Chronically Rejected Renal Allograft Replaced by a Huge Organized Hematoma Mimicking Malignancy

血腫取代慢性排斥移植腎擬似惡性變化

江國賢(Kuo-Hsien Chiang) ； 張寶源(Pau-Yang Chang) ； 劉奕祥(Yi-Xiang Liu) ； 李超群(Chau-Chin Lee) ； 嚴寶勝(Pao-Sheng Yen) ； 凌昌明(Chang-Ming Ling) ； 林昭君(Chao-Chun Lin) ； 周紹賓(Andy Shau-Bin Chou)

《慈濟醫學雜誌》 18卷3期 (2006/06) Pp. 211-215

https://doi.org/10.6440/TZUCMJ.200606.0211

摘要

一位44歲男性在接受腎臟移植一年後因感染而失敗。五年後他發現左下腹有快速變大的腫塊並伴隨不適。腹部電腦斷層顯示原移植腎被一個有多處鈣化的腫塊取代。這個腫瘤內有不均勻的顯示及疑似血管構造。主動脈攝影中看到在左下腹有一個巨大的低血管性腫瘤。在接受移植腎切除後發現是一個血腫，伴有鈣化及血栓。血腫是腎臟移植常見的併發症，可能是因為移植腎破裂或是血管的傷害。目前尚未發現血腫可以在移植失敗後慢性的擴大。電腦斷層在此案例術前的診斷只有提供有限的資訊。

關鍵字

電腦斷層 ； 血腫 ； 腎臟移植

並列摘要

A 44-year-old man received a cadaveric renal allograft, however, the allograft failed after 1 year owing to septic complications. Five years after the complications, the patient noted an enlarged mass in the lower left abdominal area accompanied by discomfort. Abdominal computed tomography (CT) revealed the failed kidney transplant had been replaced by a mass with multiple calcifications. The tumor showed heterogenous-enhancement, as well as some vascular structures that were noted within the tumor. Aortogram demonstrated a huge hypovascular lesion in the lower left abdominal area with displacement of adjacent arteries. He received transplant nephrectomy and histological examination of the tumor showed a hematoma with organization and calcification accompanied by thromboemolism in the blood vessels. A hematoma is a common acute or chronic complication of kidney transplantation. It can be secondary to graft rupture or injury to the vascular pedicle. It is not well known that a hematoma can develop and slow expansion and total replacement can occur after graft failure. CT is limited in helping to determine the definitive pre-operative diagnosis.

並列關鍵字

CT ； hematoma ； renal allograft