Walker D E, Barry J M, Hodges C V
J Urol. 1976 Dec;116(6):712-4. doi: 10.1016/s0022-5347(17)58984-3.
Four cases of renal angiomyolipoma are presented, 3 of which were diagnosed in non-tuberous sclerosis patients. In 1 case diagnosis was made preoperatively and in another case it was made intraoperatively, allowing for preservation of functioning renal parenchyma. The second successful kidney transplant in a patient with tuberous sclerosis and renal failure is reported. One cannot always differentiate renal angiomyolipomas from adenocarcinoma. However, if the classical angiographic findings of sacculated pseduo-aneurysms supplied by the interlobular and interlobar arteries are present non-operative observation or limited surgery with preservation of renal tissue is possible. Also, knowledge of the gross pathologic appearance and the syndrome of tuberous sclerosis will allow one to make a preoperative or intraoperative diagnosis with confidence.
本文报告了4例肾血管平滑肌脂肪瘤，其中3例诊断于非结节性硬化症患者。1例术前确诊，另1例术中确诊，从而得以保留有功能的肾实质。本文还报告了1例结节性硬化症合并肾衰竭患者成功接受第二次肾移植的病例。肾血管平滑肌脂肪瘤与腺癌有时难以鉴别。然而，如果出现由小叶间动脉和叶间动脉供血的囊状假性动脉瘤的典型血管造影表现，则可行非手术观察或保留肾组织的有限手术。此外，了解大体病理表现和结节性硬化症综合征有助于在术前或术中作出可靠诊断。
