Berkenblit Robert, Ricci Zina, Kanmaniraja Devaraju, Sarungbam Judy
Department of Radiology, Montefiore Medical Center, Bronx, NY, United States of America.
Department of Radiology, Montefiore Medical Center, Bronx, NY, United States of America.
Clin Imaging. 2022 Mar;83:83-86. doi: 10.1016/j.clinimag.2021.12.022. Epub 2022 Jan 5.
Acquired cystic kidney disease-associated renal cell carcinoma (ACKD-RCC) is a relatively recently described entity with scarce literature describing its imaging appearance (1, 2). The purpose of this study was to determine typical and potentially unique features of ACKD-RCC on CT scan that could aid lesion identification.
A retrospective review of the CT scans of 24 patients with 29 histologically proven ACKD-RCC lesions was performed. Imaging features were recorded based on consensus readings of two radiologists.
Tumors ranged in size from 1.2 to 5 cm. Nineteen lesions were right-sided and 10 left-sided. Nineteen lesions were exophytic. One patient had bilateral lesions and three patients had multiple lesions in the same kidney. All lesions had well-defined margins with 21 round, 7 lobulated and 1 crescentic in shape. On non-enhanced exam 4 lesions were hypodense, 16 iso-dense and 9 hyperdense; 5 had gross calcifications. Twenty two patients had contrast-enhanced CT exams, with 13 lesions demonstrating homogeneous enhancement (solid pattern) and 14 having inhomogeneous enhancement (cystic or mixed solid and cystic pattern). Only 1 patient had metastatic disease. Eight patients had a history of renal transplants.
ACKD-RCCs are well-defined lesions of variable size that are almost always rounded and most often exophytic. They occasionally have calcifications and are not uncommonly hyperdense on non-enhanced exam. They are most often iso-dense on non-enhanced exam and can be solid, cystic or mixed in attenuation on enhanced exam.
获得性囊性肾病相关性肾细胞癌（ACKD-RCC）是一种相对较新描述的实体，关于其影像学表现的文献较少（1,2）。本研究的目的是确定CT扫描上ACKD-RCC的典型和潜在独特特征，以帮助识别病变。
对24例经组织学证实有29个ACKD-RCC病变的患者的CT扫描进行回顾性研究。影像特征由两位放射科医生通过共识解读记录。
肿瘤大小从1.2厘米至5厘米不等。19个病变位于右侧，10个位于左侧。19个病变为外生性。1例患者有双侧病变，3例患者在同一侧肾脏有多个病变。所有病变边界清晰，21个呈圆形，7个呈分叶状，1个呈新月形。在平扫检查中，4个病变呈低密度，16个等密度，9个高密度；5个有粗大钙化。22例患者进行了增强CT检查，13个病变表现为均匀强化（实性模式），14个表现为不均匀强化（囊性或实性与囊性混合模式）。只有1例患者有转移疾病。8例患者有肾移植病史。
ACKD-RCC是边界清晰、大小不一的病变，几乎总是圆形，最常见为外生性。它们偶尔有钙化，在平扫检查中高密度并不少见。在平扫检查中它们最常为等密度，在增强检查中密度可呈实性、囊性或混合性。
