Mukamel E, Konichezky M, Engelstein D, Servadio C
Department of Urology, Beilinson Medical Center, Petah Tiqva, Israel.
J Urol. 1988 Jul;140(1):22-4. doi: 10.1016/s0022-5347(17)41474-1.
We searched 66 kidneys with renal cell carcinoma for subcapsular or intraparenchymal small nodules in the apparently normal-appearing portion of the kidney. Differentiation between adenoma and carcinoma was done according to histological characteristics. Of the 66 kidneys 20 (30 per cent) contained a total of 58 small nodules ranging from 1 to 15 mm. in diameter. In 9 kidneys the lesions were consistent histologically with carcinoma, in 7 with adenoma and in 4 with carcinoma plus adenoma. Thus, 13 of the 66 kidneys (19.7 per cent) contained small carcinoma. In view of the high incidence of small carcinoma accompanying clinically overt renal cell carcinoma, we suggest that the indications for partial nephrectomy in the management of renal cell carcinoma should be reevaluated.
我们在66个患有肾细胞癌的肾脏中，于肾脏外观看似正常的部分寻找包膜下或实质内小结节。根据组织学特征对腺瘤和癌进行鉴别。在这66个肾脏中，20个（30%）共含有58个直径为1至15毫米的小结节。在9个肾脏中，病变在组织学上与癌一致，7个与腺瘤一致，4个既有癌又有腺瘤。因此，66个肾脏中有13个（19.7%）含有小癌灶。鉴于小癌灶伴随临床明显肾细胞癌的高发生率，我们建议应重新评估肾细胞癌治疗中部分肾切除术的适应证。
