Agrawal Abhinav, Sahni Sonu, Iftikhar Asma, Talwar Arunabh
Monmouth Medical Center, Department of Medicine, 300 Second Avenue Long Branch, NJ 07740, United States.
North Shore-Long Island Jewish Health System, Department of Pulmonary, Critical Care and Sleep Medicine, 410 Lakeville Rd. Suite 107, New Hyde Park, NY 11040, United States; Feinstein Institute for Medical Research, Center for Heart and Lung Research, 350 Community Drive Manhasset, NY 11030, United States.
Respir Med. 2015 Dec;109(12):1505-8. doi: 10.1016/j.rmed.2015.10.002. Epub 2015 Oct 9.
Renal cell carcinoma (RCC) accounts for majority of all primary renal neoplasms. Classic manifestations of RCC include the triad of flank pain, hematuria and a palpable renal mass. Patients with RCC can develop various extra renal manifestations including involvements of the lungs, inferior vena cava, liver and the bones. The pulmonary manifestations of renal cell carcinoma include metastatic disease including endobronchial, pleural, parenchymal or lymph node metastasis, pleural effusion or hemothorax. Pulmonary embolism and tumor embolism is another common manifestation of renal cell carcinoma. RCC is a highly vascular tumor and can cause pulmonary arterio-venous fistulas leading to high output failure. Rarely, RCC can also present with paraneoplastic presentations including cough or bilateral diaphragm paralysis. Drugs used to treat RCC have been associated with drug related pneumonitis and form an important differential diagnosis in patients with RCC on therapy presenting with shortness of breath. In this review we discuss the various pulmonary manifestations of RCC. A high index of suspicion with these presentations can lead to an early diagnosis and assist in instituting an appropriate intervention.
肾细胞癌（RCC）占所有原发性肾肿瘤的大多数。RCC的典型表现包括胁腹痛、血尿和可触及的肾肿块三联征。RCC患者可出现各种肾外表现，包括肺部、下腔静脉、肝脏和骨骼受累。肾细胞癌的肺部表现包括转移性疾病，包括支气管内、胸膜、实质或淋巴结转移、胸腔积液或血胸。肺栓塞和肿瘤栓塞是肾细胞癌的另一种常见表现。RCC是一种血管丰富的肿瘤，可导致肺动静脉瘘，进而导致高输出量衰竭。罕见情况下，RCC也可表现为副肿瘤症状，包括咳嗽或双侧膈肌麻痹。用于治疗RCC的药物与药物相关性肺炎有关，是接受治疗的RCC患者出现气短时的重要鉴别诊断。在本综述中，我们讨论了RCC的各种肺部表现。对这些表现保持高度怀疑指数可导致早期诊断，并有助于进行适当干预。
