) has gained clinical importance over the last years for the characterization of hepatic masses.Its role in extrahepatic indications has been investigated repeatedly but has been less comprehensively studied.Currently more than 50% of renal masses are incidentally diagnosed,mostly by B-mode ultrasound.The method of choice for characterization of renal lesions is contrast enhanced computed tomography(CECT).In the case of cystic lesions CECT refers to the Bosniak classification for cystic lesions to assess the risk of malignant behavior.The majority of masses are renal cell carcinoma,but the exact proportion is controversial.Disadvantages of CECT are a significant risk for patients with impaired renal function,allergic reactions and hyperthyroidism due to iodinated contrast agents.Several studies concerning CEUS for the characterization of both solid and cystic renal lesions have been published,but prospective multicenter studies are missing,the presented data being mainly descriptive.The aim of the this manuscript is to review the current literature for CEUS in renal masses,to summarize the available data and focus on possible concepts for studies in the future.展开更多
文摘To differentiate renal oncocytoma from renal carcinoma, the clinical data of four patients with incidentally found renal oncocytomas were studied in this report. And additional Immunohistochemistry examinations were done to confirm diagnosis. Renal oncocytomas were found incidentally in four patients during medical examination. No characteristic changes were found in laboratory tests. Radiology examination provided the location and possibility of renal oncocytoma. History, laboratory test and radiology exanimation indicated the diagnosis of renal oncocytoma, but the final identify of renal oncocytoma need pathology examination.
文摘Introduction: The gold of this work was to study the clinical and therapeutic management aspects of renal oncocytoma in our settings. Our Observations: Case 1: there was a 44-year-old patient being followed up for a urinary tract infection due to Escherichia coli. The urological CT-scan showed a tumor-like process on a horseshoe kidney. Radical nephrectomy was performed and the histology report confirmed renal oncocytoma;Case 2: it involved a 62-year-old hypertensive patient. Clinical examination revealed a grade II cystocele and medical imaging showed a tumor-like mass at the lower pole of the right kidney. Radical nephrectomy was performed and histology was concluded in favor of renal oncocytoma;Case 3: there was a 64-year-old patient monitored for chronic renal failure and on dialysis for 6 months. Imaging showed a heterogeneous mass developing from the kidney. Histology and immunohistochemistry confirmed renal oncocytoma. Conclusion: Imaging could contribute greatly to preoperative diagnosis. However, there is a need to think about renal oncocytoma when evaluating kidney tissue masses.
文摘Background：The difference between renal oncocytomas （RO） and renal clear cell carcinomas （RCCs） presents the greatest diagnostic challenge.The aim of this study was to retrospectively determine ifRO and RCCs could be differentiated on computed tomography （CT） images on the basis of their enhancement patterns with a new enhancement correcting method.Methods：Forty-six patients with a solitary renal mass who underwent total or partial nephrectomy were included in this study.Fourteen of those were RO and 32 were RCCs.All patients were examined with contrast-enhanced CT.The pattern and degree of enhancement were evaluated.We selected the area that demonstrated the greatest degree of enhancement of the renal lesion in the corticomedullary nephrographic and excretory phase images.Regions of interest （ROI） were also placed in adjacent normal renal cortex for normalization.We used the values of the normal renal cortex that were measured at the same time as divisors.The ratios of lesion-to-renal cortex enhancement were calculated for all three phases.The Student＆#39;s t-test and Pearson＆#39;s Chi-square test were used for statistical analyses.Results：All RCCs masses showed contrast that appeared to be better enhanced than RO on all contrast-enhanced phases of CT imaging,but there was no significant difference in absolute attenuation values between these two diseases （P 〉 0.05）.The ratio of lesion-to-cortex attenuation in the corticomedullary phase showed significantly different values between RO and RCCs.The degree of contrast enhancement in RCCs was equal to or greater than that of the normal renal cortex,but it was less than that of the normal cortex in RO in the corticomedullary phase.The ratio of lesion-to-cortex attenuation in the corticomedullary phase was higher than the cut off value of 1.0 in most RCCs （84%,27/32） and lower than 1.0 in most RO （93%,13/14） （P 〈 0.05）.In the nephrographic phase,the ratio of lesion-to-cortex attenuation was higher than that in the corticomedullary phase in most RO （71%,10/14）,showing a prolonged enhancement pattern; and was lower than that in most RCCs （97%,31/32）,showing an early washout pattern （P 〈 0.05）.In the differentiation of RO from RCCs,the sensitivity was 93%,specificity 84%,positive predictive value 72%,negative predictive value 84%,and accuracy for RO was 87,if the ratio of lesion-to-cortex attenuation in a cortex phase was lower than the cutoff value of 1.0.The sensitivity was 71%,specificity was 97%,positive predictive value was 91%,negative predictive value was 91%,and accuracy for RO was 89%,if the ratio of lesion-to-cortex attenuation in nephrographic phase was higher than that in the corticomedullary phase.Conclusions：The ratios of renal lesion-to-cortex attenuation ratios may be helpful in differentiating RO from RCCs.
文摘Contrast enhanced ultrasound(CEUS) has gained clinical importance over the last years for the characterization of hepatic masses.Its role in extrahepatic indications has been investigated repeatedly but has been less comprehensively studied.Currently more than 50% of renal masses are incidentally diagnosed,mostly by B-mode ultrasound.The method of choice for characterization of renal lesions is contrast enhanced computed tomography(CECT).In the case of cystic lesions CECT refers to the Bosniak classification for cystic lesions to assess the risk of malignant behavior.The majority of masses are renal cell carcinoma,but the exact proportion is controversial.Disadvantages of CECT are a significant risk for patients with impaired renal function,allergic reactions and hyperthyroidism due to iodinated contrast agents.Several studies concerning CEUS for the characterization of both solid and cystic renal lesions have been published,but prospective multicenter studies are missing,the presented data being mainly descriptive.The aim of the this manuscript is to review the current literature for CEUS in renal masses,to summarize the available data and focus on possible concepts for studies in the future.
