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1、Case discussion,by abdomen group 2012-3-14,History,Female 63y get wound in a fall 1 month ago USG:solid mass lesion of left kidney SPECT：high perfusion in the mass lesion of left kidney,Cortical period（CT value: 110HU;36HU),Medulla period（CT value:180HU;62HU),Discharge period（CT value:107HU;57HU),VR
2、,Operation：left kidney radical correction Pathology ：Renal oncocytoma,DDX,Renal oncocytoma ,RO,Renal oncocytoma,Renal oncocytomas are benign,rare, solid tumours of the kidney,derived renal cortex epithelium of proximal convoluted tubule.，comprising 37% of all renal tumors Occur in all ages, the most
3、 in about 50y，generally men more than women ,M:F 1. 51. 7 :1 Most is solitary ,can also be complicated with Polycystic kidney , renal angiomyolipomas , renal cancer usually asymptomatic and discovered incidentally,Renal oncocytoma,CT scanner A well-defined margin Central stellate scar d 3cm, homogen
4、eous, rare scar d3cm,with volume become larger,central or eccentrical scar will be occurred follower calcification Cystic or necrosis rarely,Renal oncocytoma,CT enhancement： Cortical period or Medulla period :substantial part improved obviously and homogeneously, the degree of enhancement is larger
5、than or equal to the cortex in the same period Discharge period :enhanced degree reduce , below the renal parenchyma density , higher than muscle density A centrally placed non-enhancing area,likely representing a fibrous scar Spoke-wheel-like enhancement Part of the coating can be seen in rough ves
6、sels,plain scan,cortical period,Medulla period,Discharge period,L-RO,plain scan,Dortical period,Discharge period,L-RO,双肾嗜酸细胞瘤 伴钙化,双肾嗜酸细胞瘤,右肾嗜酸细胞瘤,Differential Diagnosis,renal angiomyolipoma renal chromophobe cell carcinoma,RCCC renal clear cell carcinoma,renal clear cell carcinoma,Diagnostic point L
7、ocated in the cortex，inordinance shape, irregular margin cystic or necrosis is common，density nonuniform in the plain scan renal pelvis and renal calyx be destroyed, easy to transfer rich blood supply for tumor, the degree of enhancement is greater than or equal to the cortex of the same period in t
8、he cortical period, CT100HU, CT value fell rapidly in the medulla period, “Quick in quick out”,Renal chromophobe cell carcinoma(RCCC),Diagnostic point Located in the medullary , expansion growth to renal sinus and renal cortical , tumor size larger , on the surrounding renal organization performance
9、 for the only signs of oppression Enhanced scanning: Light to moderate , homogeneous strengthening of the tumor, change of density is not obvious in each period, And there is no clinical symptoms and transfer of the patients RCCC can also see scar, but less than the RO Cystic or necrosis rarely Identify points：The enhanced, almost the strengthening of the RO significantly higher than RCCC , but sometimes RO and RCCC performance has across, therefore need to pathological diagnosis,Thank you！,
