PDF(Pubmed)
Abstract：
The terms \"renal regenerating nodule\" and \"nodular compensatory hypertrophy\" are used in the literature to describe functioning pseudo-tumors (FPT) in the setting of an extensively scarred kidney. FPTs are usually discovered incidentally during routine renal imaging. Differentiating these FPTs from renal neoplasms is critical but can be challenging in the setting of chronic kidney disease (CKD) given the limitations related to using contrast-based imaging.
We report a pediatric case series of 5 CKD patients, with history of urinary tract infections, in which tumor-like lesions evolved in scarred kidneys and were incidentally discovered on routine renal imaging. These were diagnosed as FPT by utilizing dimercaptosuccinic acid (DMSA) imaging and showed stable size and appearance upon follow-up with ultrasound and MRI.
FPTs can be picked up on routine imaging of pediatric patients with CKD. Although larger cohort studies are needed to confirm these conclusions, our case series supports the evidence that DMSA scan showing uptake at the site of the mass can be a useful tool to suggest the diagnosis of FPTs in children with kidney scarring, and that SPECT DMSA scan adds more precision in picking up and accurately localizing FPTs compared to planar DMSA.
We report a pediatric case series of 5 CKD patients, with history of urinary tract infections, in which tumor-like lesions evolved in scarred kidneys and were incidentally discovered on routine renal imaging. These were diagnosed as FPT by utilizing dimercaptosuccinic acid (DMSA) imaging and showed stable size and appearance upon follow-up with ultrasound and MRI.
FPTs can be picked up on routine imaging of pediatric patients with CKD. Although larger cohort studies are needed to confirm these conclusions, our case series supports the evidence that DMSA scan showing uptake at the site of the mass can be a useful tool to suggest the diagnosis of FPTs in children with kidney scarring, and that SPECT DMSA scan adds more precision in picking up and accurately localizing FPTs compared to planar DMSA.
摘要：
背景：文献中使用术语“肾再生结节”和“结节性代偿性肥大”来描述广泛结疤的肾脏中的功能性假性肿瘤（FPT）。FPT通常在常规肾脏成像过程中偶然发现。区分这些FPT与肾肿瘤是至关重要的，但在慢性肾病（CKD）的背景下，考虑到与使用基于对比的成像相关的局限性，可能具有挑战性。
方法：我们报告了5例CKD患者的儿科病例系列，有尿路感染史,其中肿瘤样病变在结疤的肾脏中演变，并在常规肾脏成像中偶然发现。通过利用二巯基琥珀酸（DMSA）成像将其诊断为FPT，并在超声和MRI随访中显示出稳定的大小和外观。
结论：CKD患儿常规影像学检查可检出FPT。尽管需要更大的队列研究来证实这些结论，我们的病例系列支持的证据表明，DMSA扫描显示在肿块部位的摄取可能是一个有用的工具，以建议诊断患有肾脏瘢痕的儿童的FPT，与平面DMSA相比，SPECTDMSA扫描在拾取和精确定位FPT方面增加了更高的精度。
方法：我们报告了5例CKD患者的儿科病例系列，有尿路感染史,其中肿瘤样病变在结疤的肾脏中演变，并在常规肾脏成像中偶然发现。通过利用二巯基琥珀酸（DMSA）成像将其诊断为FPT，并在超声和MRI随访中显示出稳定的大小和外观。
结论：CKD患儿常规影像学检查可检出FPT。尽管需要更大的队列研究来证实这些结论，我们的病例系列支持的证据表明，DMSA扫描显示在肿块部位的摄取可能是一个有用的工具，以建议诊断患有肾脏瘢痕的儿童的FPT，与平面DMSA相比，SPECTDMSA扫描在拾取和精确定位FPT方面增加了更高的精度。
