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两岁女童肾结核表现为肿块性病变:1例罕见病例报告

Renal Tuberculosis Presenting as a Mass Lesion in a Two-year-old Girl: Report of a rare case.

作者信息

Santra Avradip, Mandi Falguni, Bandyopadhyay Abhishek

机构信息

Departments of Chest Medicine, Nil Ratan Sircar Medical College, Kolkata, India.

Pathology, Nil Ratan Sircar Medical College, Kolkata, India.

出版信息

Sultan Qaboos Univ Med J. 2016 Feb;16(1):e105-8. doi: 10.18295/squmj.2016.16.01.020. Epub 2016 Feb 2.

Abstract

Genitourinary tuberculosis usually occurs in young adults and the middle-aged and is very uncommon in the paediatric population. It generally presents with haematuria, pyuria, irritative voiding symptoms and flank pain; presentation as a renal mass is highly unusual. We report a two-year-old girl who was referred to the Nil Ratan Sircar Medical College, Kolkata, India, in June 2014 with abdominal pain. Subsequent radiological investigations revealed a left renal hypoechoic mass lesion. A left nephroureterectomy was performed on suspicion of a Wilms' tumour. Histopathology indicated an epithelioid granuloma with lymphocytic infiltration, suggestive of a tubercular aetiology. A Mantoux tuberculin skin test was positive; however, there was no evidence of tuberculosis detected elsewhere in the body and the source of the infection could not be identified. A diagnosis of renal tuberculosis was made and the child was treated with antitubercular drugs. The patient was asymptomatic at a six-month follow-up.

摘要

泌尿生殖系统结核通常发生在青壮年,在儿科人群中非常罕见。其一般表现为血尿、脓尿、刺激性排尿症状和胁腹疼痛;以肾肿块形式出现极为少见。我们报告一名两岁女童,于2014年6月因腹痛被转诊至印度加尔各答的尼尔·拉坦·西卡尔医学院。随后的影像学检查发现左肾有低回声肿块病变。因怀疑是肾母细胞瘤而进行了左肾输尿管切除术。组织病理学显示为上皮样肉芽肿伴淋巴细胞浸润,提示结核病因。结核菌素皮肤试验呈阳性;然而,身体其他部位未发现结核病证据,且感染源无法确定。诊断为肾结核,该患儿接受了抗结核药物治疗。在六个月的随访中,患者无症状。

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本文引用的文献

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Renal tuberculosis in infancy.婴儿期肾结核
J Indian Assoc Pediatr Surg. 2011 Apr;16(2):69-71. doi: 10.4103/0971-9261.78136.
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Surgical management of renal tuberculosis.肾结核的外科治疗
Indian J Urol. 2008 Jul;24(3):369-75. doi: 10.4103/0970-1591.42620.
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The time-table of tuberculosis.结核病的时间表。
Tubercle. 1948 Nov;29(11):245-51. doi: 10.1016/s0041-3879(48)80033-4.

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