目的:嗜酸性实性囊性肾细胞癌(ESC-RCC)是罕见且难以诊断的。因此,我们旨在探讨ESC-RCC的影像学和病理特征。
方法:回顾性收集经病理证实的ESC-RCC15例,其中CT15例,MRI9例。
结果:在这些患者中(男性6例,女性9例)(年龄:平均,53.3±14.7年;范围,27-72岁),所有肿瘤都是单侧的,肾,单发,无临床症状,分为1型:囊实性成分,囊性和实性成分相等,最常见(8/15,53.3%);2型:主要是囊性,有少量固体成分(4/15,26.7%);3型:主要是固体(3/15,20%)。固体成分在CT平扫中显示出相等/略高的密度,T1加权图像(T1WI)上的信号相等/稍高,和低信号在T2加权图像(T2WI)。10例表现为进行性增强,而5显示出快速冲洗和快速冲洗的增强。一名患者出现出血,而其他人没有出血的迹象,坏死,脂肪,或钙化。病理上,肿瘤显示囊性,有嗜酸性细胞浆和颗粒状嗜碱性色斑,CK20局灶性或弥漫性表达。10例患者进行了肾部分切除术,5例进行了根治性肾切除术。随访8~49个月,均无复发或转移。
结论:本研究描述了一种罕见类型的肾癌的影像学和病理特征,并提出了3种影像学类型,以增强医师对这种疾病的诊断并指导临床诊断和治疗。
OBJECTIVE: Eosinophilic solid and cystic renal cell carcinoma (ESC-RCC) is rare and difficult to diagnose. Therefore, we aim to investigate the imaging and pathologic features of ESC-RCC.
METHODS: Fifteen cases of ESC-RCC with pathologically confirmed diagnoses were retrospectively collected: CT was performed in 15 cases and MRI in 9 cases.
RESULTS: In these patients (6 males and 9 females) (age: mean, 53.3 ± 14.7 years; range, 27-72 years), all tumors were unilateral, renal, and solitary with no clinical symptoms and were classified into-type 1: cystic-solid component, with equal cystic and solid components, was the most common (8/15, 53.3%); type 2: predominantly cystic with a small solid component (4/15, 26.7%); and type 3: predominantly solid (3/15, 20%). The solid component showed equal/slightly higher density on the CT-plain-scan, equal/slightly high signal on the T1-weighted image (T1WI), and low signal on the T2-weighted image (T2WI). Ten cases showed progressive enhancement, while 5 showed a fast-wash-in and fast-wash-out enhancement. One patient experienced hemorrhage, while the others showed no signs of hemorrhage, necrosis, fat, or calcification. Pathologically, the tumor showed cystic solidity, with eosinophilic cytoplasm and granular basophilic-colored spots with focal or diffuse expression of CK20. Ten patients had componential nephrectomy and 5 had radical nephrectomy. No recurrence or metastasis was noted in any case at the follow-up (8-49 months).
CONCLUSIONS: This study describes the imaging and pathologic features of a rare type of renal cancer and proposes 3 imaging types to enhance physicians\' diagnosis of this disease and guide clinical diagnosis and treatment.