Fujimoto N, Tada Y, Ichikawa Y, Koide T
Hinyokika Kiyo. 1986 Feb;32(2):227-31.
Recent reports have described that the accurate preoperative diagnosis of renal angiomyolipoma is possible with computerized tomography (CT). There are, however, some cases of angiomyolipoma which are indistinguishable from renal cell carcinoma on CT. Herein we report a case of renal angiomyolipoma which CT failed to reveal preoperatively. In a 71-year-old Japanese male, a left renal tumor was incidentally suspected on excretory urogram. Then CT demonstrated a homogeneous mass in the upper part of the left kidney, 6 cm in diameter, which showed a positive attenuation coefficient, slightly denser than renal parenchyma. Selective left renal arteriogram showed hypervascularity without aneurysmal formation or arteriovenous fistula. These radiologic findings strongly suggested renal cell carcinoma and radical left nephrectomy was performed. Histological examination confirmed angiomyolipoma composed mainly of smooth muscle with thick-walled vessels and immature fat cells. We reviewed the literature and discussed the computerized tomographic-pathologic correlation of angiomyolipoma.
近期报告称，利用计算机断层扫描（CT）可对肾血管平滑肌脂肪瘤进行准确的术前诊断。然而，仍有一些血管平滑肌脂肪瘤病例在CT上无法与肾细胞癌区分开来。在此，我们报告一例术前CT未能显示的肾血管平滑肌脂肪瘤病例。一名71岁的日本男性，排泄性尿路造影偶然发现左肾肿瘤。随后CT显示左肾上部有一均匀肿块，直径6厘米，衰减系数为正值，比肾实质略致密。选择性左肾动脉造影显示血管增多，无动脉瘤形成或动静脉瘘。这些影像学表现强烈提示为肾细胞癌，遂行根治性左肾切除术。组织学检查证实为血管平滑肌脂肪瘤，主要由平滑肌、厚壁血管和未成熟脂肪细胞组成。我们回顾了文献并讨论了血管平滑肌脂肪瘤的计算机断层扫描与病理的相关性。
