摘要:
目的:探讨肾上皮样血管平滑肌脂肪瘤(EAML)的影像学特征及病理学特点,提高对该疾病的认识。材料和方法:回顾性分析2008年1月至2014年4月间本院7例经手术病理证实为肾脏EAML的影像学表现及病理特点。结果:7个病例8个病灶,其中5个病灶部分突出肾轮廓外,2个病灶突入肾窦,1个病灶同时突出肾轮廓外及肾窦;CT平扫3例呈稍高密度,2例呈等密度,1例MRI呈稍长T1短T2;增强扫描2例病灶呈“快进快出”,2例呈“快进慢出”;5例见“皮质掀起征”,5例见“黑星征”,其中4例同时出现“皮质掀起征”及“黑星征”;2例病理有恶性表现。组织学表现:肿瘤主要由上皮样细胞、平滑肌、厚壁血管及脂肪组成。免疫组化:常表达肿瘤细胞S-100、瘤细胞Vim、HMB-45、HHF-35及CD34。结论:肾上皮样血管平滑肌脂肪瘤的影像学表现多样化,影像学表现难与其他疾病相鉴别,当肿瘤部分突出肾轮廓外或向肾窦内生长,CT平扫密度呈稍高或等密度应考虑有EAML可能。
Abstract:
objective: To study the imaging features and pathological characteristics of renal epithelioid angiomyolipoma(EAML). Material and Method: Image findings and pathologic features of 7 cases with EAML proved by pathology were retrospectively studied from 2008-2014. Results: There were totally 8 lesions of 7cases, including five lesion extruded of the kidney, 2 lesions grown into renal sinus, 1 lesion simultaneously extruded of the kidney and grown into renal sinus;; Unenhanced CT, three cases showed slightly highdensity, two cases showed iso-density. One case showed hypointense on T1-weighted imagingand hyperintense on T2-weighted imaging;After intravenous enhancement, two cases showed "fast-forward and slow-out" and two cases showed “fast-in and fast-out” on enhanced CT; "Renal cortex lifted sign " may be seen in five case), "Black star sign" could also be found in five cases, "Renal cortex lifted sign" and" black star sign” can be seen simultaneously in 4cases; 2 cases had malignant sign in histologic examination. Histologically, the tumors were predominantly composed of epithelioid cells, smooth muscle, thick-walled blood vessels and adipose tissue. Immunohistochemical study showed that the tumor cells were positive for S-100, vimentin, HMB-45, HHF-35 and CD34. Conclusions: The imaging findings of EAML are multivarious. And it's difficult to distinguish with other diseases. If part of the tumor extrude of the kidney or grow into renal sinus and the lesions are slightly high density or iso-density in plain CT scan, it may be a suggestive diagnosis of EMAL.
百度学术
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