Renal cell carcinoma

RCC also known as renal cell carcinoma, the most common kidney cancer [123]. Under pathological classification of renal cell carcinoma can be divided into several types, most of them with clear cell carcinoma, about 67. 6 %~76. 2 vs 225], followed by particles and papillary carcinoma cell carcinoma. The former and the latter two are CT, MRI different [6210]. Literature on the pathological subtype of renal cell carcinoma CT, and MRI findings of the [9211] rarely reported. The author has collected 165 cases of renal cell carcinoma, now CT, MRI for a report, and papillary renal cell carcinoma, renal cell carcinoma particles CT, MRI contrast performance. 1 Materials and Methods 1. 1 general information on 165 patients, 111 male, 54 female, 29~77 age, an average of 54. 4 years old. A total of 185 inspections, 127 cases in which single CT; Single MRI in 18 cases; CT plus MRI in 20 cases, both the time of 0-14 days apart. 1. 2 CT scan 147 regular and enhanced axial CT scan. Scan method : After intravenous injection syringes used high-pressure elbow mgI/ concentration of 300 ml 90 ml of non-ionic contrast medium. According to the subjects of vaccination rate of 2-3 ml's body. 40 to 45 s after the injection of contrast agents began Corticomedullary (artery) scanning, 4 min excretion following the scan. 1. 3 MRI in 38 patients and MRI. Siemens used MagnetomVision Plus 1. 5 T MRI scanner. Axial T1 and T2-weighted images scan sequence scanning sequence and coronal T2-weighted images. 2~3ml/'s scan with contrast medium injection rate (Gd2DTPA agents 15.0-30.0 ml) after About 30's, were carried out Corticomedullary Phase 4 minutes, the excretory phase T1 transverse scanning. Results 2. 1 tumor number, distribution, morphology and marginalized groups a total of 172 lesions in 165 cases. 160 patients with single lesions, five cases of multiple foci (n = 1 to 4 bilateral lesion. 1% for the two cases of renal lesion, two cases of unilateral lesion 2). Renal tumors in the upper 44, Central 34, the lower 22, upper left kidney 30, Central 19, below 23. Tumor sustained round or oval shape (long - was part of the larger circle), diameter of 1-12 cm long. Average 4. 6 cm, 57 cm in diameter ≤ 3 Department. 147 pseudocapsule Office, Department margin of 81 hours, leaves, leaf, 14 minutes is dark. 2. CT peace eliminate 16 2 ≤ 4 cm diameter of the tumors were more uniform density, and renal tissues around, were, or slightly lower density (Figure 1A), and the remaining 138 or mixed tumors showed inhomogeneous density (Figure 2A). 19 tumors showed slight enhancement, the strip-shaped or irregular calcification, a high-density, 14 tumor hemorrhage. Scan, in addition to three smaller tumors were more homogeneous enhancement, the 151 Office tumors uneven; Paper pulp period there were obvious or significant enhancement of 149 Office : The most obvious areas to strengthen renal cortex were strong in the neighboring 74 (map 2B), which is similar to or slightly less than 75 neighboring renal cortex, just above the plain uniform density was significantly lower than neighboring five renal cortex (Figure 1B). 18 tumors are abnormal vessels. Compared with the tumor renal excretion was significantly low-density lesion boundaries more clearly, 128 lesions with different degrees necrosis and cystic degeneration. In this group with six cases of cystic renal cell carcinoma, cystic lesions, performed simple renal cysts, but shows mural nodules. Grid separated significantly strengthen scan (Figure 3). 2. 3 MRI scan see eight T1 signal intensity lesions in uniform. However, in both uneven or less homogeneous signal intensity (Figure 1C). The remaining lesions in T1 and T2-weighted images showed inhomogeneous or mixed signal (Figure 2C). four of which are within the tumor hemorrhage (T1 and T2-weighted images showed high signal). All lesions were no obvious calcifications. Scan tumors were less homogeneous or inhomogeneous strengthen, Corticomedullary Phase 2 lesions showed slight enhancement (Figure 1D). The most obvious areas to strengthen renal cortex were 19 strong in the neighboring Department (Figure 2D), renal cortex were similar or slightly less than 17 places nearby. 1 Department of abnormal vascular tumors. Compared with the tumor renal excretion was significantly lower signal more clearly focus the border, 28 necrotic lesions in varying degrees, cystic degeneration. 2. 4 renal lesions was not found 165 cases of lymph node metastasis of renal area, two cases of renal vein thrombosis see. 1 next inferior vena cava lung metastasis. 2. 5 surgery, pathological findings in this group except three cases percutaneous biopsy, More than 162 patients were suffering from renal tumor resection or enucleation, pathological lesions were 172 renal cell carcinoma. 