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散发性多发性肾血管平滑肌脂肪瘤伴淋巴结受累:1例报告并文献复习

Sporadic multiple renal angiomyolipoma with lymph node involvement: a case report and literature review.

作者信息

Ding Xiaobo, Cui Meizi, Wang Tiejun, Wang Helei, Wang Xinyu, Qiu Wei, Wang Yanbo

机构信息

Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin, P.R. China.

Department of Cadre Ward, The First Hospital of Jilin University, Changchun, Jilin, P.R. China.

出版信息

J Int Med Res. 2021 Mar;49(3):3000605211001710. doi: 10.1177/03000605211001710.

Abstract

Angiomyolipoma (AML) is a benign tumor that mainly occurs in the kidneys. Simultaneous involvement of the kidney and local regional lymph nodes is very rare and might be misdiagnosed as a metastasizing malignant cancer. In the present study, a 50-year-old woman was referred to our hospital after a routine health screening ultrasound. Sporadic multiple renal AML with lymph node involvement was suspected based on the clinical manifestations and radiologic features. Partial nephrectomy was performed and a para-inferior vena cava lymph node was removed. The pathologic results confirmed multiple AML with lymph node invasion. We also reviewed the English-language literature regarding renal AML with lymph node involvement. We found that middle-aged women were likely to develop this disease and that loin pain was the main presenting feature. Most patients had no history of tuberous sclerosis complex. Radical nephrectomy was the predominant treatment. No local recurrence or distant metastasis occurred in any patients after radical nephrectomy or partial nephrectomy. In conclusion, renal AML with lymph node involvement is rare but can occur in both patients with tuberous sclerosis complex and those with multiple sporadic AML. Partial nephrectomy should be the first-line treatment, after which further treatment is not necessary.

摘要

血管平滑肌脂肪瘤(AML)是一种主要发生于肾脏的良性肿瘤。肾脏及局部区域淋巴结同时受累的情况非常罕见,可能会被误诊为转移性恶性肿瘤。在本研究中,一名50岁女性在常规健康筛查超声检查后被转诊至我院。根据临床表现和影像学特征,怀疑为散发性多发性肾AML伴淋巴结受累。行部分肾切除术并切除下腔静脉旁淋巴结。病理结果证实为多发性AML伴淋巴结侵犯。我们还回顾了关于肾AML伴淋巴结受累的英文文献。我们发现中年女性易患此病,主要表现为腰痛。大多数患者无结节性硬化症病史。根治性肾切除术是主要的治疗方法。根治性肾切除术或部分肾切除术后,所有患者均未发生局部复发或远处转移。总之,肾AML伴淋巴结受累罕见,但可发生于结节性硬化症患者和散发性多发性AML患者。部分肾切除术应作为一线治疗方法,术后无需进一步治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee4c/8020106/a57e7ffd4908/10.1177_03000605211001710-fig1.jpg

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