Department of Medical Imaging, Fuzhou Teaching Hospital of Bengbu Medical College, Fuzhou General Hospital of Nanjing Military Region, Fuzhou 350025, China
Abstract：Objective To investigate the CT and MRI features of renal oncocytoma, so as to provide reference for the clinical diagnosis of renal oncocytoma.Methods The imaging features of 24 patients with renal oncocytoma by surgical pathology in Fuzhou General Hospital from February 2011 to July 2017 were analyzed retrospectively. There were 12 males and 12 females, with age 36-71 (55.2±10.4) years. Preoperative CT scanning and enhanced scanning, or MRI scanning and enhanced scanning were used to evaluate the location, size, morphology, border, necroses and cystic degeneration, stellate scar and enhancement features in different phases, as well as renal tissue invasion and lymph node metastasis.Results In 24 patients, 22 routine CT tests and 5 routine MRI tests were performed. There were 25 lesions, 1 case revolved in bilateral renal, which was solitary while 23 cases were unilateral solitary lesions. Among the 9 cases in the right kidney and 16 cases in the left kidney, the largest diameter was (3.4±1.2) cm. CT scanning of 22 cases of 23 lesions. On pre-contrast CT scanning, the 13 tumors showed isodensity and calcification were observed in 2 cases, small cystic low density was observed in 3 cases and stellate scar was seen in 10 cases. On multiple phase contrast scanning, most cases appeared obvious enhancement, which displayed a steep increase and then progressive washout pattern for dynamic enhancement curve. On MRI, 5 cases of 5 lesions. All 5 tumors showed iso-hypo signal intensity on T1WI and heterogeneously hyper-intensity on T2WI and DWI. The small cystic low density was observed in 1 case and stellate scar was seen in 1 case. All the lipid spaces around the kidney were clear. No tumor plug was found in renal vein and inferior vena cava. No enlarged lymph nodes were found beside renal hilum and abdominal aorta.Conclusions The CT and MRI imaging manifestation of renal oncocytoma has certain characteristics. It could improve the understanding of this disease and reduce unnecessary radical nephrectomy, which has important clinical application value.
Kuroda N, Toi M, Hiroi M, et al. Review of renal oncocytoma with focus on clinical and pathobiological aspects[J]. Histol Histopathol, 2003, 18(3): 935-942. DOI:10.14670/HH-18.935
Zippel J. Zur kenntnis der onkocyten[J]. Virchows Arch, 1941, 308(2): 360-382. DOI:10.1007/bf02593372
[4]
Klein MJ, Valensi QJ. Proximal tubular adenomas of kidney with so-called oncocytic features.A clinicopathologic study of 13 cases of a rarely reported neoplasm[J]. Cancer, 1976, 38(2): 906-914. DOI:10.1002/1097-0142(197608)38:2<906::aid-cncr2820380238>3.0.co;2-w
[5]
Amin MB, Crotty TB, Tickoo SK, et al. Renal oncocytoma: a reappraisal of morphologic features with clinicopathologic findings in 80 cases[J]. Am J Surg Pathol, 1997, 21(1): 1-12
[6]
Davidson AJ, Hayes WS, Hartman DS, et al. Renal oncocytoma and carcinoma: failure of differentiation with CT[J]. Radiology, 1993, 186(3): 693-696. DOI:10.1148/radiology.186.3.8430176
赵振威, 李延江, 俞亮. 不同病理类型肾细胞癌临床分析[J]. 青岛大学医学院学报, 2013, 49(4): 351-353. DOI :10.11712/qdyxy201304023
[10]
Kodama K, Nagano K, Akimoto M, et al. Small renal oncocytoma with central cystic degeneration[J]. Int J Urol, 2004, 11(2): 110-113. DOI: org/10.1111/j.1442-2042.2004.00742.x
Perez-Ordonez B, Hamed G, Campbell S, et al. Renal oncocytoma: a clinicopathologic study of 70 cases[J]. Am J Surg Pathol, 1997, 21(8): 871-883
[13]
Kim JI, Cho JY, Moon KC, et al. Segmental enhancement inversion at biphasic multidetector CT characteristic finding of small renal oncocytoma[J]. Radiology, 2009, 252(2):441-448. DOI:10.1148/radiol.2522081180
Zhong Y, Wang H, Shen Y, et al. Diffusion-weighted imaging versus contrast-enhanced MR imaging for the differentiation of renal oncocytomas and chromophobe renal cell carcinomas[J]. Eur Radiol, 2017, 27(12): 4913-4922. DOI:10.1007/s00330-017-4906-9
[17]
Galmiche C, Bernhard JC, Yacoub M, et al. Is multiparametric MRI useful for differentiating oncocytomas from chromophobe renal cell carcinomas?[J]. AJR Am J Roentgenol, 2017, 208(2): 343-350. DOI:10.2214/AJR.16.16832
[18]
Young JR, Coy H, Kim HJ, et al. Performance of relative enhancement on multiphasic MRI for the differentiation of clear cell renal cell carcinoma (RCC) from papillary and chromophobe RCC subtypes and oncocytoma[J]. AJR Am J Roentgenol, 2017, 208(4): 812-819. DOI:10.2214/ajr.16.17152
[19]
Mirka H, Korcakova E, Kastner J, et al. Diffusion-weighted imaging using 3.0 T MRI as a possible biomarker of renal tumors[J]. Anticancer Res, 2015, 35(4): 2351-2357.
2018, Vol. 23 
