The diagnostic value of MSCT in atypical renal cell carcinoma
ZHANG Wei1, HUANGFU You-tian1, XUE Peng1, CHEN Yong1, YANG Xue-hua2, ZHANG Si-jia1, WANG Lan-rong3
1. Department of Radiology, Zhengzhou People’s Hospital, Zhengzhou 450003, China;2. Department of Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China;3. Department of Oncology, the Third People’s Hospital of Zhengzhou, Zhengzhou 450000, China
Abstract：Objective: To study the CT features of atypical renal cell carcinoma(RCC) and the value of MSCT. Materials and Methods: CT findings of 16 cases of atypical RCC confirmed pathologically were analyzed retrospectively. All the cases received plain CT scan and dual-phase contrast-enhanced CT scan by MSCT. Then three-dimensional reconstruction was performed. Results: All of the tumours were single and located in unilateral kidney. Among the 16 cases, 8 showed solid appearance, 6 showed cystic-solid appearance, and 2 showed cystic appearance; 10 cases displayed the characteristic of lack of blood supply. Solid RCC lack of blood supply was slightly-moderately enhanced or not enhanced in cortical phase, then slightly reduced in the following parenchyma phase, and no trend of progressive enhancement was found. Among the 8 cases of solid RCC, 5 cases intruded into renal sinus, and 2 cases had circular calcification. The solid portion of 4 cystic-solid RCC were rich in blood supply and enhanced according to the rhythm of solid RCC which was rich of blood supply. The 2 cases of cystic RCC showed uneven thickness of cyst wall with shallow lobulation. In one case, soft tissue with slight enhancement was seen in the junctional zone between the cystic lesion and normal renal parenchyma. The diffuse infiltrative RCC with ill-defined margin was slightly enhanced, which was similar to the inflammatory lesion, and the acanthoid protuberance was found on the edge of kidney, accompanied with thickened perinephric fascia, widened bridge interval and enlarged lymph nodes adjacent to renal hilus. Conclusion: Atypical RCC shows various forms and must be analyzed comprehensively according to shape and pattern of enhancement. The lesion can be displayed well by MSCT which has the advantage in showing the detail of lesions and contributes to differential diagnosis.
2012, Vol. 23 
