Jordan J M, Gunnells J C
South Med J. 1985 Nov;78(11):1353-6.
We have reported our experience at Duke University Medical Center with juxtaglomerular apparatus tumor, a rare but remediable cause of significant hypertension. Our three cases illustrate markedly different clinical courses and diagnostic difficulties. Results of the usual diagnostic studies, including intravenous pyelogram and renal angiogram with selective renal vein renin assessment, may be normal, but abdominal CT with contrast can show even small lesions. Thus we propose the addition of CT in evaluating all cases of high-renin hypertension when renal artery stenosis has been excluded. Periodic reevaluation of these patients is mandatory to increase diagnostic accuracy and avoid unnecessary morbidity and mortality. Local resection, rather than total nephrectomy, should be considered because the tumors have low invasive potential.
我们已报告了我们在杜克大学医学中心处理近球小体肿瘤的经验，这是一种导致严重高血压的罕见但可治愈的病因。我们的三例病例展现出明显不同的临床病程及诊断困难。包括静脉肾盂造影以及通过选择性肾静脉肾素评估进行肾血管造影等常规诊断检查的结果可能正常，但增强腹部CT甚至能够显示微小病变。因此，我们建议在排除肾动脉狭窄后，对所有高肾素性高血压病例进行评估时增加CT检查。对这些患者进行定期重新评估对于提高诊断准确性以及避免不必要的发病率和死亡率而言是必不可少的。鉴于这些肿瘤的侵袭潜力较低，应考虑进行局部切除而非全肾切除术。
