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作 者:张红英[1] 魏兵[1] 王晓洁[1] 刘柏龄[1] 林涛[2]
机构地区:[1]四川大学华西医院病理科,成都610041 [2]四川大学华西医院泌尿外科,成都610041
出 处:《诊断病理学杂志》2003年第1期8-10,I003,共4页Chinese Journal of Diagnostic Pathology
基 金:纽约中华医学基金会 (CMB)基金项目 ( 0 0 -72 2 )。
摘 要:目的 分析肾细胞癌和肾血管平滑肌脂肪瘤冷冻切片误诊原因以及提高诊断准确率的方法。方法 分析术中肾冷冻切片 112例 ,根据最后诊断结果分为两组 ,第一组 2 4例 ,为肾血管平滑肌脂肪瘤 ;第二组 88例 ,为肾细胞癌。将患者的临床资料、冷冻切片及术后常规石蜡切片诊断结果作对照。结果 第一组中 1例术中诊断为肉瘤样癌 ,2例良恶性难定 ,2 1例诊断正确 ;第二组中 6例术中诊断为肾血管平滑肌脂肪瘤 ,1例黄色肉芽肿性肾盂肾炎 ,2例良恶性难定 ,79例诊断正确。结论 提高冷冻切片准确率的关键在于详尽了解临床资料、正确而全面地取材以及丰富的经验。Objective To study the causes of misdiagnosis in renal frozen sections of renal cell carcinoma and renal angiolipoma and to improve the accuracy of diagnosis. Methods 112 cases of intraoperative renal frozen section were studied. All cases were divided into two groups according to the final diagnosis: the first group was renal angiolipoma (RAML)and the second group was renal cell carcinoma (RCC). There were 24 cases in the first group while 88 cases in the second. A retrospective study was done including reviewing the CT imaging, clinical diagnosis, gross characteristics, frozen- and paraffin-section diagnosis. Results In the first group, 21 cases were diagnosed correctively, 1 case was misdiagnosed as renal sarcomatoid carcinoma and 2 cases were difficult to be diagnosed definitely in frozen section. In the second group, 79 cases were diagnosed correctively, 6 cases were misdiagnosed as RAML, 1 case was misdiagnosed as xantho-granulomatous pyelonephritis and 2 cases were difficult to diagnose definitely. Conclusions The key points to improve the accuracy of frozen section in the diagnosis of renal tumors include: ①pathologists and clinicians should keep contact with each other in operation; ②a detailed clinical data, careful gross checkup of tumor and correct procedure of making frozen sections are always necessary; ③pathologists should have a rich experience in renal pathology.
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