신장 호산성과립세포종의 영상의학적 소견
Radiologic Findings of Renal Oncocytomas
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Purpose To radiologically differentiate renal oncocytoma from other renal solid tumors, we analyzed and characterized, retrogradely, radiologic findings of renal oncocytomas. Materials and Methods Radiologic findings of pathologically proven renal oncocytoma were analyzed in 9 patients. CT was performed in all patients, ultrasonography in 4 patients and MRI in 3 patients. (51) Results On ultrasonography, the echogenicity of the mass was slightly more hyperechoic than normal renal parenchyma in all 4 cases. Two cases were homogeneous and the remaining two cases were relatively homogeneous. On CT, all 8 cases showed iso-density to slightly low density compared to normal renal parenchyma and 5 cases were homogeneous but the central portion of the mass was of a slightly lower density than the peripheral portion in 3 cases. All six cases had an arterial phase scan and were heterogeneously enhanced. An irregular, lower-enhancing portion was found in the central portion of the mass. Segmental inversion of contrast enhancement was found in 5 of 6 cases that had a dynamic enhancement study. On MR T1-weighted imaging, the mass was of iso-signal intensity to normal renal parenchyma and the central portion of the mass had a slightly hypo-signal intensity than the peripheral portion. On T2-weighted imaging, 2 cases were heterogeneous; the peripheral portion was of low signal intensity and the central portion was of higher signal intensity than normal renal parenchyma. One case was relatively homogeneous and showed a slightly lower signal intensity than that of normal renal parenchyma, except for a central small portion showing high signal intensity. For 2 cases that had a dynamic study, a segmental inversion of contrast enhancement was noted. Conclusion Renal oncocytoma is seen as a well-marginated solid mass lesion. On enhanced scans it is heterogeneously enhanced and segmental inversion of contrast enhancement may be seen. The possibility of oncocytoma can be suggested in cases showing these radiologic findings.
Abstract
Purpose To radiologically differentiate renal oncocytoma from other renal solid tumors, we analyzed and characterized, retrogradely, radiologic findings of renal oncocytomas. Materials and Methods Radiologic findings of pathologically proven renal oncocytoma were analyzed in 9 patients. CT was performed in all patients, ultrasonography in 4 patients and MRI in 3 patients. (51) Results On ultrasonography, the echogenicity of the mass was slightly more hyperechoic than normal renal parenchyma in all 4 cases. Two cases were homogeneous and the remaining two cases were relatively homogeneous. On CT, all 8 cases showed iso-density to slightly low density compared to normal renal parenchyma and 5 cases were homogeneous but the central portion of the mass was of a slightly lower density than the peripheral portion in 3 cases. All six cases had an arterial phase scan and were heterogeneously enhanced. An irregular, lower-enhancing portion was found in the central portion of the mass. Segmental inversion of contrast enhancement was found in 5 of 6 cases that had a dynamic enhancement study. On MR T1-weighted imaging, the mass was of iso-signal intensity to normal renal parenchyma and the central portion of the mass had a slightly hypo-signal intensity than the peripheral portion. On T2-weighted imaging, 2 cases were heterogeneous; the peripheral portion was of low signal intensity and the central portion was of higher signal intensity than normal renal parenchyma. One case was relatively homogeneous and showed a slightly lower signal intensity than that of normal renal parenchyma, except for a central small portion showing high signal intensity. For 2 cases that had a dynamic study, a segmental inversion of contrast enhancement was noted. Conclusion Renal oncocytoma is seen as a well-marginated solid mass lesion. On enhanced scans it is heterogeneously enhanced and segmental inversion of contrast enhancement may be seen. The possibility of oncocytoma can be suggested in cases showing these radiologic findings.
참고문헌 (19)
- Levine E, "Small renal neoplasms: clinical, pathologic, and imaging features", AJR Am J Roentgenol, 153(1), pp.69~73 (1989)
- Homma Y, "Increased incidental detection and reduced mortality in renal cancer--recent retrospective analysis at eight institutions", Int J Urol, 2(2), pp.77~80 (1995)
- Jayson M, "Increased incidence of serendipitously discovered renal cell carcinoma", Urology, 51(2), pp.203~205 (1998)
- Frank I, "Solid renal tumors: an analysis of pathological features related to tumor size", J Urol, 170(6 Pt 1), pp.2217~2220 (2003)
- Dechet CB, "Renal oncocytoma: multifocality, bilateralism, metachronous tumor development and coexistent renal cell carcinoma", J Urol, 162(1), pp.40~42 (1999)
- Schatz SM, "Update on oncocytoma", Curr Urol Rep, 4(1), pp.30~35 (2003)
- Villanueva Peña A, "Bilateral multiple renal oncocytoma. Case report and review of the literature", Prog Urol, 17(5), pp.997~999 (2007)
- Perez-Ordonez B, "Renal oncocytoma: a clinicopathologic study of 70 cases", Am J Surg Pathol, 21(8), pp.871~883 (1997)
- Levine E, "Computed tomography of renal oncocytoma", AJR Am J Roentgenol, 141(4), pp.741~746 (1983)
- Silverberg SS, "Principles and practice of surgical pathology and cytopathology" (1997), Churchill-Livingstone
- Weider N, "The difficult diagnosis in surgical pathology" (1996), WB Saunders
- Goiney RC, "Renal oncocytoma: sonographic analysis of 14 cases", AJR Am J Roentgenol, 143(5), pp.1001~1004 (1984)
- Bandhu S, "Spoke-wheel pattern in renal oncocytoma seen on double-phase helical CT", Australas Radiol, 47(3), pp.298~301 (2003)
- Choudhary S, "Renal oncocytoma: CT features cannot reliably distinguish oncocytoma from other renal neoplasms", Clin Radiol, 64(5), pp.517~522 (2009)
- Quinn MJ, "Renal oncocytoma: new observations", Radiology, 153(1), pp.49~53 (1984)
- Davidson AJ, "Renal oncocytoma and carcinoma: failure of differentiation with CT", Radiology, 186(3), pp.693~696 (1993)
- Kim JD, "Segmental inversion of enhancement in biphasic MDCT: a characteristic finding of small renal oncocytoma", Proceeding of the 6th annual meeting of the Korean Society of Uroradiology, pp.74~ (2007)
- Harmon WJ, "Renal oncocytoma: magnetic resonance imaging characteristics", J Urol, 155(3), pp.863~867 (1996)
- Ball DS, "Scar sign of renal oncocytoma: magnetic resonance imaging appearance and lack of specificity", Urol Radiol, 8(1), pp.46~48 (1986)