Srisung Weeraporn, Mankongpaisarnrung Charoen, Warraich Irfan, Sotello David, Yarbrough Shannon, Laski Melvin
Departments of Internal Medicine (Srisung, Mankongpaisarnrung, Sotello, Yarbrough, Laski) and Pathology (Warraich), Texas Tech University Health Sciences Center, Lubbock, Texas.
Proc (Bayl Univ Med Cent). 2015 Apr;28(2):221-3. doi: 10.1080/08998280.2015.11929235.
Bilateral enlarged kidneys can be caused by a number of conditions. Renal metastasis is included in the differential diagnosis. We report a case of a 67-year-old woman with a 6-month history of productive cough and unintentional weight loss. Cavitary pulmonary lesions and bilateral enlarged kidneys were noted on imaging studies. Hematuria, azotemia, and proteinuria were present. Renal biopsy showed squamous carcinoma cells invading normal-appearing glomeruli and atrophic tubules. The invasive squamous cells stained negative for CK7 and CK 20. Lung biopsy confirmed squamous cell carcinoma. Our case shows that in patients with renal enlargement, even with the absence of a focal mass, renal metastasis should be considered, especially in those with suspected or diagnosed malignancy elsewhere.
双侧肾脏肿大可由多种情况引起。鉴别诊断包括肾转移。我们报告一例67岁女性，有6个月的咳痰和非故意体重减轻病史。影像学检查发现肺部有空洞性病变和双侧肾脏肿大。存在血尿、氮质血症和蛋白尿。肾活检显示鳞状癌细胞侵犯外观正常的肾小球和萎缩的肾小管。侵袭性鳞状细胞CK7和CK 20染色阴性。肺活检证实为鳞状细胞癌。我们的病例表明，对于肾脏肿大的患者，即使没有局灶性肿块，也应考虑肾转移，尤其是那些在其他部位有疑似或确诊恶性肿瘤的患者。
