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[一例肾腺瘤合并鹿角形结石]

[A case of renal adenoma associated with staghorn calculus].

作者信息

Fukuoka H, Yamazaki A, Kitamura H

出版信息

Hinyokika Kiyo. 1984 Sep;30(9):1225-30.

PMID:6524564
Abstract

A case of renal adenoma associated with staghorn calculus is reported. The patient was a 52-year-old man. In 1973, he underwent an ileal conduit because of tuberculous contracted bladder and impediment in renal function. At that time, small calculi were already present in the right kidney. Later, in the left kidney, calculi developed into staghorn calculus. An ureteral calculus was also present in the right side and contracted kidney was observed. In 1983, he suffered from continuous left abdominal pain and macroscopic hematuria. Left nephrolithotomy was performed on August 23, 1983. During surgery, a yellow subcapsular flat mass the size of the tip of an index finger was found in the upper pole of the left kidney and was easily excised. An 11 cm incision was made in the renal parenchyma and the calculi were completely removed. At the center of the incised region, biopsy was performed. The wound was closed by the one-layer interrupted parenchymal suture method designed by Taguchi. Pedicle clamp time was 37 minutes and postoperative macroscopic hematuria was seen for only two days. The postoperative course was uneventful. The resected tumor was 18 X 16 X 10 mm in size. Histological examination revealed presence of fibrous capsules and papillary or tubular proliferation of cells which were suspected to have originated in the renal tubule. Also, there were scattered nests of foam cells. On the basis of these histological findings, the mass was diagnosed as renal adenoma. In addition, examination of the biopsied parenchyma also revealed small multiple adenomas, which were supposed to be remaining in the left kidney.

摘要

报告了一例肾腺瘤合并鹿角形结石的病例。患者为一名52岁男性。1973年,由于结核性挛缩膀胱和肾功能障碍,他接受了回肠代膀胱术。当时,右肾已存在小结石。后来,左肾的结石发展为鹿角形结石。右侧还存在输尿管结石,并观察到肾脏萎缩。1983年,他出现持续的左腹痛和肉眼血尿。1983年8月23日进行了左肾切开取石术。手术过程中,在左肾上极发现一个黄色的、位于包膜下的扁平肿块,大小如食指尖,易于切除。在肾实质做了一个11厘米的切口,结石被完全取出。在切开区域的中心进行了活检。伤口采用田口设计的单层间断实质缝合方法关闭。肾蒂钳夹时间为37分钟,术后仅出现两天肉眼血尿。术后病程顺利。切除的肿瘤大小为18×16×10毫米。组织学检查显示有纤维包膜,细胞呈乳头样或管状增生,怀疑起源于肾小管。此外,还有散在的泡沫细胞巢。根据这些组织学表现,该肿块被诊断为肾腺瘤。另外,对活检的肾实质检查还发现了多个小腺瘤,推测为左肾残留。

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