肾嗜酸细胞瘤2例报告并文献复习.pdfVIP

· 548· 中国肿瘤临床与康复2007年l2月第l4卷第6期 Chin J Clin Oncol Rehabil，December2007，Vol 14，No．6 · 临床应用 · 肾嗜酸细胞瘤2例报告并文献复习 陈修德 金讯波 熊晖 蒋绍博 夏庆华 赵勇 孙鹏 王慕文 (山东省立医院泌尿微创医学中心，济南 250021) 【摘要】 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。 【关键词】 肾肿瘤／诊断学； 肾肿瘤／治疗学；腹腔镜 【中图分类号】R737．11；R730．56 【文献标识码】A 【文章编号】1005—8664(2007)06-0548-03 Renal oncocytoma：report of 2 cases and review of literature CHENXdu—de，jlN Xun—bo。XIONG Hui，et al (Department of Minimally Invasive Urology，Shandong Provincial Hospital，Jinan 250021，China) 【Abstract】 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 re— served．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． 【Key words】Renal neoplasms／diagnosis；Renal neoplasms／treatment；Laparoscopy 肾嗜酸细胞瘤是一种非常少见的肾脏良性肿 周。患者5 d前查体时发现右肾有一占位性病变， 瘤，国内报道肾嗜酸细胞瘤往往被当作肾癌而行根 无血尿、尿急、尿痛等尿路刺激症