后肾始基腺瘤的CT与病理学特点分析

目的:探讨后肾始基腺瘤的CT特征及病理特点。方法:回顾性分析经手术病理证实的18例后肾始基腺瘤患者的临床资料,其中男10例,女8例,年龄33~75岁(平均50岁),均为单侧发病,左肾8例,右肾10例。患者均行CT平扫及增强扫描。分析18例患者CT和病理特点以及两者之间的关系。结果:18例患者CT平扫肿物呈等密度或稍低密度软组织肿块,最大径1.5~7.0cm,平均3.6cm;呈类圆形12例,不规则形6例;边界清晰6例,欠清晰7例,边界不清晰5例;密度均匀及不均匀各4例,密度欠均匀10例;CT值27~45HU,平均39HU。CT增强扫描示肿物未强化2例,轻到中度强化16例,呈软组织密度肿物影,低于肾实质强化水平,CT值50~77HU,平均63HU。11例延迟期扫描示肾盂肾盏有造影剂充盈并显示受压移位。患者术后病理学均证实为后肾始基腺瘤,光镜下肿瘤细胞体积较小,均匀分布,紧密排列,大小一致,形成长管样结构,部分可见乳头状或肾小球样结构。结论:后肾腺瘤的CT检查特征与病理特点有一定的相关性;正确认识其CT及病理学特点,有助于指导手术方案的制定,避免不必要的全肾切除术。

CT and pathological characteristics of metanephric adenoma

Objective： To evaluate CT and pathological characteristics of metanephric adenoma. Method： We collected the clinical data of 18 cases certified by pathology as metanephric adenoma. There were 10 males and 8 females whose age was 33 75 years old with an average of 50. Eighteen cases were found single tumor unilaterally. All patients were given plain CT scans and enhancement scannings. CT and pathological characteristics of 18 cases and their relationships were analyzed. Result： CT scan showed the characteristics of little low density soft tissue mass： irregularly shaped, oval-shaped, sharply marginated, homogeneous and slightly inhomogeneous density. The maximum diameter was 1.5-7. @ cm with an average of 3.6 cm. CT value was 27 45 HU. Contrast enhanced CT scan showed the lesions were not enhanced in two cases and mild to moderate enhancement in 16 cases, and soft tissue density mass shadow could be observed. The degree of enhancement of the renal mass was less than that of the adjacent normal renal parenchyma. Delayed phase image showed renal pelvis with contrast agent filling and pressure shift in 11 cases. The pathologic diagnosis of the cases were metanephric adenoma. Microscopically. the tumors were composed of densely packed small and cuboidal epithelial cells that formed a tubular pattern or glomerulus like structure. Conclusion： CT scan and pathological characteristics of metanephric adenoma might have a certain correlation. Understanding CT and pathological characteristics is helpful for operation guidance so as to avoid unnecessary total nephrectomy.