肾脏嗜酸细胞腺瘤影像学误诊分析OACSTPCD

Objective To investigate the clinical features and imaging manifestations of renal oncocytoma(RO),and to summarize the causes of misdiagnosis and preventive measures.Methods The clinical and imaging data of 2 patients with RO misdiagnosed before operation were analyzed retrospectively.Results Both patients were females,aged 45 years and 67 years respectively,and presented with space-occupying lesions of kidney detected in physical examination.Preoperative renal ultrasonography and enhanced CT examination were performed in both patients,with one lesion located in the left and right kidneys respectively in the two patients,showing a quasi-circular shape with clear boundary and protrusion outward to the kid-ney.Ultrasound examination showed slightly high echo in one patient,and cystic-solid mixed echo in the other patient.Color Doppler flow imaging showed blood flow signals in and around the tumor in 2 patients.CT plain scan showed slightly low den-sity in 2 patients,enhanced scan showed obvious enhancement in 1 patient and mild enhancement in 1 patient,and the en-hancement showed a ＂fast in and slow out＂ mode.No venous tumor thrombin was found in 2 patients,and no enlarged lymph nodes were found near renal portal and retroperitoneum.They were misdiagnosed as chromophobe renal cell carcinoma and clear cell renal cell carcinoma respectively before operation.The misdiagnosis lasted 2-5 d.One patient underwent radical right nephrectomy and the other underwent partial left nephrectomy.RO was confirmed by pathological examination after opera-tion.No recurrence or metastasis was observed in the 2 patients.Conclusion RO is rare,with no specific clinical manifesta-tions,and imaging findings overlap with renal carcinoma,which often lead to misdiagnosis before surgery.For patients with round or quasi-circular isolated renal masses with clear boundaries,when the masses show a＂fast in and slow out＂ enhance-ment mode,especially when the tumor has delayed enhancement of star-shaped central scars and＂segmental enhancement in-version＂ and other characteristics,the possibility of this disease should be highly suspected.