肾黏液性小管状和梭形细胞癌超声造影表现1例

患者男,33岁,外院体检发现左肾实质性占位,为进一步治疗收治入院。实验室检查：血肌酐116μmol/L,血沉25 mm/L,全血细胞计数、血尿素氮、尿分析和尿细胞学值均在正常范围内。胸片未见明显异常。常规超声检查示左肾下段见一大小48 mm×47 mm的团块状低回声,边界清晰,形态规则,突出肾皮质,周边点状彩色血流信号,内部见散在血流信号（图1）。     

肾黏液小管状和梭形细胞癌1例

病例女,39岁,体检发现右肾占位1周入院。患者无明显不适,1周前常规体检B超示右肾占位性病变,胸片、血常规、尿常规及肝肾功能等未见明显异常。体格检查未见明显阳性体征。CT平扫示右肾下极类圆形肿块,形态清晰光整,     

肾黏液样小管状和梭形细胞癌1例报道

<正>肾黏液样小管状和梭形细胞癌(mucinous tubular and spindle cell carcinoma of kidney,MTSCC)是一种罕见的低级别多形性肾上皮性肿瘤,WHO(2004)泌尿和男性生殖系统肿瘤分类中将其列为单独的亚型。目前相关文献报道较少,为提高对该肿瘤的认识,本文报道1例MTSCC并复习文献,讨论其临床病理学特点、免疫组化、诊断及鉴别诊断。1材料与方法1. 1临床资料患者女性,76岁。因尿频、尿急、尿痛、肉眼血尿5天入院。查体无阳性发现。彩超     

左肾巨大黏液样小管状和梭形细胞癌1例

1例51岁女性患者因左腰腹疼痛伴肉眼血尿入院,CT检查提示左肾占位伴出血.患者行左肾切除术和肠粘连松解术,术后病理检查诊断为左肾黏液样小管状和梭形细胞癌.随访7个月,患者无复发或转移.     

乳腺梭形细胞癌超声表现1例

患者女,41岁,左乳肿块切除术后6个月,局部再次发现肿块3个月人院.6月前外院手术切除左乳-10 mm左右肿块,病理诊断乳腺纤维腺瘤.查体:左乳外上象限触及20 mm×20 mm、15 mm×12 mm大小两个肿块,质硬、活动欠佳,边界不清,表面欠光滑,无压痛,无乳头内陷,周边皮肤无桔皮征.左腋下未触及明显肿大淋巴结.超声表现:双侧乳房皮肤回声正常,皮下脂肪层较薄,回声清晰.左乳外上象限测及低回声区,范围29 mm×13 mm×11 mm,边界欠清,形态不规则,内回声不均(图1).彩色多普勒示其内见少许点状血流信号.其旁另见类似低回声,范围约8 mm×4 mm.双侧腋窝未及明显肿大淋巴结.     

肾黏液样小管状和梭形细胞癌1例并文献复习

<正>患者女性,60岁,患者于5年前无明显诱因出现左下肢红肿热痛,膝关节以下显著,查体发现皮肤发红,皮温高,伴静息痛、烧灼痛,临床诊断为丹毒,加重8 h入院。入院检查下腹部CT提示右肾类圆形等密度灶,下腹部增强CT显示右肾占位性病变,右肾超声造影、双肾核磁平扫+增强提示肾占位性病变。病理检查楔形切除肾组织一块,大小6. 5 cm×4. 5 cm×3. 2 cm,切面见肿物一个,大小5. 5 cm×4 cm×3 cm,切面灰     

肾黏液小管状和梭形细胞癌临床病理观察

目的探讨肾黏液小管状和梭形细胞癌(MTSCC)的临床病理特征以及鉴别诊断。方法观察1例肾MTSCC的临床表现、组织学特征和免疫組化,并复习相关文献。结果患者女性,64岁。体检发现右肾占位。病理检查见右肾下极一个大小5.5 cm×4.7 cm×3.5 cm的肿物;切面为实性、灰白色,与周围肾组织界限较清晰。镜下肿瘤由紧密排列的狭长小管及梭形细胞样结构构成,间质为淡染的黏液样基质,瘤细胞立方形,细胞核圆形或卵圆形,核仁小或不明显,无明显异型性,核分裂象少见,未见坏死。瘤细胞广谱CK、CK7、EMA、34βE12和vimentin(+),P504S灶状(+)。结论 MTSCC是一种罕见的肿瘤,可以在典型的组织表现基础上出现其他非特异性改变,了解MTSCC各种形态上的变异,有助于对其做出正确的诊断。     

