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目的探讨肾嗜酸细胞腺瘤的诊断和治疗的方法。方法回顾性分析23例肾嗜酸细胞腺瘤患者的临床特征、影像学、病理学表现,治疗及预后,并复习相关文献。结果 23例患者,男15例,女8例;年龄52～73岁。病变均为单侧,左侧10例,右侧13例。直径2～17 cm。有症状者11例,主要表现为患侧腰部胀痛不适;有体征者5例,均表现为腹部包块;另7例体检时行超声检查发现。B超均表现为质均、边界清楚的实性回声;CT表现为肿瘤密度均匀,瘤体中央有星状结构。行根治性肾切除术12例,肾部分切除术11例。免疫组化染色重组人细胞角蛋白18(CK18)强阳性、波形蛋白(Vimentin)阴性。术后病理回报均为肾嗜酸细胞腺瘤。18例患者随访2～62个月无肿瘤复发或转移。结论综合病史及影像学检查特点可考虑肾嗜酸细胞腺瘤的诊断,确诊靠术后病理。选择保留肾单位的肿瘤切除术是其首选治疗方法。
Objective To investigate the diagnosis and treatment of renal oncocytoma. Methods The clinical features, imaging, pathology, treatment and prognosis of 23 patients with renal oncocytoma were retrospectively reviewed. The related literatures were reviewed. Results 23 patients, 15 males and 8 females; aged 52 to 73 years. Lesions were unilateral, left 10 cases, right 13 cases. Diameter 2 ~ 17 cm. Symptomatic in 11 cases, mainly for the ipsilateral lower back pain discomfort; 5 cases were signs, showed abdominal mass; the other 7 cases were examined by ultrasound examination. B-ultrasound showed homogeneous quality, clear boundary echogenicity; CT showed uniform tumor density, the tumor has a star-shaped central structure. Radical nephrectomy in 12 cases, partial nephrectomy in 11 cases. Immunohistochemical staining of recombinant human cytokeratin 18 (CK18) strongly positive, vimentin (Vimentin) negative. Postoperative pathological findings were renal oncocytoma. 18 patients were followed up for 2 to 62 months without tumor recurrence or metastasis. Conclusion The comprehensive history and imaging features of renal oncocytoma can be considered diagnosis, diagnosis by postoperative pathology. Tumor resection for nephron preservation is the preferred treatment.