肾、肾盂、输尿管原发肉瘤样癌MSCT表现与临床分析(附4例报告)  

MSCT manifestations and clinical analyses of the primary sarcomatoid carcinoma from kidney,renal pelvis and ureter(report of 4 cases)

作　　者：江凯[1] 邓生德[1] 王玉涛[1] 白延军[2] 孙书本 徐裕[1] 王蓼[1] 汪建华[1] 

机构地区：[1]宁波大学医学院附属医院放射科,浙江宁波315020 [2]浙江大学第一附属院北仑分院影像科,浙江宁波3158006 [3]宁波大学医学院附属医院泌尿外科,浙江宁波315020

出　　处：《医学影像学杂志》2016年第4期670-673,共4页Journal of Medical Imaging

摘　　要：目的探讨肾、肾盂、输尿管原发肉瘤样癌MSCT表现。方法分析4例经病理证实的肾、肾盂、输尿管原发肉瘤样癌的MSCT表现,并与病理对照,复习文献。结果肾盂肉瘤样癌2例,伴肾积水,肝脏、脾脏、后腹膜区淋巴结多发转移,1例肿块巨大,伴以边缘分布为主的多发低密度区;右输尿管中下段肉瘤样癌1例,累及膀胱,伴右肾积水、萎缩;左肾中上极肉瘤样癌1例伴坏死及左肾上盏积水;增强CT检查皮质期、实质期强化明显,延迟扫描强化程度减退不明显。结论肾盂、输尿管肉瘤样癌恶性程度高,预后不良。MSCT对于术前定位、治疗方案的制订及术后随访具有重要价值。Objective To investigate the MSCT manifestations of primary sarcomatoid carcinoma from kidney,renal pelvis and ureter. Methods We retrospectively analyzed four cases of primary sarcomatoid carcinoma from kidney,renal pelvis and ureter confirmed by pathology,compared the pathological findings,and reviewed the relevant literatures in this work. Results Two cases of sarcomatoid carcinomaderived from the renal pelvis,which accompanied with hydronephrosis and metastases of liver,spleen,and retroperitoneal lymph node. Of which one presented with the great massthat accompanied by the multiple low density areas mainly distributed in the margin. One case of sarcomatoid carcinoma originated from the right middle and lower ureter,which involved in the bladder,with hydronephrosis and atrophy in the right kidney. One case of sarcomatoid carcinoma arose from the left kidney,with necrosis and hydrops of upper renal calyx. Enhanced CT showed that the cortex and substance were strengthened significantly,but,the scanning degree of enhancement were subsided in the delayed phase. Conclusion MSCT has for preoperative localization,develop and postoperative follow-up treatment programs have great value. The sarcomatoid carcinoma from kidney,renal pelvis and ureter has high degree of malignancy,with poor prognosis. MSCT has great value for preoperative localization,making the treatment plan and postoperative follow-up.

关 键 词：肾 肾盂 输尿管 原发肉瘤样癌 体层摄影术 X线计算机 

分 类 号：R737.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]