Veneziano S, Pavlica P, Busato F, Taglia F, Ferri C
Servizio di Radiologia, Ospedale M. Malpighi, Bologna.
Radiol Med. 1989 Oct;78(4):343-7.
Fifteen patients with sarcomatoid renal cell carcinoma were studied from 1975 through 1987. For each case the radiological, sonographic (US), and histopathological features were reviewed. Neither ivp nor US detected any specific patterns, though demonstrating frequently-necrotic and infiltrating masses. Angiography and/or CT were more useful because they allowed the staging of the tumors and the evaluation of their vascularity. In particular, a frequent correlation was observed between the degree of vascularity and the percentage of sarcomatoid component at histopathology. Sarcomatoid renal cell carcinoma were hypo-avascular in 7 cases and hypervascular in 8. Six of the 7 hypo-avascular cases had a high percentage of sarcomatoid tissue (greater than 50%) and were highly malignant. Seven of the 8 hypervascular neoplasms had a low percentage of sarcomatoid component and presented radiological features similar to clear/granular cell tumors. The survival of the patients with sarcomatoid tumors was much shorter than that of the patients with other kidney carcinomas. Among sarcomatoid tumors, prognosis was worst for the patients with hypo-avascular neoplasms.
1975年至1987年期间，对15例肉瘤样肾细胞癌患者进行了研究。对每例患者的放射学、超声（US）及组织病理学特征进行了回顾。静脉肾盂造影（IVP）和超声均未发现任何特异性表现，不过二者常显示为坏死性及浸润性肿块。血管造影和/或CT更有用，因为它们可对肿瘤进行分期并评估其血供情况。特别是，组织病理学检查发现血供程度与肉瘤样成分百分比之间常存在相关性。肉瘤样肾细胞癌7例血供减少，8例血供增加。血供减少的7例患者中，6例肉瘤样组织百分比高（大于50%），且恶性程度高。血供增加的8例肿瘤中，7例肉瘤样成分百分比低，其放射学表现与透明/颗粒细胞肿瘤相似。肉瘤样肿瘤患者的生存期比其他肾癌患者短得多。在肉瘤样肿瘤中，血供减少的肿瘤患者预后最差。
