Hendaoui L, Horchani A, Slim R, Ben Jilani S, Dziri C H, Zmerli S
J Urol (Paris). 1984;90(1):11-4.
The authors report a case of multilocular cyst of the kidney in an adult. The diagnosis was made, despite the fact that hydatid disease was endemic in the area, on the basis of the finding at urography of a renal mass with the density of water, the finding at echotomography of a multiloculated mass of mixed nature and finally the absence of any blood supply at arteriography. Excision of the multilocular mass left in place a normal kidney with a good result confirmed after 18 months' follow-up. This case is used as a basis to describe the differential diagnosis in the context of the results of special investigations: I.V.U., echotomography, CT scan and arteriography. Diagnoses which must be eliminated are: renal adenocarcinoma in its necrosed form, solitary renal cyst, angiomyolipoma, nephroblastoma and, in endemic areas obviously, hydatid cyst, in particular in its multivesicular form. Despite the multiplicity of investigations, the diagnosis is often uncertain until the time of surgery. Treatment is excision of the abnormal mass with preservation of healthy parenchyma.
作者报告了一例成人肾多房性囊肿病例。尽管该地区包虫病流行,但根据静脉尿路造影显示肾肿块密度似水、超声断层扫描显示多房性混合性肿块以及动脉造影显示无血供等检查结果,仍做出了诊断。多房性肿块切除后,肾脏恢复正常,18个月的随访证实效果良好。以此病例为基础,结合静脉尿路造影、超声断层扫描、CT扫描及动脉造影等特殊检查结果,描述了鉴别诊断方法。必须排除的诊断包括:坏死型肾腺癌、孤立性肾囊肿、血管平滑肌脂肪瘤、肾母细胞瘤,在流行地区显然还包括包虫囊肿,尤其是多泡型。尽管检查项目繁多,但在手术前诊断往往仍不明确。治疗方法是切除异常肿块并保留健康的肾实质。