Department of Pathology, University of Erlangen-Nürnberg, Germany.
Urology. 2011 Aug;78(2):427-30. doi: 10.1016/j.urology.2010.11.027. Epub 2011 Mar 12.
A 12-year-old girl presented with recurrent gross hematuria over 3 months and regular findings in sonography of the urogenital tract. The first suspected diagnosis of familial IgA glomerulonephritis was excluded by kidney biopsy. After a further episode of gross hematuria leading to vesical tamponade, the patient received magnetic resonance imaging with angiography and urography, which was suspicious for a renal tumor. Consecutively, unilateral nephrectomy was performed and a nephroblastoma was diagnosed. This case demonstrates that even in grossly normal renal ultrasound, relapsing episodes of gross hematuria can be caused by renal tumor, and therefore in unclear situations, further diagnostic is necessary.
一位 12 岁女孩因反复发作性肉眼血尿 3 个月就诊,且泌尿生殖系统超声检查结果持续异常。肾活检排除了家族性 IgA 肾小球肾炎的最初可疑诊断。在导致膀胱填塞的另一次肉眼血尿发作后,患者接受了磁共振成像血管造影和尿路造影检查,结果提示存在肾肿瘤。随后,实施了单侧肾切除术,并诊断为肾母细胞瘤。本病例表明,即使在肾脏超声明显正常的情况下,反复发作性肉眼血尿也可能由肾肿瘤引起,因此在情况不明时,需要进一步诊断。