腎臟含脂肪腫瘤之超音波影像評詁

Sonographic Findings in Lipomatous Tumor of the Kidney

滕顒章(Yong-Jing Terng) ； 周宜宏(Yi-Hong Chou) ； 刁翠美(Chui-Mei Tiu) ； 許重權(Chung-Chuan Hsu) ； 王家槐(Jia-Hwia Wang) ； 王一雄(Yi-Hsiong Wang) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 16卷3期 (1991/09) Pp. 275-281

摘要

台北榮民總醫院放射線部共以超音波術診斷27例含脂肪成份之腎臟腫瘤；患者以女性居多（20例）。其中5例是結節性硬化症；均合併兩側腎缺陷瘤，亦以女性居多（4例）。門診腹部超音波檢查偶然發現，判定疑以小型腎缺陷瘤者12例；均爲單一病灶，直徑小於3cm，其中8例經電腦斷層攝影發現病灶內含脂肪密度。含脂肪腎臟腫瘤中11例開刀病理證實爲腎缺陷瘤（其中2例是結節性硬化症）。疑似合併肝臟缺陷瘤者3例，均爲高回音性無音影或遠方回音增強；其中2例是結節性硬化症，另1例腎缺陷瘤以〝多發型〞廣泛性侵犯腎臟。腎臟缺陷瘤合併腎細胞癌者2例；兩種腫瘤發生於同一側腎臟者1例，另1例則各自侵犯不同側之腎。典型之腎臟缺陷瘤超音波常爲均勻固質高回音性，與腎竇回音強度相近(Gr 3)，佔81.2%。超音波不典型者6例；其中以不典型囊腫表現者1例，另5例多以不均勻回音型式表現，而此5例中有2例電腦斷層攝影未發現脂肪成份。單一性病灶可大可小；以〝多發型〞或單一性大型表現之腫瘤，常使腎輪廓變形或不清。

關鍵字

缺陷瘤 ； 含脂肪腫瘤 ； 腎臟超音波 ； 結節性硬化症

並列摘要

We have diagnosed 27 cases of lipomatous tumor of the kidney using ultrasonography in Department of Radilogy, VGH-Taipei. It is a predilection in female (20 case). Five cases presented bilateral ”numerous pattern” of renal hamartoma as part of a syndome of tuberous sclerosis, also with a predilection in female (4 cases). Among these 27 patients, 12 were suspicious small renal hamartoma found incidentally by abdominal sonography for other reasons. All the 12 lesions were solitary and less than 3 cm in size, and 8 lesions were proved to have fat density by CT scan. Eleven patients were proved to be renel hamartoma by operation, which included 2 patients of tuberous sclerosis. Three patients, were suspicious to combine with hepatic hamartoma, whose echo-patterns resembled renal lesions. Two were tuberous sclerosis and the other one also presented ”numerous pattern” of renal hamartoma. The coexisting renal cell carcinoma was noted in 2 cases: one was located in the ipisilateral kidney and the other was in the contralateral one.
The typical sonographic appearance of renal hamartoma often shows a homogeneous, solid echogenic mass similar to the echogenicity of renal sinus (Gr. 3), as 81.2% of our cases did. Atypical sonographic pattern of renal hamartoma was evident in 6 cases (18.8%). One presented as an atypical cyst. Most of the other 5 cases showed heterogeneous echogenicity and in 2 cases there was hardly detectable fat density in CT. Renal hamartoma in association with tumor bleeding was only found in one case. ”numerous pattern” or solitary big lesion often caused deformed renal shape or indistinct renal margin.

並列關鍵字

hamartoma ； lipoma or lipomatosis ； kidney ； ultrasound ； tuberous sclerosis