肾脏嗜酸性细胞瘤的诊断与治疗

摘要

目的:探讨肾嗜酸性细胞瘤的诊疗方法,提高肾嗜酸性细胞瘤的诊疗水平.方法:回顾性分析本院12例肾嗜酸性细胞瘤患者的临床资料,并结合文献探讨其诊疗方法及预后.结果:12例患者术前影像学均诊断为肾占位性病变,其中T1aN0M0期5例,T1bN0M0期 7例.术中及术后病理学检查证实为肾嗜酸性细胞瘤.2例行根治性肾切除术,10例行根治性肾部分切除术,术后随访18~36个月无复发转移.结论:肾嗜酸细胞瘤系肾脏的良性倾向肿瘤,预后良好,术前仅靠临床症状和影像学特征难以与肾癌相鉴别,易误诊为肾癌.对于可疑病例,须行术中快速冰冻病理检查.诊断需依据病理组织学、免疫组化及特点综合判断.治疗以保肾手术首选,术后应密切随访.%Objective:To investigate renal oncocytoma treatment methods and to improve the diagnosis and treatment of renal oncocytoma.Methods:The clinical data of 12 cases of patients with renal oncocytoma in our hospital were analyzed retrospectively and combined with literature to explore its diagnosis,treatment and prognosis.Results:12 patients were diagnosed with preoperative imaging of renal occupying lesions,among them T1aN0M0 5 cases,T1bN0M0 7 cases.Intraoperative and postoperative pathologic examination confirmed renal oncocytoma.2 patients underwent partial and 10 patients nephrectomy radical nephrectomy,all ptients were followed up for 18 to 36 months without recurrence.Conclusion:Renal oncocytoma was tends to kidney benign tumors,the prognosis is good.It's difficult to differentiate it from renal cell carcinoma only relying on preoperative clinical symptoms and imaging features,and it often misdiagnosed as kidney cancer.For suspected cases,fast intraoperative frozen pathology is necessary.The final diagnosis was confirmed on the basis of histological,immunohistochemical and features comprehensive judgments.The first choice of treatment was nephron-sparing surgery,postoperative patients should be closely followed up.