Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
Radiographics. 2010 Oct;30(6):1525-40. doi: 10.1148/rg.306105517.
Mesenchymal neoplasms of the kidney in adults cover a wide spectrum with characteristic ontogeny and histologic findings and variable biologic profiles and imaging findings. Benign mesenchymal renal tumors include angiomyolipoma, leiomyoma, hemangioma, lymphangioma, juxtaglomerular cell tumor, renomedullary interstitial cell tumor (medullary fibroma), lipoma, solitary fibrous tumor, and schwannoma. Malignant renal tumors of mesenchymal origin include leiomyosarcoma, rhabdomyosarcoma, angiosarcoma, osteosarcoma, synovial sarcoma, fibrosarcoma, malignant fibrous histiocytoma, and solitary fibrous tumor. Cross-sectional imaging findings for mesenchymal renal tumors in adults are varied. Although angiomyolipomas and lipomas show macroscopic fat, lymphangiomas are cystic in appearance. Renal hemangioma may show phleboliths and a characteristic enhancement pattern. Leiomyoma typically arises from the capsule and causes buckling of the renal cortex. Although osteosarcoma may demonstrate characteristic dense ossification, most renal sarcomas demonstrate imaging features that are indistinguishable from the more common renal cell carcinoma. Although some renal mesenchymal tumors have typical imaging findings, biopsy is warranted to establish a definitive diagnosis. Awareness of the various mesenchymal renal tumors and familiarity with their imaging findings permit optimal patient management.
成人肾脏间叶性肿瘤涵盖广泛，具有特征性的发生学和组织学表现，以及不同的生物学特征和影像学表现。良性间叶性肾肿瘤包括血管平滑肌脂肪瘤、平滑肌瘤、血管瘤、淋巴管瘤、肾小球旁细胞瘤、肾髓质间质细胞瘤（髓质纤维瘤）、脂肪瘤、孤立性纤维瘤和 schwann 瘤。间叶性来源的恶性肾肿瘤包括平滑肌肉瘤、横纹肌肉瘤、血管肉瘤、骨肉瘤、滑膜肉瘤、纤维肉瘤、恶性纤维组织细胞瘤和孤立性纤维瘤。成人间叶性肾肿瘤的影像学表现多种多样。虽然血管平滑肌脂肪瘤和脂肪瘤表现为肉眼可见的脂肪，但淋巴管瘤表现为囊性。肾血管瘤可能显示静脉石和特征性的强化模式。平滑肌瘤通常起源于包膜，引起肾皮质的弯曲。虽然骨肉瘤可能表现出典型的密集骨化，但大多数肾肉瘤的影像学表现与更为常见的肾细胞癌无法区分。虽然一些肾脏间叶性肿瘤具有典型的影像学表现，但为了明确诊断，仍需要进行活检。了解各种间叶性肾肿瘤及其影像学表现可以实现最佳的患者管理。
