CAJ | 학술논문

目的探讨肾黏液纤维瘤的临床表现、诊断与治疗方法. 方法结合文献复习,回顾性分析2013年2月16日收治的1例肾黏液纤维瘤患者的资料,女,47岁.因体检发现左肾囊性肿物8个月入院.发病以来偶伴左腰部不适.B超及CT检查示左肾中下部囊实性占位,直径约4 cm,腹部CT增强和动态超声造影检查均可见肿物缓慢增强,密度不均.术前诊断为左肾占位性病变.全麻下行左肾探查术,术中见左肾中下部肾窦内一直径约5 cm饱满圆形实性肿块,质稍硬,与周围组织粘连紧密,完整切除患肾. 结果病理检查:肿物标本大体观表面饱满光滑,呈淡黄色、有光泽;镜下见肿瘤以纤维瘤样细胞为主,大小不等,形态不一,排列不规则,呈菱形或梭形,核质淡染,偶见核分裂,肿瘤含丰富的黏液及血管组织,可见少量成纤维细胞.病理诊断为黏液纤维瘤(不成熟型),有恶变倾向.术后未行特殊治疗,随访6个月未见肿瘤复发. 结论黏液纤维瘤一般为良性肿瘤,少数有恶变及转移可能,原发于肾脏的黏液纤维瘤非常罕见,术前影像学检查难以确诊,病理诊断为该病诊断的金标准,对该病应积极手术治疗,术后定期复查.
목적 탐토신점액섬유류적림상표현、진단여치료방법. 방법 결합문헌복습,회고성분석2013년2월16일수치적1례신점액섬유류환자적자료,녀,47세.인체검발현좌신낭성종물8개월입원.발병이래우반좌요부불괄.B초급CT검사시좌신중하부낭실성점위,직경약4 cm,복부CT증강화동태초성조영검사균가견종물완만증강,밀도불균.술전진단위좌신점위성병변.전마하행좌신탐사술,술중견좌신중하부신두내일직경약5 cm포만원형실성종괴,질초경,여주위조직점련긴밀,완정절제환신. 결과 병리검사:종물표본대체관표면포만광활,정담황색、유광택;경하견종류이섬유류양세포위주,대소불등,형태불일,배렬불규칙,정릉형혹사형,핵질담염,우견핵분렬,종류함봉부적점액급혈관조직,가견소량성섬유세포.병리진단위점액섬유류(불성숙형),유악변경향.술후미행특수치료,수방6개월미견종류복발. 결론 점액섬유류일반위량성종류,소수유악변급전이가능,원발우신장적점액섬유류비상한견,술전영상학검사난이학진,병리진단위해병진단적금표준,대해병응적겁수술치료,술후정기복사.
Objective To study the clinical manifestation,diagnosis and treatment of the renal myxofibromata.Methods Combined with reviewing the relevant literature,we retrospectively analyzed the clinical data of a case of renal myxofibromata.A 47-year-old female patient was found left renal cystic lesion by ultrasound 8 months before admission.CT showed a 4 cm cystic and solid lesions in the lower pole of left kidney,which was similar to the results of ultrasound.The enhanced abdominal CT and dynamic contrast-enhanced ultrasound showed that the lesions could be enhanced slowly with uneven density.The patient underwent left kidney exploration under the general anaesthesia.During operation,a round solid mass about 5 cm in diameter can been seen in the low part of renal sinus,which was a bit hard.The mass was close with surrounding tissue.Then,the left kidney was excised.Results The surface of the mass was full and smooth with pale yellow luster.In the HE section,the tumor was composed with fibroma like cell,which demonstrated the inhomogeneous size,shape and irregular organization.The nucleus showed the spindle shape,with rare mitosis phase.Large quantity of mucus and vascular tissue could be observed in the tumor.Few fibroblast cells could also be found in the section.The pathological result was myxofibromata (immature) with malignant tendency.No special treatment was given after surgery.Recurrence was not recorded within 6 months following-up.Conclusions Commonly,the myxofibromata is a kind of benign tumor.Only a few can result in the malignant transformation and distant metastasis.Primary renal myxofibromata is extremely rare.The preoperative imagine manifestation is difficult to provide the accurate diagnosis.Pathologic result is the gold standard in diagnosing this disease.Actively surgical treatment and regular following-up after surgery should be considered.