Talja M, Bondestam S, Mäkinen J, Lehtonen T
Eur Urol. 1984;10(2):107-13. doi: 10.1159/000463766.
6 cases of renal oncocytomas are described. Preoperative diagnosis is difficult in spite of new clinical diagnostic methods. In our series oncocytoma was diagnosed angiographically in 1 case and in 3 cases carcinoma was suspected. 5 of 6 cases, reevaluated postoperatively, fulfilled three of the four criteria of Ambos et al. for oncocytoma. Ultrasonography is a good exclusion diagnostic method for renal neoplasms. Oncocytoma may be suspected if the tumor projects nearly totally outside the renal contour as we found in 3 of our 6 cases. Aspiration biopsy smears have a diagnostic value in the evaluation of renal neoplasms. Cytologically we preoperatively diagnosed oncocytoma in 1 of 3 cases in which biopsy was performed. We warn, however, about the mosaic pattern of renal neoplasms. Renal cell carcinomas may have large areas composed of oncocytes. Frozen section analysis is a potentially hazardous peroperative diagnostic method in large tumors if oncocytoma is suspected.
本文描述了6例肾嗜酸细胞瘤。尽管有新的临床诊断方法,但术前诊断仍很困难。在我们的病例系列中,1例通过血管造影诊断为嗜酸细胞瘤,3例怀疑为癌。6例中的5例术后重新评估,符合安博斯等人提出的嗜酸细胞瘤四项标准中的三项。超声检查是肾肿瘤的一种很好的排除诊断方法。如果肿瘤几乎完全突出于肾轮廓之外,如我们6例中的3例所见,则可能怀疑为嗜酸细胞瘤。穿刺活检涂片在肾肿瘤评估中具有诊断价值。在进行活检的3例中,有1例术前通过细胞学诊断为嗜酸细胞瘤。然而,我们要提醒注意肾肿瘤的镶嵌模式。肾细胞癌可能有大片由嗜酸细胞组成的区域。如果怀疑是嗜酸细胞瘤,对于大肿瘤,冰冻切片分析是一种潜在危险的术中诊断方法。