摘要
目的 :探讨肉瘤样肾细胞癌的CT表现与临床病理基础 ,提高对肉瘤样肾细胞癌的认识。方法 :对经手术病理证实的 6例肉瘤样肾细胞癌的CT和临床资料进行回顾性分析。结果 :所有病例均表现为肾实质性肿块 (右肾 4例 ,左肾 2例 )。平扫为分叶状、等密度或略高密度不均质实性肿块。有灶性坏死区 ,增强后不均匀轻度强化 ,与正常实质分界不清。全部病例侵犯肾周间隙达肾周筋膜。 4例侵犯肾静脉或 /和下腔静脉。 3例区域淋巴结转移。 2例远处转移。术后3月内复发 2例。半年内 4例因复发或 /和远处转移而死亡。结论 :肉瘤样肾细胞癌少见 ,多为分叶状、密度不均、边界不清肿块 ;极易侵犯周围组织、肾静脉或下腔静脉并出现淋巴结或远处转移 ;恶性度极高 ,愈后极差。CT是发现病灶、判断预后可靠和准确的方法之一。确诊依靠术前细针穿刺活检。
Objective:To study the spiral CT appearances and pathologic findings of sarcomatoid renal cell carcinoma (SRCC) to improve its diagnostic accuracy.Methods:The spiral CT appearances and corresponding surgical-pathological findings in 6 patients with primary SRCC were retrospectively analyzed.Results:All cases presented with a solitary renal mass (4 cases on the right.2 cases on the left).The tumors manifested as lobulated soft tissue mass of uneven density with poorly defined margins and intratumoral necrosis on plain scans,with similar or slight higher density compared to the normal parenchyma of kidney.All of them showed slight enhancement with heterogeneous density.Perirenal fat invasion was seen in 6 cases,invasion of renal vein or/and inferior vena cava in 4 cases,lymph nodes metastases 3 cases,distant metastases 2 cases.2 recurrent tumors were found in 3 monthes after operation,4 cases died of recurrence or/a nd distant metastases in half a year.Conclusion:SRCC is a rare renal cell carcinoma with lobulated soft tissue mass of uneven density and poorly defined margins,which has higher malignant behavior and unfavorable prognosis.CT scanning is a reliable and accurate examination for detecting the SRCC and evaluating the prognosis.Fine -needle aspiration before operation can establish the pathologic diagnosis.
出处
《放射学实践》
2004年第11期821-824,共4页
Radiologic Practice
