肾嗜酸性细胞瘤的诊断与治疗

目的总结临床诊治肾脏嗜酸性细胞瘤的经验，提高肾嗜酸性细胞瘤的诊治水平。方法回顾性分析8例经手术及病理证实为肾嗜酸性细胞瘤患者的临床资料。结果8例患者平均病程7～30d，平均15．5d。术前均行B超、CT，或同时行MRI检查。B超检查提示肾脏均质性低回声。CT检查提示：肿瘤最大直径20～65mm，平均47．1mm。肿瘤表现为高密度影6例，等密度影2例，其中注射造影剂后4例有不同程度的强化。术后病理均证实为肾嗜酸性细胞瘤。8例镜下均胞浆丰富，红染。免疫组化结果：8例CD10、CK7、VI染色均阴性。术后随访1～54个月，平均15个月，未见肿瘤转移及复发。结论肾嗜酸性细胞瘤在常规临床实验室检查和影像学上术前难以与肾癌鉴别，但术中肿瘤大体、肿瘤侵犯情况及术中冰冻病理结果对诊断很有帮助。对于诊断为肾嗜酸性细胞瘤的患者，可适当放宽肾脏部分切除的手术适应症，尽量减少肾切除手术。嗜酸性细胞瘤通常为良性肿瘤，手术效果确切，术后预后良好。

Diagnosis and therapy of renal oncocytoma

oncocytoma. Objective To summarize the experience of diagnosing and managing 8 cases of renal Methods The clinical data of 8 cases renal oncocytoma confirmed by operation and pathology examination were analyzed. Results Average course of disease was 15.5 days （7 - 30 d ）. Ultrasound examination, CT and/or MRI were performed in all cases. The tumor mass showed low level echo in ultrasound examination. Maximum diameters of the tumors were between 20 mm to 70 mm （mean 47.5 mm）. Six cases showed high density on CT, two cases showed isodensity, and four cases showed image enhancement with CT enhancement injection. All 8 cases were confirmed as renal oncocytoma by pathology examination after operation. There were abundant granular eosinophilic cells shoun under microscopic examination with CD10 （ - ）, CK7 （ - ）, VI（ - ） by immunohistochemical assay. The follow-up lasted for 1 to 42 months without recurrence or metastasis. Conclusion Renal oncocytoma is a benign tumor proven difficult to differentiate from renal cancer with laboratory observation and image examination. The result of pathology examination during operation could only be useful for a definite diagnosis. When confirmed by pathology examination, partial nephrectomy was encouraged to remove the renal oncocytoma, and complete nephrectomy should be avoided. Renal oncocytoma is a benign tumor with slow growth rate, and the tumor can be removed by operation with a good prognosis.