摘要目的 探讨肾脏嗜酸细胞瘤的临床特点、诊断、病理、治疗和预后.方法 回顾性分析2000年6月至2016年10月武警湖北省总队医院收治的23例肾嗜酸细胞瘤患者的临床资料.23例患者均行肾脏彩色多普勒超声、静脉尿路造影检查、CT平扫及增强检查,12例行MRI平扫及增强检查.23例患者均在全身麻醉或连续硬膜外麻醉下行手术治疗,早期9例患者行开放或后腹腔镜下患肾根治性切除术,后期14例患者行后腹腔镜下保留肾单位术,术中均未行快速冰冻切片病理检查.结果 术中出血50～ 200 ml,平均85 ml,所有患者围术期均未输血.23例患者住院时间5～12d,平均7.8d;术后均无严重并发症.术后病理检查均诊断为肾嗜酸细胞瘤.12例患者行免疫组化检查.术后随访21例,2例失访;随访时间12～51个月,平均22.4个月.随访期间无复发、转移、自然死亡病例,均无瘤存活.结论 肾嗜酸细胞瘤属于少见的肾脏良性肿瘤,临床症状较少;CT特征性表现为星状瘢痕、轮辐状强化、局部强化倒置;MRI特征性表现为表面弥散系数高、强化速度快、信号强度系数低.检测CyclinD1、CK7、CD117、BCA-2蛋白有助于鉴别肾嗜酸细胞瘤.标准治疗为动态观察或保留肾单位手术,术后预后良好.

abstractsObjective To analyze the clinical features,diagnosis,pathology,treatment and prognosis of renal oncocytoma.Methods The clinical data of 23 patients with renal oncocytoma admitted to the General Hospital of Hubei Armed Police Corps from June 2000 to October 2016 were retrospectively analyzed.Renal color Doppler ultrasonography,intravenous urography,CT plain scan and enhanced examination were performed on the 23 patients;magnetic resonance imaging (MRI) plain scan and enhanced examination were performed on 12 cases.All patients underwent surgery with general anaesthesia or continuous epidural anesthesia;open or retroperitoneal laparoscopic radical nephrectomy was performed on 9 patients in the early stage,and retroperitoneal laparoscopic nephron sparing surgery was implemented on 14 patients in the late stage.No rapid frozen section pathological examination was performed during the operation.Results The mean intraoperative bleeding was 85 ml (range 50-200 ml),and no blood transfusion occurred in any patients during perioperative period.The mean duration of hospitalization was 7.8 days (range 5-12 days),and none of 23 patients had serious postoperative complications.All patients were diagnosed with renal oncocytoma by pathological examination.Twelve patients underwent immunohistochemical examination.Twenty-one cases were followedup and the average follow up period was 22.4 months (range 12-51 months).No recurrence,metastasis or natural death occurred during the follow-up period,and all patients were alive without tumor.Conclusions Renal oncocytoma is a rare benign tumor and it is mostly asymptomatic.Stellate scar,spoken-wheel-like enhancement and segmental enhancement inversion are renal oncocytoma CT features;while higher apparent diffusion coefficient,faster enhancement and lower signal-intensity index are MRI features.The standard treatment of renal oncocytoma is dynamic observation or nephron sparing surgery.The prognosis of renal oncocytoma is good.