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目的:探讨非IGg4相关性腹膜后纤维化(retroperitoneal fibrosis,RPF)表现为左肾盂肿瘤的临床特点、诊断和治疗方法。方法:回顾性分析1例非IGg4相关性RPF表现为左肾盂肿瘤患者的临床资料:女,44岁,因左腰部酸胀伴低热1月余、发现左肾盂占位病变2周入院。超声检查提示左肾集合系统分离,宽约1.0cm,内见实性回声,范围3.9cm×3.0cm,延肾盂分布,未见明确血流。CT检查示左肾门软组织密度灶,平扫CT值为44~50HU,增强后CT值为75~97HU,左侧部分肾盏扩张积水,左输尿管未见造影剂进入,考虑梗阻位于左肾门,左肾门软组织密度性质待定。行腹腔镜左肾根治性切除术,完整切除肾脏和部分输尿管。结果:肿物剖开后可见左肾盂内及肾周灰白色实性占位浸润。术后病理报告为非IGg4相关性特发性RPF。患者恢复良好,术后10天出院。术后6个月复查CT发现左肾窝处有不规则密度影,伴不均匀强化。全身PET-CT提示左肾床代谢略高软组织密度影,不除外肿瘤复发。结论:非IGg4相关性RPF表现为左肾盂肿瘤临床罕见,但非IGg4相关性RPF也应为肾盂肿瘤的鉴别诊断指标之一;对于伴有自身免疫性疾病的肾盂占位病变的患者,应考虑到此病的可能。
Objective: To investigate the clinical features, diagnosis and treatment of non-IGg4-associated retroperitoneal fibrosis (RPF) in patients with left renal pelvis. Methods: A retrospective analysis of 1 non-IGg4-related clinical manifestations of RPF in patients with left renal pelvis tumors: female, 44 years old, due to left lower extremity soreness with fever more than 1 month, found that left renal pelvis lesions were hospitalized for 2 weeks. Ultrasound examination prompted the left renal collection system separation, width 1.0cm, see the real echo, the scope of 3.9cm × 3.0cm, delay renal pelvis distribution, no clear blood flow. CT examination showed the left renal pelvis soft tissue density, CT scan value of 44 ~ 50HU, enhanced CT value of 75 ~ 97HU, the left part of the calyx expansion of water, left ureter no contrast agent to enter, consider the obstruction located in the left kidney Door, left renal soft tissue density properties to be determined. Laparoscopic radical nephrectomy, complete removal of the kidneys and part of the ureter. Results: After the tumor was dissected, the left renal pelvis and perineal appendix were observed with gray-white solid infiltration. Postoperative pathology was reported as non-IGg4-related idiopathic RPF. The patient recovered well and was discharged 10 days after surgery. 6 months after the review of the CT found that the left renal cell at irregular density, with uneven enhancement. Whole-body PET-CT prompts slightly higher soft tissue density in the left kidney bed metabolism, no exception tumor recurrence. CONCLUSIONS: Non-IGg4-associated RPF is clinically rare in patients with left renal pelvis, but non-IGg4-associated RPF should also be one of the differential diagnosis markers of renal pelvis. For patients with renal pelvis lesions with autoimmune diseases, The disease may be.