超声造影诊断肾脏黏液样管状和梭形细胞癌一例

患者女，56岁，因间断血尿半年在当地医院就诊，常规超声检查发现左肾实性占位病变，因未确诊转我院行常规超声、增强螺旋CT、增强MRI检查均提示左肾门下内侧突出于肾表面直径约2．5cm的实性占位，包膜完整，增强CT、MRI不增强；声像图呈均质、低回声（图1），彩色多普勒超声检测内部未见血流信号，均提示左肾实性占位病变，性质待定。     

肾脏黏液样小管状和梭形细胞癌3例报道

肾脏黏液样小管状和梭形细胞癌(mucinous tubular and spindle cell carcinoma,MTSCC)是一种少见的低度恶性上皮性肿瘤,在肾细胞癌中占比＜1％.自1996年由Ordeonez等[1]首次报道以来,WHO(2004)泌尿系统和男性生殖系统肿瘤分类中正式命名为一种独立的肾细胞癌亚型...     

超声误诊静脉内平滑肌瘤病1例

正患者女,46岁,因反复胸闷气促入院。5年前曾有子宫多发肌瘤病史。超声心动图检查:右房增大,内见一大小约4.3 cm×5.1 cm稍强回声占位,呈类圆形(图1),随心脏舒缩而运动,CDFI于瘤体两侧探及舒张期三尖瓣口五彩镶嵌的射流束(图2)。下腔静脉宽约2.5 cm,内见条状低回声占位,其长度约18.2 cm(图3),CDFI探及下腔静脉内细条状血流信号。超声提示:(1)血     

异基因外周血造血干细胞移植治疗急性非淋巴细胞白血病合并肾细胞癌切除术后1例

本研究探索异基因造血干细胞移植治疗急性非淋巴细胞白血病合并肾细胞癌切除术后患者的有效性与安全性。对1例急性非淋巴细胞白血病合并肾细胞癌患者术后施行了清髓性HLA全相合的异基因外周血造血干细胞移植,预处理方案为全身照射、环磷酰胺及阿糖胞苷,移植物抗宿主病预防方案为环孢霉素A、霉酚酸酯及短程甲氨蝶呤。收集相关临床和随访资料进行分析。结果显示,该患者移植后第16天造血重建,第30天及第100天STR-PCR法检测为完全供者型嵌合,未发生急性或慢性GVHD,无严重并发症,随访44个月无病生存。结论：异基因造血干细胞移植治疗急性非淋巴细胞白血病合并肾细胞癌是可行而有效的。     

Contrast-Enhanced Ultrasound Characteristics of Renal Pelvis Urothelial Carcinoma and Its Relationship with Microvessel Density

We studied the characteristics of contrast-enhanced ultrasound (CEUS) in renal pelvic urothelial carcinomas and explored its performance in assessing microvessel density (MVD) of tumor tissues. We retrospectively analyzed the characteristics of 125 cases, which were confirmed pathologically to be renal pelvic urothelial carcinomas using CEUS. We performed CEUS and found that most tumors presented with an enhanced mode of “slow-in (mean = 16.7 ± 2.6 s, range: 12–25 s), hypo-enhancement and fast-out (mean = 69.3 ± 16.2 s, range: 42–113 s).” However, the wash-in pattern, homogeneity and wash-out pattern observed with CEUS was not correlated with pT stage and grade (p > 0.05). But advanced-pT-stage and high-grade tumors had a higher peak enhancement than early-pT-stage and low-grade tumors (p < 0.01). Peak enhancement obtained with CEUS can be used to evaluate the pT stage and grade of renal pelvic urothelial carcinomas more effectively. The MVD of those tissues was observed using immunohistochemical staining of cluster of differentiation 34 (CD34). MVD in the advanced-pT-stage and high-grade groups was significantly higher than that in the early-pT-stage and low-grade groups (p < 0.01). As tumor pT stage and grade improved, CEUS peak enhancement intensity and MVD of tumors also exhibited an upward trend. CEUS peak enhancement intensity has the potential to determine MVD of renal pelvic urothelial carcinomas.     

