renal oncocytoma
Introduction
Introduction to renal eosinophils Renal neonatal cell tumor (renaloncocytoma) is a kind of renal adenoma, which is relatively rare in clinical practice, accounting for 4.3% of renal parenchymal tumors. Typical cases of benign tumors are unilateral lesions, 10% are multiple, and a few are bilateral lesions. More men than women, the size of the mass is different, the average diameter is 6cm. The gross specimen is yellow-brown or light brown with a central dense fiber band with fibrous trabeculae. basic knowledge The proportion of illness: 0.02% - 0.07% Susceptible people: no special people Mode of infection: non-infectious Complications: low back pain - hematuria syndrome
Cause
Cause of renal eosinophilia
(1) Causes of the disease
The specific incidence rate is unknown. According to a large number of literature reports, renal eosinophils account for 3% to 7% of renal parenchymal tumors. Male patients are about twice as many as female patients. The age of the disease is similar to that of renal clear cell carcinoma. The age of onset is wide, and the age of onset is about 70 years old. The vast majority of patients with sporadic disease, but also have a familial morbidity, about 6% of patients with double kidney disease. The exact cause is unknown, but the cytogenetic characteristics of the disease are more obvious. There are deletions of chromosome 1 and Y chromosome, loss of heterozygosity on chromosome 14, and rearrangement of 11q13. However, it is difficult to find abnormalities of chromosomes 3, 7, and 17 in renal eosinophils, which may be called differential identification of renal eosinophils and renal clear cell carcinoma.
(two) pathogenesis
Renal eosinophils vary in size, with an average size of about 6 cm in diameter, which can occur throughout the body and is not necessarily limited to the kidneys. The lesion can be a single lesion, about 6% of the bilateral, at the same time or at different times. Histologically characterized by highly differentiated eosinophils, the tumor is brown or light brown, with a clear boundary and an envelope. The center has dense fibrous bands and fibrous trabeculae with star-shaped protrusions, no necrotic and multivascular areas.
Prevention
Kidney eosinophilia prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease. It is important to pay attention to the problem of renal eosinophilia. Most of the cell tumors are benign, and malignant is rare, so don't worry too much. The risk of surgery is large, but as long as the preoperative preparation (2-3 weeks): expansion treatment is the main, can greatly reduce the risk of surgery, but the surgery should go to the big hospital to do, or to say that to get better anesthesia conditions The hospital does it because the risk of surgery is mainly anesthesia during surgery. Of course, the surgeon also requires skilled. As long as the above two points are generally not a problem.
Complication
Renal eosinophilic complications Complications Low back pain - hematuria syndrome
Renal oncocytoma is a kind of renal adenoma, which is relatively rare in clinical practice, accounting for 4.3% of renal parenchymal tumors. Typical cases of benign tumors are unilateral lesions, 10% are multiple, and a few are bilateral lesions. Complications: low back pain, mostly dull pain. A lump, about 1/3 can touch the mass. Hematuria is more common with microscopic hematuria. B-ultrasound showed a uniform hypoechoic footprint in the kidney with clear boundaries and smooth capsule.
Symptom
Renal eosinophilic symptoms Common symptoms Dull pain Less urinary hematuria
58% to 83% of patients have no clinical symptoms, usually found through physical examination or other medical examinations. A small number of patients may have dull pain in the waist, abdominal mass and microscopic hematuria.
1. Low back pain: mostly dull pain.
2. Lump: About 1/3 can touch the mass.
3. Hematuria: more common with microscopic hematuria.
Examine
Examination of renal eosinophilia
Erythrocyte sedimentation rate (erythrocyte sedimentation rate) is accelerated, anemia, and blood calcium are increased.
1.B-ultrasound: The kidney has a uniform low echogenic occupancy, with clear boundaries and smooth envelope.
2. IVU: renal enlargement with localized renal parenchymal mass, renal pelvis and renal pelvis compression, displacement.
3. Renal artery angiography: The masses are arranged in a spoke-like manner, but there are few arteriovenous fistulas, which are difficult to distinguish from renal cancer with less blood vessels.
4. CT: Low-density area in the renal parenchyma, only slightly enhanced after enhancement, and the internal density is uniform.
Diagnosis
Diagnosis and identification of renal eosinophiloma
diagnosis
According to clinical manifestations and imaging examinations, it is extremely difficult to distinguish the disease from renal cancer. The two are very similar in imaging. In clinical practice, the understanding of the disease should be improved, so that early detection, early diagnosis, early diagnosis treatment.
Differential diagnosis
1. Renal cell carcinoma: also manifested as renal parenchyma mass, low back pain, but the lesion progresses faster, the gross hematuria with blood clot is relatively common, B-ultrasound, CT examination is irregular, the edge is not neat, the solid mass, often internal bleeding , necrosis, cystic changes, etc., imaging examination often shows echo or uneven density.
2. Renal angiomyolipoma: a kidney mass, low back pain similar to eosinophilia, but the tumor has a fat component, B-ultrasound is a strong echo light group, CT examination is low density, negative, and acidophilic The cell tumor has a low echo and the CT value is significantly different.
3. Polycystic kidney: manifested as mass, low back pain and microscopic hematuria, but the lesions are mostly bilateral, with a series of manifestations such as chronic renal insufficiency, IVU shows that the renal pelvis is elongated, and the skin becomes a spider-like change, B Ultrasound showed that the renal parenchyma was scattered in a circular liquid dark area. CT examination showed that the renal parenchyma was composed of many low-density cystic structures.
