CAJ | 학술논문

目的：探讨肾血管平滑肌脂肪瘤（RAML）的临床病理特点及诊断与鉴别诊断。方法：回顾性分析经术后病理证实的25例 RAML 患者的临床表现、形态特征及免疫表型特点。结果：肿瘤长径2-20cm，平均8.5cm，除去1例伴发对侧肾脂肪瘤外其余24例均为单病灶。18例有症状，其中14例腰腹胀痛，4例有血尿，7例无症状者于体检或因其他疾病影像学检查时偶然发现。病理检查经典型者24例，由血管、平滑肌和脂肪组织呈不同比例构成。术前76.2%（16/21）的患者 B 超提示 RAML，78.3%（18/23）患者 CT 扫描提示RAML。术中冰冻9例，8例明确诊断 RAML，1例延迟诊断，术后病理诊断为上皮样型 RAML。结论：影像学检查对于 RAML 有较高的特征性。术前进行影像学检查，绝大多数患者可被提示或者明确诊断为 RAML。病理切片辅以免疫组化检查对 RAML 的诊断和鉴别诊断有决定性意义。
목적：탐토신혈관평활기지방류（RAML）적림상병리특점급진단여감별진단。방법：회고성분석경술후병리증실적25례 RAML 환자적림상표현、형태특정급면역표형특점。결과：종류장경2-20cm，평균8.5cm，제거1례반발대측신지방류외기여24례균위단병조。18례유증상，기중14례요복창통，4례유혈뇨，7례무증상자우체검혹인기타질병영상학검사시우연발현。병리검사경전형자24례，유혈관、평활기화지방조직정불동비례구성。술전76.2%（16/21）적환자 B 초제시 RAML，78.3%（18/23）환자 CT 소묘제시RAML。술중빙동9례，8례명학진단 RAML，1례연지진단，술후병리진단위상피양형 RAML。결론：영상학검사대우 RAML 유교고적특정성。술전진행영상학검사，절대다수환자가피제시혹자명학진단위 RAML。병리절편보이면역조화검사대 RAML 적진단화감별진단유결정성의의。
Objective:To investigate the diagnosis and differential diagnosis of renal angiomyoliPoma(RAML)by analyzing their clinicoPathological features. Methods:The clinical and Pathological features of 25 cases of RAML were retrosPectively analyzed. Results:Of 25 cases there were 8 males and 17 females,age ranged from 20 to 69 years(me-dian age:42. 8 years). 18 Patients Present with some symPtoms:14 cases with waist Pain and 4 cases hematuria,while 7 were asymPtomatic and detected as an incidental finding on imaging examination. On gross examination,the tumors ranged from 2cm to 20cm in maximum diameter(mean size:8. 5cm). Most of cases were single lesion(96% ,24 / 25) excePt one case accomPanied with liPoma of the contralateral kidney. 76. 2% of Patients(16 / 21)and 78. 3% of Pa-tients(18 / 23)were diagnosed as RAML by B - ultrasound examination or CT scan resPectively before surgery. eisto-logically,24 cases were diagnosed as classic RAML mainly comPosed of blood vessles,smooth muscle and fat in differ-ent ProPortions,while only one was diagnosed as ePithelioid RAML with the delayed diagnosis by intraoPerative frozen section. Conclusion:It's helPful to undergo imaging examination for diagnosis of RAML. The majority of cases were di-agnosed by imaging method. BioPsy suPPlemented by immunohistochemistry is of significance in the diagnosis and dif-ferential diagnosis of RAML.