肾集合管癌的CT表现及诊断价值

目的探讨肾集合管癌的CT表现及其诊断价值,提高对本病的认识。方法结合文献回顾性总结并分析6例肾集合管癌的临床表现及影像学、病理学特征。5例行CT平扫及增强扫描,1例患者仅行CT平扫。结果6例中男3例,女3例,肿瘤位于左肾3例,右肾3例;肿瘤直径3～10 cm,平均5.8 cm;累及肾皮质和髓质者2例,同时累及肾皮质、髓质及肾盂者4例;平扫肿块呈实性成分者2例,囊实性混杂成分者4例;增强扫描肿块多呈轻中度强化;4例肾脏轮廓改变;4例肿瘤内可见钙化;肾门周围淋巴结转移者5例,肺转移1例,左侧胸壁转移者1例,腰骶椎椎体转移1例;术前诊断为肾癌者5例,肾淋巴瘤1例。结论肾集合管癌的CT表现具有一定的特征,起源于髓质、增强扫描轻中度强化并且呈浸润性生长的肿瘤应考虑到该病可能。

The CT Diagnosis of Collecting Duct Carcinoma

Objective To analyze the CT features of the collecting duct carcinoma and its diagnostic values.MethodsClinical manifestations and imaging,pathologic features of six cases with renal collecting duct carcinoma were reviewed retrospectively.Plain and enhanced CT scanning were performed in 5 cases.Only plain CT was taken in 1 case.Results The patients included 3 males and 3 females.All of the 6 tumors were localized in the left kidney(3 cases) and right kidney(3cases),with the mean diameter of 5.8 cm(ranged from 3 cm to 10 cm).All of the tumors involved renal cortex and medulla(n=2),renal cortex and medulla as well as renal pelvis(n=4).Tumor mass was solid(n=2) and solid with cystic change(n=4).After injection of contrast media,the enhancement in solid mass was mostly mild to moderate.The renal contours were changed in 4 cases.Calcification was observed in 4 cases;the renal hilum lymph node metastasis in 5 cases,lung metastasis in 1 case,the left chest wall metastasis in 1 case,lumbar vertebral metastasis in 1 case.Preoperative diagnosis of renal cell carcinoma was 5 patients and renal lymphoma was 1 case.Conclusion The renal collecting duct carcinoma have certain CT characteristics which should be suspected when the tumor originate in the medulla with mild to moderate enhancement and invasive growth.