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经尿道膀胱肿瘤切除术(TURBT)和肾肿瘤射频消融术:乳糜尿的罕见病因。

Trans-urethral resection of bladder tumor (TURBT) and radiofrequency ablation of renal tumor: Rare etiologies of chyluria.

作者信息

Assaker Richard, El Hasbani Georges, Vargas Jose, Parashar Kalind, Thomas Ginu A, Yagan Neda

机构信息

St. Vincent's Medical Center, Bridgeport, CT, USA.

American University of Beirut Medical Center, Beirut, Lebanon.

出版信息

Radiol Case Rep. 2020 Jul 10;15(9):1579-1583. doi: 10.1016/j.radcr.2020.06.007. eCollection 2020 Sep.

Abstract

Chyluria is a rare entity which is caused by abnormal communication between the lymphatic system and the urinary tract, which allows the passage of chyle into the urine. Whenever symptomatic, chyluria presents with lower urinary tract symptoms such as dysuria and hematuria. Multiple imaging modalities can aid in diagnosis such as lymphoscintigraphy, retrograde pyelography, CT scan of the abdomen and pelvis, and magnetic resonance imaging. Numerous etiologies are associated with chyluria among which are surgical interventions. Partial and radical nephrectomy have been reported in a number of symptomatic and asymptomatic cases, while radiofrequency ablation of renal tumors has been very rarely reported. Herein, we report 2 cases of chyluria; one caused by trans-urethral resection of a bladder tumor and another by radiofrequency ablation of a renal oncocytoma. Fat-fluid level in the urinary bladder was seen on both precontrast and postcontrast images of CT scan of the abdomen and pelvis. Cystoscopy demonstrated no evidence of any abnormality of the urinary bladder.

摘要

乳糜尿是一种罕见的病症,由淋巴系统与泌尿道之间的异常连通引起,使得乳糜进入尿液。有症状时,乳糜尿表现为下尿路症状,如排尿困难和血尿。多种成像方式有助于诊断,如淋巴闪烁显像、逆行肾盂造影、腹部和盆腔CT扫描以及磁共振成像。乳糜尿与多种病因相关,其中包括外科手术干预。部分和根治性肾切除术已在许多有症状和无症状的病例中报道过,而肾肿瘤的射频消融术报道极少。在此,我们报告2例乳糜尿病例;1例由膀胱肿瘤经尿道切除术引起,另1例由肾嗜酸细胞瘤射频消融术引起。在腹部和盆腔CT扫描的平扫和增强图像上均可见膀胱内的脂肪-液体平面。膀胱镜检查未发现膀胱有任何异常迹象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bed/7355992/9caa65239377/gr1.jpg

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