CAJ | 학술논문

目的：探讨CT对肾脏原发滑膜肉瘤的诊断价值。材料与方法回顾性分析5例经手术病理证实肾脏原发性滑膜肉瘤的CT表现，并与病理对照。结果5例患者原发滑膜肉瘤均表现为单发肿块，其中1例合并肾盂肾癌。3例位于右肾，2例位于左肾。肿块最大径4.2-10.9cm(中位值7.6cm)。5例均表现为伴有多发囊性区域的软组织肿块，其中2例破裂伴有肾周血肿。4例位于肾脏边缘且与周围肾组织分界清晰，1例侵犯肾盂并破坏肾脏的结构。肿块实性成分增强后不均匀强化，囊性区域壁光整。5例大体标本均表现为切面灰白的囊实性软组织肿块，囊性部分壁光整。镜检显示肿瘤由高核-浆比和核分裂相的梭形细胞组成，包埋有扩张的肾小管。结论肾脏原发滑膜肉瘤CT特征包括边界清晰囊实性肿块，囊性部分壁光整，增强后实性成分不均匀强化，容易破裂合并肾包膜下血肿。囊性部分为肿瘤包埋扩张的肾小管。
목적：탐토CT대신장원발활막육류적진단개치。재료여방법회고성분석5례경수술병리증실신장원발성활막육류적CT표현，병여병리대조。결과5례환자원발활막육류균표현위단발종괴，기중1례합병신우신암。3례위우우신，2례위우좌신。종괴최대경4.2-10.9cm(중위치7.6cm)。5례균표현위반유다발낭성구역적연조직종괴，기중2례파렬반유신주혈종。4례위우신장변연차여주위신조직분계청석，1례침범신우병파배신장적결구。종괴실성성분증강후불균균강화，낭성구역벽광정。5례대체표본균표현위절면회백적낭실성연조직종괴，낭성부분벽광정。경검현시종류유고핵-장비화핵분렬상적사형세포조성，포매유확장적신소관。결론신장원발활막육류CT특정포괄변계청석낭실성종괴，낭성부분벽광정，증강후실성성분불균균강화，용역파렬합병신포막하혈종。낭성부분위종류포매확장적신소관。
Objective To investigate value of CT in diagnosis of primary synovial sarcoma of the kidney. Methods CT findings of five patients with pathologically confirmed primary synovial sarcoma of the kidney were retrospectively viewed and correlated with pathologic features. Results Five primary synovial sarcomas of the kidney had one renal mass and one patient had one renal mass collided with a ureteral carcinoma. Three synovial sarcomas were in the right kidney, while two in the left kidney. The maximum diameter were 4.2-10.9cm with a median of 7.6 cm. The five synovial sarcomas presented as soft tissue masses with multiple cystic areas. Rupture and subscapular hematoma were seen in two cases. The walls of cysts were smooth predominantly and the soft tissue components were heterogeneous enhanced after iv contrast materials. Microscopic examinations revealed entrapped and dilated renal tubules were noticed. Conclision Primary synovial sarcoma of the kidney may manifested as a well-defined renal mass with multiple smooth wall cysts Its solid components showed heterogeneous enhancement after iv contrast materials. Rupture and subscapular hematoma may be seen also.