Hatanaka Y, Hanai T, Miyatake R, Katoh Y, Iguchi M
Department of Urology, Kaizuka City Hospital.
Hinyokika Kiyo. 2001 Jan;47(1):35-8.
We experienced a rare case of tumor-forming type of chronic pyelonephritis that could hardly be differentiated from renal cell carcinoma. A 62-year-old man was admitted to our department with right renal tumor which was discovered when he underwent examination for gastric cancer. Abdominal ultrasound sonography and computed tomography revealed a mass in the middle portion of the right kidney, measuring 3.8 x 3.5 cm in diameter, with irregular surface and isoechoic and isodense inner mass. Renal angiography demonstrated a hypervascular area in the middle portion. Radical nephrectomy and subtotal gastrectomy were performed under a tentative diagnosis of right renal cell carcinoma and early gastric cancer. The excised specimen macroscopically demonstrated a yellowish mass in the middle portion and microscopically revealed many lymphocytes and few neutrophils, macrophages or foam cells. The patient was diagnosed as tumor-forming type of chronic pyelonephritis. Such obvious inflammatory findings very rarely exist in the tumor-forming type of chronic pyelonephritis. Therefore, caution should be exercised in the differential diagnosis between this disease and renal cell carcinoma.
我们遇到了一例罕见的肿瘤形成型慢性肾盂肾炎，很难与肾细胞癌区分开来。一名62岁男性因右肾肿瘤入院，该肿瘤是在他接受胃癌检查时发现的。腹部超声检查和计算机断层扫描显示右肾中部有一个肿块，直径为3.8×3.5厘米，表面不规则，内部肿块呈等回声和等密度。肾血管造影显示中部有一个高血管区域。在初步诊断为右肾细胞癌和早期胃癌的情况下，进行了根治性肾切除术和胃次全切除术。切除的标本肉眼可见中部有一个淡黄色肿块，显微镜下可见许多淋巴细胞，少量中性粒细胞、巨噬细胞或泡沫细胞。该患者被诊断为肿瘤形成型慢性肾盂肾炎。这种明显的炎症表现很少存在于肿瘤形成型慢性肾盂肾炎中。因此，在该疾病与肾细胞癌的鉴别诊断中应谨慎。
