肾脏非肿瘤实性肿块诊治分析(附12例报告)

目的:提高肾脏非肿瘤实性肿块的诊治水平。方法:回顾12例的诊治过程,分析其临床表现、病理和影像学特点。结果:除肾炎性假瘤和肾血肿有可疑或明确的病史外,其余无明确病史;全部病例行B超、CT检查,1例肾血肿CT提示“血肿不能除外”其余均诊断肾癌或肾肿瘤。手术治疗7例,4例按肾癌行肾癌根治术,1例行肾切除术;2例行术中冷冻活检1例提示黄色肉芽肿性肾盂肾炎,1例提示肾炎性假瘤。5例未手术者观察随访1～4个月后B超复查包块均消失。结论:虽然B超、CT等影像学的检查对肾肿瘤有重要的诊断价值,但是临床医生不应过高评价这些影像检查的诊断学意义。提高诊断水平,术前影像学的复查,肾穿刺活检及术中行冷冻病理检查可减少误诊误治。

The diagnosis and management of renal nontumorous parenchymatous mass

Objective:To improve the diagnosis and management of renal nontumorous parenchymatous mass.Methods:The data of 12 patients of renal nontumorous parenchymatous mass were reviewed, and the clinical presentation, pathology and radiographic diagnosis were analysed.Results:The history of inflammatory pseudotumor and renal hematoma patients was doubtful or clear, the rest was not clear . All patients were checked with ultrasound and CT. 11 patients of all were diagnosed as renal cancer or renal tumor, 1 patient was diagnosed doubtful renal hematoma with CT. And 7 patients were operated ,4 patients with radical nephrectomy, 1 patient with simple nephrectomy ,2 patients were diagnosed renal xanthogranunoma (XGP)and inflammatory pseudotumor (RIP) by frozen biopsy. 5 patients were not operated, they have been followed up 1 to 4 months from hospitalization and the mass vanished at ultyasound check.Conclusions:Although ultrasonograph and CT scans are important methods to diagnose renal tumor, but we can not overrate the diagnostic meaning of radiography check. Renal biopsy and rapid frozen section analysis at operation are helpful to reduce misdiagnosis and mistreatment.