Yugandhar Samireddypalle, Sureka Sanjoy Kumar, Yadav Priyank, Lal Hira
Department of Radiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
BMJ Case Rep. 2017 Oct 9;2017:bcr-2017-221846. doi: 10.1136/bcr-2017-221846.
A 30-year-old immunocompetent female presented with right flank pain since 3 years. MRI revealed a large well-defined T1 and T2 hypointense mildly enhancing lesion in the right anterior pararenal space displacing the right kidney and encasing the right ureter with T2 hyperintense wall thickening of the left renal pelvis and ureter. A provisional diagnosis of solitary fibrous tumour was kept. Bilateral double J stenting was done for hydronephrosis. Surgical debulking of the lesion was done with biopsy from the left periureteral wall thickening and was found to be myelolipoma on histopathological examination. This case is a novel variety of myelolipoma which is lipid poor, extra-adrenal and in bilateral perirenal and periureteric location.
一名30岁免疫功能正常的女性,3年来一直有右侧胁腹疼痛。磁共振成像(MRI)显示右肾前间隙有一个边界清晰的大肿块,T1和T2加权像呈低信号,轻度强化,推移右肾并包绕右输尿管,同时左肾盂和输尿管壁T2加权像呈高信号增厚。初步诊断为孤立性纤维瘤。因肾积水行双侧双J管置入术。对病变进行手术切除,并从左输尿管壁增厚处取组织活检,组织病理学检查发现为髓脂肪瘤。该病例是一种新型的髓脂肪瘤,脂质含量少,位于肾上腺外,双侧肾周和输尿管周围。