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Casediscussion
byabdomengroup2012-3-14Casediscussion1HistoryFemale63ygetwoundinafall1monthagoUSG:solidmasslesionofleftkidneySPECT:highperfusioninthemasslesionofleftkidneyHistoryFemale63y2Corticalperiod(CTvalue:110HU;36HU)Corticalperiod(CTvalue:110H3Medullaperiod(CTvalue:180HU;62HU)Medullaperiod(CTvalue:180HU;4Dischargeperiod(CTvalue:107HU;57HU)Dischargeperiod(CTvalue:107H5《肾嗜酸细胞瘤》教学课件6VRVR7Operation:leftkidneyradicalcorrectionPathology:RenaloncocytomaOperation:leftkidneyradical8DDXRenaloncocytoma,RODDXRenaloncocytoma,RO9RenaloncocytomaRenaloncocytomasarebenign,rare,solidtumoursofthekidney,derivedrenalcortexepitheliumofproximalconvolutedtubule.,comprising3–7%ofallrenaltumors
Occurinallages,themostinabout50y,generallymenmorethanwomen,M:F1.5~1.7:1Mostissolitary,canalsobecomplicatedwithPolycystickidney,renalangiomyolipomas,renalcancerusuallyasymptomaticanddiscoveredincidentallyRenaloncocytomaRenaloncocyto10RenaloncocytomaCTscannerAwell-definedmarginCentralstellatescard<3cm,homogeneous,
rare
scard≥3cm,withvolumebecomelarger,centraloreccentricalscarwillbeoccurredfollower
calcification
CysticornecrosisrarelyRenaloncocytomaCTscanner11RenaloncocytomaCTenhancement:Corticalperiod
orMedullaperiod:substantialpartimprovedobviouslyandhomogeneously,thedegreeofenhancementislargerthanorequaltothecortexinthesameperiodDischargeperiod
:enhanceddegreereduce,belowtherenalparenchymadensity,higherthanmuscledensityAcentrallyplacednon-enhancingarea,likelyrepresentingafibrousscarSpoke-wheel-likeenhancementPartofthecoatingcanbeseeninroughvesselsRenaloncocytomaCTenhancement12plainscancorticalperiodMedullaperiodDischargeperiodL-ROplainscancorticalperiodMedul13plainscanDorticalperiodDischargeperiodL-ROplainscanDorticalperiodDisch14双肾嗜酸细胞瘤伴钙化双肾嗜酸细胞瘤15双肾嗜酸细胞瘤双肾嗜酸细胞瘤16右肾嗜酸细胞瘤右肾嗜酸细胞瘤17DifferentialDiagnosisrenalangiomyolipomarenalchromophobecellcarcinoma,RCCCrenalclearcellcarcinomaDifferentialDiagnosisrenalan18renalclearcellcarcinomaDiagnosticpointLocatedinthecortex,inordinanceshape,irregularmargincysticornecrosisiscommon,densitynonuniformintheplainscanrenalpelvisandrenalcalyxbedestroyed,easytotransferrichbloodsupplyfortumor,thedegreeofenhancementisgreaterthanorequaltothecortexofthesameperiodinthecorticalperiod,CT>100HU,CTvaluefellrapidlyinthemedullaperiod,“Quickinquickout”renalclearcellcarcinomaDiag19Renalchromophobecellcarcinoma
(RCCC)DiagnosticpointLocatedinthemedullary,expansiongrowthtorenalsinusandrenalcortical,tumorsizelarger,onthesurroundingrenalorganizationperformancefortheonlysignsofoppressionEnhancedscanning:Lighttomoderate,homogeneousstrengtheningofthetumor,changeofdensityisnotobviousineachperiod,AndthereisnoclinicalsymptomsandtransferofthepatientsRCCCcanalsoseescar,butlessthantheROCysticornecrosisrarelyIdentifypoints:Theenhanced,almostthestrengtheningoftheROsignificantlyhigherthanRCCC,butsometimesROandRCCCperformancehasacross,thereforeneedtopathologicaldiagnosisRenalchromophobecellcarcino20Thankyou!!Thankyou!!21
Casediscussion
byabdomengroup2012-3-14Casediscussion22HistoryFemale63ygetwoundinafall1monthagoUSG:solidmasslesionofleftkidneySPECT:highperfusioninthemasslesionofleftkidneyHistoryFemale63y23Corticalperiod(CTvalue:110HU;36HU)Corticalperiod(CTvalue:110H24Medullaperiod(CTvalue:180HU;62HU)Medullaperiod(CTvalue:180HU;25Dischargeperiod(CTvalue:107HU;57HU)Dischargeperiod(CTvalue:107H26《肾嗜酸细胞瘤》教学课件27VRVR28Operation:leftkidneyradicalcorrectionPathology:RenaloncocytomaOperation:leftkidneyradical29DDXRenaloncocytoma,RODDXRenaloncocytoma,RO30RenaloncocytomaRenaloncocytomasarebenign,rare,solidtumoursofthekidney,derivedrenalcortexepitheliumofproximalconvolutedtubule.,comprising3–7%ofallrenaltumors
Occurinallages,themostinabout50y,generallymenmorethanwomen,M:F1.5~1.7:1Mostissolitary,canalsobecomplicatedwithPolycystickidney,renalangiomyolipomas,renalcancerusuallyasymptomaticanddiscoveredincidentallyRenaloncocytomaRenaloncocyto31RenaloncocytomaCTscannerAwell-definedmarginCentralstellatescard<3cm,homogeneous,
rare
scard≥3cm,withvolumebecomelarger,centraloreccentricalscarwillbeoccurredfollower
calcification
CysticornecrosisrarelyRenaloncocytomaCTscanner32RenaloncocytomaCTenhancement:Corticalperiod
orMedullaperiod:substantialpartimprovedobviouslyandhomogeneously,thedegreeofenhancementislargerthanorequaltothecortexinthesameperiodDischargeperiod
:enhanceddegreereduce,belowtherenalparenchymadensity,higherthanmuscledensityAcentrallyplacednon-enhancingarea,likelyrepresentingafibrousscarSpoke-wheel-likeenhancementPartofthecoatingcanbeseeninroughvesselsRenaloncocytomaCTenhancement33plainscancorticalperiodMedullaperiodDischargeperiodL-ROplainscancorticalperiodMedul34plainscanDorticalperiodDischargeperiodL-ROplainscanDorticalperiodDisch35双肾嗜酸细胞瘤伴钙化双肾嗜酸细胞瘤36双肾嗜酸细胞瘤双肾嗜酸细胞瘤37右肾嗜酸细胞瘤右肾嗜酸细胞瘤38DifferentialDiagnosisrenalangiomyolipomarenalchromophobecellcarcinoma,RCCCrenalclearcellcarcinomaDifferentialDiagnosisrenalan39renalclearcellcarcinomaDiagnosticpointLocatedinthecortex,inordinanceshape,irregularmargincysticornecrosisiscommon,densitynonuniformintheplainscanrenalpelvisandrenalcalyxbedestroyed,easytotransferrichbloodsupplyfortumor,thedegreeofenhancementisgreaterthanorequaltothecortexofthesameperiodinthecorticalperiod,CT>100HU,CTvaluefellrapidlyinthemedullaperiod,“Quickinquickout”renalclearcellcarcinomaDiag40Renalchromophobecellcarcinoma
(RCCC)Diagnosticpoi
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