基于腹腔镜超声的纹理分析鉴别诊断肾透明细胞癌和非透明细胞癌的价值初探

目的 探讨基于腹腔镜超声图像的纹理分析在鉴别诊断肾透明细胞癌与非透明细胞癌中的价值.方法 回顾性分析我院经病理证实的83例肾细胞癌患者的腹腔镜超声检查资料,其中肾透明细胞癌66例,非透明细胞癌17例.在腹腔镜二维超声图像上通过ITK-SNAP软件手工勾画感兴趣区,采用Pyradiomics工具包提取纹理特征.使用组内相关系数选择具有良好稳定性和可重复性的特征;使用最大相关最小冗余(mRMR)和最小绝对收缩和选择算子(LASSO)回归进行特征选择并构建预测模型;绘制受试者工作特征(ROC)曲线分析该预测模型的诊断效能.结果 基于6个纹理特征构建的预测模型为:Y=-1.452+0.329×wavelet.LL glszm SmallAreaLowGrayLevelEmphasis-0.187×wavelet.LH firstorder Mean-0.209×wavelet.HH glszm SmallAreaLowGrayLevelEmphasis-0.107×original gldm DependenceVariance+0.351×wavelet.LH glrlm RunEntropy+0.058×wavelet.HH glszm ZonePercentage.该模型鉴别肾透明细胞癌与非透明细胞癌的ROC曲线下面积、敏感性、特异性和准确率及其对应的95例可信区间分别为0.860(0.771～0.945)、0.765(0.529～0.941)、0.864(0.788～0.939)、0.843(0.747～0.914).结论 基于腹腔镜超声图像的纹理分析可以准确鉴别肾透明细胞癌与非透明细胞癌.     

结直肠癌肝转移灶超声造影与 CT影像表现的比较

目的:比较结直肠癌肝转移灶超声造影与增强CT血流灌注的异同。方法:对比60例60个结直肠癌肝转移灶超声造影与增强CT动脉期及门脉期的增强表现。结果:60个病灶超声造影动脉期均增强,53.3%(32/60)周边增强,46.7%(28/60)整体增强;增强CT见78.3%(47/60)的病灶周边增强,16.7%(10/60)整体增强,5%(3/60)未见增强(P0.01)。动脉期病灶的增强程度方面,超声造影示93.3%(56/60)的病灶增强程度高于肝实质,6.7%(4/60)增强程度低于肝实质;增强CT示91.2%(52/57)的病灶增强程度高于肝实质,8.8%(5/57)增强程度低于肝实质(P0.05);门脉期,超声造影示100%(60/60)的病灶增强减退,较周围肝实质呈低回声,增强CT门脉期示100%(60/60)的病灶较周围肝实质呈低密度,两种影像方法所示的转移灶增强程度均低于肝实质(P0.05)。结论:结直肠癌肝转移灶的超声造影和增强CT增强表现不完全相同,超声造影在反映部分结直肠癌肝转移灶动脉血流灌注方面较增强CT有一定优势。     

Contrast-Enhanced Ultrasound for the Evaluation of Renal Transplants

Contrast-enhanced ultrasound has emerged as a useful imaging modality for the evaluation of the transplant kidney. Advantages over traditional imaging modalities such as computed tomography and magnetic resonance imaging include the ability to visualize a lesion's enhancement pattern in real time, the lack of nephrotoxicity, and relatively low cost. Potential uses of contrast-enhanced ultrasound include characterization of solid and cystic transplant renal masses, assessment for pyelonephritis and identification of its complications, and evaluation of transplant complications in immediate and delayed settings. Contrast-enhanced ultrasound will likely play an increasing role for evaluating the transplant kidney, as an accurate diagnosis based on imaging can direct treatment and prevent unnecessary interventions.