肾细胞癌非透明细胞亚型的CT表现并文献复习  

Non-clear-cell subtypes of renal cell carcinoma:CT findings and literature review

作　　者：杨惠君 尚芸芸[1] 赵新湘[1] 郝金钢[1] YANG Huijun;SHANG Yunyun;ZHAO Xinxiang;HAO Jingang(Department of Radiology,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院放射科,云南昆明650101

出　　处：《实用放射学杂志》2022年第3期445-449,共5页Journal of Practical Radiology

摘　　要：目的探讨肾细胞癌(RCC)非透明细胞亚型的CT影像特点.方法回顾性分析经病理证实的42例RCC非透明细胞亚型的CT影像资料,其中乳头状肾细胞癌(PRCC)9例,嫌色细胞癌(CHRCC)16例,低度恶性潜能的多房囊性肾肿瘤(MCRNLMP)2例,黏液性小管状和梭形细胞癌(MTSCC)3例,Xp11.2易位/TFE3基因融合相关性肾癌(Xp11.2/TFE3 RCC)6例,集合管癌(CDC)6例.结果PRCC增强呈进行性轻度不均匀延迟强化,包膜完整.CHRCC可见典型的轮辐状及反转强化等征象,2例有钙化,包膜完整或不完整.MCRNLMP为囊实性,囊性成分较多,增强分隔及实性成分呈轻中度延时强化,包膜完整.MTSCC增强呈不均匀持续轻度强化,1例可见假包膜.Xp11.2/TFE3 RCC增强皮质期呈明显不均匀强化,1例有明显出血、坏死、囊变,1例肾门区淋巴结肿大.CDC呈蟹足样弥漫浸润性沿集合管生长,边界不清,无包膜,增强呈渐进性轻中度强化,5例可见肾门区淋巴结肿大.结论RCC非透明细胞亚型的CT表现有其自身特点,平扫多呈圆形或类圆形,边界清楚或模糊,密度均匀或不均匀,可伴坏死、出血、囊变及钙化,增强呈轻中度渐进性强化或早期明显强化,各期强化程度均低于肾皮髓质,部分包膜完整或不完整,少数早期或晚期可出现转移.Objective To investigate the CT features of non-clear-cell subtypes renal cell carcinoma(RCC).Methods CT findings of 42 cases with non-clear-cell subtypes RCC with pathology proved were analyzed retrospectively,including 9 cases were papillary(PRCC),16 cases were chromophobe renal cell carcinoma(CHRCC),2 cases were multilocular cystic renal neoplasm of low malignant potential(MCRNLMP),3 cases were mucinous tubular and spindle cell carcinoma(MTSCC),6 cases were renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion(Xp11.2/TFE3 RCC)and 6 cases were collecting duct carcinoma(CDC).Results PRCC showed continuous mild heterogeneous delayed enhancement with intact capsules.CHRCC,with calcifications in 2 cases,showed typical signs of wheel-like and inversion enhancement and intact or incomplete capsules.MCRNLMP were solid-cystic,more cystic components,with intact capsules and the septal and solid components showed mild to moderate delayed enhancement.MTSCC showed continuous heterogeneous mild enhancement,and pseudo-capsule was seen in 1 case.Xp11.2/TFE3 RCC showed marked heterogeneous enhancement in the cortical phase,with obvious hemorrhage,necrosis and cystic degeneration in 1 case and renal hilum lymph nodes enlargement in another.CDC showed crab foot-like diffuse infiltrative growth along the collecting duct,without clear margins and capsules,and showed gradually mild to moderate enhancement.Renal hilum lymph nodes enlargement were found in 5 cases.Conclusion CT manifestations of non-clear-cell subtypes RCC has their own characteristics.In plain scan,the tumors are round or round-like,well-defined margin or not,homogeneous or heterogeneous densities,accompanied with necrosis,hemorrhage,cystic degeneration and calcification.The tumors shows mild to moderate progressive enhancement or obvious enhancement in early phase,and the degree of enhancement in every phase is lower than that in the renal cortex and medulla.The capsules are intact or incomplete.Some tumors shows metastasis in early or late sta

关 键 词：肾细胞癌 计算机体层成像 病理学 

分 类 号：R737.11[医药卫生—肿瘤] R814.42[医药卫生—临床医学] R446.8