147 Office tumor capsule, CT and CT scan revealed calcification. MRI see a hemorrhage see corresponding pathology reports were pathological changes. 2. CT and MRI of the six groups plus 20 routine CT MRI, CT, MRI see the 20 lesions. CT scan density lesions on MRI were more evenly than the T1 signal uniformity. But in less homogeneous or inhomogeneous signal intensity (Figure 1C) CT scan in the MRI lesions inhomogeneous density or mixed The T1 and T2-weighted images showed uneven or mixed signal (Figure 2C). CT and MRI found calcifications were not revealed. Enhanced CT, CT and MRI tumor basically the same degree of enhancement (Figure 2B,2D) and the uneven degrees tumors MRI is more sensitive than CT (Figure 1B,1D). 3 discussion 3. 1 renal cell carcinoma consists of pathology and prognosis in renal cell carcinoma cell carcinoma, granulosa cell cancer. papillary carcinoma, mixed cell carcinoma, spindle cell carcinoma, the past 20 years Europe and the United States to abolish the naming of granulosa cell carcinoma, and will be categorized as such chromophobe cell carcinoma [427], and the Mainland and Japan in recent years, there are still reports of granulosa cell carcinoma [123. 7210]. Chromophobe cell carcinoma (granulosa cell carcinoma), carcinoma of low malignant cancer cells than transparent, less transfers, the five-year survival rate is high [5, 6, 12]. The rich blood supply less than the prognosis of renal cell carcinoma of the renal papillary carcinoma of the blood supply, poor chromophobe renal cell carcinoma. In recent years, because of the image, the discovery of asymptomatic renal cell carcinoma increased significantly, so that the treatment of renal cell carcinoma from the radical nephrectomy, the kidney tumors develop, laparoscopic resection. cryotherapy, radiofrequency treatment [12]. As noted above, various types of renal cell carcinoma and malignant prognosis different subtypes such as preoperative diagnosis of renal cell carcinoma. to develop a greater role in guiding the treatment program. 3. 2 renal cell carcinoma CT, MRI in addition to some smaller extent, The majority of renal cell carcinoma Group (167/ 172, 97. 1%) of the rich blood supply, CT. MRI scan of the tumor characteristics : density / or heterogeneous signal generally uneven. scan tumor and heterogeneous enhancement. Paper pulp kidney tumor Department to strengthen the most obvious enhancement degree of renal cortex with similar or stronger neighbors. 6 (3. 5%), cystic renal cell carcinoma, although most of cystic tumors. But partial remains rich blood supply (Figure 3). Clear cell carcinomas are prone to hemorrhage, necrosis, cystic degeneration, and therefore with less homogeneous or inhomogeneous texture, CT. MRI was less homogeneous or inhomogeneous density / signal intensity in MRI is more sensitive (Figure 1). Nearly half of renal scan Corticomedullary Phase enhanced tumor Department strengthen much stronger than in neighboring most obvious in renal cortex. Section 18 of the abnormal vessels within the tumor, its rich blood supply. [8] 637 other findings : Small cell carcinoma is more transparent bubble-like structure (BLM architec2ture) usually scan the paper pulp was significantly strengthened. Kim, as well Jinzaki etc. [6, 7] reported that Clear cell carcinoma of the skin in the pulp period CT scan values rose more than 100 Hu, in line with this information. 3. 3 small collection of blood for the identification of renal cell carcinoma of the renal cell carcinoma. The writer also collected 12 cases of papillary renal cell carcinoma, and clear cell carcinoma, This 12 cases of papillary renal cell carcinoma CT scan tumor has the following characteristics : high proportion of uniform density. Corticomedullary Phase renal scan were significantly weaker than the degree of renal cortical tumors, and others 3 tumor bleeding, a complete tumor capsule. Chromophobe cell carcinoma (granulosa cell carcinoma) less malignant tumor is not easy bleeding, necrosis, cystic degeneration, more uniform texture. I have a group of eight cases reported granulosa cell cancer, CT, enhanced CT scan and MRI showed homogeneous or uniform density / signal. 37. 8% (8, c) tumor calcification, have an intact capsule. injection of contrast enhanced CT scan of the tumor were evenly or uniformly mild strengthening, Strengthening the extent of renal Corticomedullary renal cortex was significantly less than that in the 47-CT 78Hu[ 9]. [6 inzaki etc. etc. and J. Kim, 7] reported papillary renal cell carcinoma and chromophobe renal cell carcinoma in the Corticomedullary Phase CT scan in the following 100 Hu .