polypoid lesions
Introduction
Introduction Polypoid lesions: The left renal cyst gene alters the metabolism of tubular epithelial cells and cystic cells, and the tubular epithelial cells proliferate continuously, which can form polypoid lesions and cause tubular obstruction. The fluid in the tube in front of the obstruction is retained and expanded into a cyst. In addition, the polypoid substance formed by hyperplasia can cause a semi-obstructive state in the neck of the cyst, making the liquid not easy to flow out, and the cyst is enlarged.
Cause
Cause
The tubular epithelial cells proliferate continuously, which can form polypoid lesions and cause tubular obstruction. The fluid in the tube in front of the obstruction is retained and expanded into a cyst. In addition, the polypoid-like substance formed by hyperplasia can cause a semi-obstructive state in the neck of the cyst, so that the liquid does not easily flow out, and the cyst is enlarged.
Examine
an examination
Related inspection
Renal CT examination
1. Waist, abdominal discomfort or pain: The reason is that due to enlargement and expansion of the kidney, the renal capsule tension is increased, the renal pedicle is pulled, or the adjacent organs are stressed. In addition, due to the large water content of the polycystic sac, the kidney becomes heavy, and it can cause waist pain when it is pulled down. Pain is characterized by dull pain, dull pain, fixed on one or both sides, radiating to the lower and lower back. If there is intracapsular hemorrhage or secondary infection, the pain suddenly increases. Renal colic can occur if the blood clot blocks the urinary tract after merging stones or bleeding.
2. Hematuria: can be expressed as microscopic hematuria or gross hematuria. The episode is periodic. Low back pain is often exacerbated during seizures, and strenuous exercise, trauma, and infection can be induced or aggravated. The reason for the bleeding is because there are many arteries under the wall of the capsule. Due to the increase of pressure or the infection, the blood vessels of the capsule wall are ruptured due to excessive pulling.
3. Abdominal mass: Sometimes the main cause of the patient's visit, 60-80% can reach the enlarged kidney. The larger the kidney, the worse the kidney function.
Diagnosis
Differential diagnosis
(1) Kidney cancer: It is a space-occupying lesion, but it is prone to occur in the deep part, which causes more obvious pyelectus curvature. The hematuria is common, while the cyst is not seen. When the renal parenchyma tumor is pressed on the psoas muscle, the abdomen is flat. The edge of the muscle is not visible on the film, and the cyst is still visible, evidence of metastasis (such as weight loss, fatigue, swelling on the clavicle, metastatic nodules), polycythemia, hypercalcemia Symptoms and accelerated erythrocyte sedimentation rate are prompted for cancer. It should be remembered that the cyst wall will also undergo cancerous changes. If the renal vein is blocked by cancer, excretory urography is unclear or even undeveloped. Ultrasound images and CT Always used for differential diagnosis, angiography and renal tomography can show that in a tumor with abundant blood vessels, there is a contrast-intensive "pond", while the density of the cyst is unaffected, and it is proven to be other Before the disease, it is wise to assume all kidney-occupying lesions as cancer.
(2) Polycystic kidney disease: As shown by urography, the disease is almost always bilateral, and the pervasive renal pelvis and renal pelvis are distorted. The simple renal cyst is mostly isolated, Polycystic kidney disease is often accompanied by renal impairment and high blood pressure, while renal cysts are not.
(3) renal pelvis: This disease is rare. When collecting medical history, it can be found that there is a history of skin infection in the weeks before the fever and local pain. Urinary angiography shows that the lesion is similar to cyst and tumor, but due to the influence of periarteritis, The kidney contour and the lumbar muscles are blurred. At this time, the kidneys are more fixed, and the kidney position can be confirmed when the patient is supine and erect. The angiography can show a bloodless lesion, gallium-67 scan. It can show the inflammatory nature of the lesion, but the infected simple cyst can also have a similar performance.
(4) hydronephrosis: symptoms and signs can be consistent with the performance of simple renal cysts, but urography is quite different, cysts cause kidney deformation, and hydronephrosis is due to obstruction caused by renal pelvis and renal pelvis The expansion of acute or subacute hydronephrosis often results in more limited pain due to increased intra-renal pressure and is complicated by infection.
(5) Extrarenal tumors (such as adrenal glands, mixed retroperitoneal sarcoma): can shift the kidneys, but rarely invade the kidneys and deform the renal pelvis.
(6) Can echinococcosis: When the cyst is not connected with the renal pelvis, it is difficult to distinguish it from simple renal cyst. Because there is no worm and its larva in the urine, the renal hydatid cyst is often found on the X-ray examination. It is helpful to diagnose the disease with calcification and skin sensitivity tests.
an examination
1. Waist, abdominal discomfort or pain: The reason is that due to enlargement and expansion of the kidney, the renal capsule tension is increased, the renal pedicle is pulled, or the adjacent organs are stressed. In addition, due to the large water content of the polycystic sac, the kidney becomes heavy, and it can cause waist pain when it is pulled down. Pain is characterized by dull pain, dull pain, fixed on one or both sides, radiating to the lower and lower back. If there is intracapsular hemorrhage or secondary infection, the pain suddenly increases. Renal colic can occur if the blood clot blocks the urinary tract after merging stones or bleeding.
2. Hematuria: can be expressed as microscopic hematuria or gross hematuria. The episode is periodic. Low back pain is often exacerbated during seizures, and strenuous exercise, trauma, and infection can be induced or aggravated. The reason for the bleeding is because there are many arteries under the wall of the capsule. Due to the increase of pressure or the infection, the blood vessels of the capsule wall are ruptured due to excessive pulling.
3. Abdominal mass: Sometimes the main cause of the patient's visit, 60-80% can reach the enlarged kidney. The larger the kidney, the worse the kidney function.
