Sunassee Ashwyna, Muirhead Desirae M
University of South Dakota Sanford School of Medicine.
Sanford Pathology, Sioux Falls, South Dakota.
S D Med. 2017 Nov;70(11):511-513.
We present a 37-year-old female with a history of tuberous sclerosis. She developed flank pain, hypotension, and a sudden drop in hemoglobin levels which prompted a work-up. A computed tomography scan demonstrated enlarged heterogeneous kidneys and a large complex collection in the right kidney, likely hemorrhagic in nature. The findings were suspicious for bilateral angiomyolipomas with retroperitoneal hematoma. She was treated with bilateral transarterial embolization. She subsequently developed recurrent fever and was suspected of having emphysematous pyelonephritis, for which she underwent a right nephrectomy. The entire kidney was replaced by a tan bulging, lobular mass, with scattered tan-yellow nodules. Microscopic examination revealed an angiomyolipoma with an incidental oncocytoma. The association of renal angiomyolipoma and renal oncocytoma is rare and only 16 cases have been previously reported.
我们报告一名37岁患有结节性硬化症的女性。她出现侧腹疼痛、低血压以及血红蛋白水平突然下降，这促使进行了一系列检查。计算机断层扫描显示双侧肾脏增大且形态不均一，右肾有一个大的复杂液性包块，性质可能为出血性。这些发现怀疑是双侧肾血管平滑肌脂肪瘤伴腹膜后血肿。她接受了双侧经动脉栓塞治疗。随后她出现反复发热，怀疑患有气肿性肾盂肾炎，为此她接受了右肾切除术。整个肾脏被一个黄褐色膨出的分叶状肿块所取代，伴有散在的黄褐色结节。显微镜检查显示为一个伴有偶然发现的嗜酸性细胞瘤的肾血管平滑肌脂肪瘤。肾血管平滑肌脂肪瘤与肾嗜酸性细胞瘤的关联罕见，此前仅报道过16例。
