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[一例因怀疑恶性肿瘤而经腹腔镜手术切除的肾周非特异性淋巴结炎病例]

[A Case of Perirenal Non-Specific Lymphadenitis Resected by Laparoscopic Operation for the Possibility of Malignancy].

作者信息

Kubota Masashi, Kanno Toru, Nishiyama Ryuichi, Okada Takashi, Higashi Yoshihito, Kawamura Juichi, Yamada Hitoshi

机构信息

The Department of Urology, Ijinkai Takeda General Hospital.

The Department of Urology, Idoukai Inariyama Takeda Hospital.

出版信息

Hinyokika Kiyo. 2016 Feb;62(2):57-61.

Abstract

Various types of tumors, including benign tumors, arise from the renal parenchyma or renal capsule, but it is difficult to predict the histological type preoperatively. Here, we report a case of perirenal non-specific lymphadenitis resected laparoscopically. A 79-year-old man with a history of diabetic mellitus and noninvasive bladder cancer had an incidentally-detected enhanced mass in contact with the surface of the left kidney. Given the possibility that the tumor was malignant, we resected the mass laparoscopically. Intraoperative findings revealed that the tumor did not invade the renal parenchyma, and it could be easily resected. Microscopic findings showed that the tumor consisted of inflammation of a lymph node, lymphoid follicles with hyperplasia of germ center and granulomatous inflammation with giant cells, and there was no malignant finding. Despite various additional examinations, the specific cause of the lymphadenitis was not clarified, leading to a final diagnosis of non-specific lymphadenitis. To our knowledge this is the first report about perirenal non-specific lymphadenitis difficult to distinguish from perirenal malignant tumor in preoperative computed tomography imaging.

摘要

包括良性肿瘤在内的各种类型的肿瘤起源于肾实质或肾包膜,但术前很难预测组织学类型。在此,我们报告一例经腹腔镜切除的肾周非特异性淋巴结炎病例。一名79岁男性,有糖尿病和非侵袭性膀胱癌病史,偶然发现左肾表面有一强化肿块。鉴于肿瘤有恶性的可能,我们对肿块进行了腹腔镜切除。术中发现肿瘤未侵犯肾实质,且易于切除。显微镜检查结果显示,肿瘤由淋巴结炎症、生发中心增生的淋巴滤泡以及伴有巨细胞的肉芽肿性炎症组成,未发现恶性病变。尽管进行了各种进一步检查,但淋巴结炎的具体病因仍未明确,最终诊断为非特异性淋巴结炎。据我们所知,这是第一例关于在术前计算机断层扫描成像中难以与肾周恶性肿瘤区分的肾周非特异性淋巴结炎的报告。

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