论文摘要
目的:提高肾血管平滑肌脂肪瘤(renal angiomyolipoma, RAML)的诊断及治疗水平。方法:回顾性分析了自1991年7月至2007年8月间收治的23例肾血管平滑肌脂肪瘤患者的临床资料,对其临床表现、诊断、治疗与病理进行对照分析和讨论,根据肿瘤直径大小及症状分别采取肿瘤剜除、肾部分切除、肾切除等措施。结果:23例行超声检查15例提示为肾血管平滑肌脂肪瘤,23例行电子计算机X线体层扫描(computerized tomography,CT)检查18例提示为肾血管平滑肌脂肪瘤,怀疑肾癌6例,进一步行磁共振成像(magnetic resonance imaging,MRI)检查5例提示为肾血管平滑肌脂肪瘤,1例提示为肾癌(renal cell carcinoma,RCC)。23例均手术探查。所有23病例术后病理检查均证实为肾血管平滑肌脂肪瘤。结论:肾血管平滑肌脂肪瘤是良性肿瘤,缺乏特异性的临床症状和体征,主要依靠影像学检查明确诊断。超声检查是简便易行的筛选手段,CT和MRI是定性和定位的最可靠的诊断方法,但应注意RAML三种成分构成差异所引起的不同表现。术中冰冻切片检查对不典型病例是必要的。免疫组化快速染色可提高正确率。超声检查结合CT和MRI检查为肾血管平滑肌脂肪瘤的最佳诊断方法。对已确诊的直径大于4cm或直径小于4cm但有临床症状的肾血管平滑肌脂肪瘤患者,应积极行手术治疗,尽量保留有功能的肾组织。
论文目录
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