Department of Radiology, Hangzhou Tianshui Wulin Srteet Community Health Service Centers, Hangzhou, China.
Department of Medical Examination Center, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Int J Immunopathol Pharmacol. 2023 Jan-Dec;37:3946320231214117. doi: 10.1177/03946320231214117.
The present study reports the clinical data of a patient with renal venous malformation misdiagnosed as carcinoma. CT revealed hematocele in the left renal pelvis and ureter. CTU: the left renal pelvis and calyces showed a slightly high density shadow, a size of about 2.6 cm*1.5 cm, and mild-to-moderate enhancement was found at the edge of the lesion. Enhanced MR showed that irregular mass abnormal signal was observed in the lower calyx of the left kidney and the lesions were cast, with short T1 and slightly long T2 signals. The secondary bleeding or mucus of low-grade malignant tumor became suspicious. The patient underwent cystoscopy and left ureteroscopy under general anesthesia on December 3, 2021. Bloody urine can be seen on the left side, and multiple blood clots in the left renal pelvis can be detected. After washing, dark red bloody necrotic substances can be seen. Pathology suggests that renal venous malformation, accompanied by bleeding and thrombosis, is located in the renal medulla, involving the renal calyx, rupture and bleeding of the renal calyx, and obvious local bleeding of surrounding renal tissue. Follow-up for more than 1 year showed that the patient's condition was stable. When patients have renal colic with hematuria, enhanced CT suggests that renal mass is mild-to-moderate continuous enhancement, enhanced MRI suggests short T1 and long T2, considering that the mass may be accompanied by bleeding, and ureteroscopy suggests that dark red bloody necrotic substances should be considered in the diagnosis of renal venous malformation.
本研究报告了一例肾静脉畸形误诊为癌的患者的临床资料。CT 显示左肾盂和输尿管积血。CTU:左肾盂和肾盏呈稍高密度影,大小约为 2.6cm*1.5cm,病变边缘轻度至中度强化。增强磁共振显示左肾结石下盏不规则团块异常信号,病灶呈铸型,T1 短、T2 稍长信号。提示为低度恶性肿瘤的继发性出血或黏液。患者于 2021 年 12 月 3 日在全身麻醉下接受了膀胱镜检查和左输尿管镜检查。左侧可见血尿,左肾盂内可检测到多个血凝块。冲洗后可见暗红色血性坏死物质。病理提示肾静脉畸形,伴有出血和血栓形成,位于肾髓质,累及肾盏,肾盏破裂出血,周围肾组织明显出血。随访 1 年以上,患者病情稳定。当患者出现伴有血尿的肾绞痛时,增强 CT 提示肾肿块呈轻至中度持续强化,增强 MRI 提示 T1 短、T2 稍长,考虑肿块可能伴有出血,输尿管镜检查提示暗红色血性坏死物质,应考虑诊断为肾静脉畸形。