肾嗜酸细胞瘤2例报告并文献复习

目的提高对肾嗜酸细胞瘤的认识,探讨肾嗜酸细胞瘤的治疗方法。方法报告2例肾嗜酸细胞瘤并复习国内外文献。结果本组例1术前疑诊为肾嗜酸细胞瘤,并为术中快速冰冻切片证实,行保留肾脏的腹腔镜肿瘤剜除术,术后随访2年,一般情况良好,无复发,无转移。例2术前诊为肾癌,行腹腔镜左肾根治性切除术,术后随访3年,无复发,无转移,肝、肾功能均正常。结论肾嗜酸细胞瘤的诊断要点:(1)肿瘤无明显症状,多为偶然发现,肿瘤生长缓慢,无周围浸润或远处转移,多为单发;(2)肿瘤突出于肾轮廓之外,呈外突性生长;(3)肿瘤切面呈棕褐色;(4)CT示肿块密度均匀,无出血、坏死,有完整包膜;(5)病理检查:光镜下肿瘤由单一的嗜酸细胞构成,电镜下细胞富含线粒体。一旦确诊,应尽可能行保留肾脏的手术,避免行根治性肾切除术。

Renal oncocytoma: report of 2 cases and review of literature

Objective To improve the knowledge and diagnosis of renal oncocytoma and explore the management of renal oncocytoma.Methods Two patients with renal oncocytoma proved by pathology were studied and the literature was reviewed.Results Case 1 diagnosed suspiciously as renal oncocytoma before operation and proved by pathology in operation underwent laparoscopic tumor excision with the kidney reserved.After follow-up for two years,no metastasis and recurrence were found.Conclusion The key points of diagnosis are as follows.(1) Most renal oncocytoma are discovered incidentally without marked clinical findings.The tumor grows slowly with no distant metastasis.(2) The tumor protrudes out of the kidney.(3) The tumor is brown in color.(4)Homogenous density without hemorrhage and necrosis.(5) Only acidophil cells are found in oncocytoma.