The Role of Percutaneous Nephrostomy in the Diagnosis of Renal Stones Associated with Urothelial Tumors

經皮腎造瘻術在診斷腎結石合併泌尿道上皮腫瘤所擔任之角色

王家槐(Jia-Hwia Wang) ； 許明輝(Ming-Huei Sheu) ； 張政彥(Cheng-Yen Chang) ； 于俊(Chun Yu)

《中華放射線醫學雜誌》 20卷2期 (1995/06) Pp. 107-112

摘要

腎結石合併腎臟泌尿道上皮細胞腫瘤並不常見。它們不易被診斷，因為常會引起無功能腎。在過去九年半中，在我們實行經皮腎造瘻術之病例當中，有10 懷疑罹患腎結石合併腎臟泌尿道上皮細胞腫瘤。此10例進一步接受腎臟電腦斷層攝影檢查，而證實罹患腎臟泌尿道上皮細胞腫瘤。此10例按個別之情況而施以腎臟輸尿管摘除或腎臟摘除。病理報告證實6例為移行上皮細胞癌，其他4例則為類上皮細胞癌。有6例在治療後六個月內死亡，但仍有3例在治療後四年仍活存。腎結石合併腎臟泌尿道上皮細胞腫瘤常會引起無功能腎，因此診斷不易；而從本研究知道經皮腎造瘻術對此疾病之診斷有所助益，並期望對此疾病之預後有所改善。

關鍵字

腎臟，結石 ； 腎臟，介入性檢查 ； 腎腫瘤，電腦斷層攝影 ； 腎腫瘤，診斷

並列摘要

Renal stones associated with urothelial tumors are not frequently seen. During the past nine and a half years, 2,936 percutaneous nephrostomy(PCN) procedures were done in our hospital. Suspicion of associated urothelial tumors was noted in 10 cases of these patients received PCN. Computed tomography of the kidneys of these 10 patients assisted a diagnosis of urothelial tumors associated with renal stones. Nephroureterectomy or nephrectomy for these 10 cases identified six cases of transitional cell carcinoma and four cases of squamous cell carcinoma, all confirmed by results of pathology. Poor prognosis was noted. Six patients died within six months after diagnosis and treatment. But three patients were still alive after a four-year follow-up. Urothelial tumors associated with renal stones are difficult to diagnose, because they quite often cause nonfunctioning kidneys. From this study, PCN with concomitant antegrade pyelogram is helpful in making diagnoses, and may improve patient prognoses.

並列關鍵字

Kidney, calculi ； kidney, interventional procedure ； kidney neoplasms, CT ； kidney neoplasms, diagnosis