CT-guided percutaneous lumbar puncture needle injecting glacial acetic acid cure renal cyst 59 cases / 中国基层医药

Objective To summarize the efficacy and experience of treatment of renal cyst CT-guided percutaneous lumbar puncture needle inject glacial acetic acid.Methods Guided by CT,passing the skin,drawing out cyst liquor then injecting 45% glacial acetic acid with lumbar puncture needle,71 renal cyst of 59 cases was treated,cyst diameter 2.0～8.9cm.When liquor was drawn out inject a small dose of glacial acetic acid to renal cyst,then CT scan was performed to identify the drug solution in cyst and no leakage,the volume of 45% glacial acetic acid was equal to 1/4～1/5 cyst cubic capacity,rinses cyst 2～3 times with the drug,after 20～30 minutes drawn out,the final volume of 45% glacial acetic acid equal to 1/5 cyst was injected and retained in cyst.Results All cases were healed successfully and drew out 11～420ml liquor.100% effective rate,unilateral single cyst disappearance rate of 96%,unilateral multiple cyst of 63%,bilateral solitary cyst to 100%.No serious complications happened.Conclusion The treatment CT-guided percutaneous lumbar puncture needle inject 45% glacial acetic acid made cure one or more of renal cyst is of a simple and safe and efficient operation.

Percutaneous Sclerotherapy of Renal Cysts with a Beta-Emitting Radionuclide, Holmium-166-chitosan Complex

OBJECTIVE: To evaluate the usefulness of a beta-emitting radionuclide (holmium-166-chitosan complex) as a sclerosing agent for the treatment of renal cysts. MATERIALS AND METHODS: Using 10-30 mCi of holmium-166-chitosan complex, 20 renal cysts in 17 patients (14 male and 3 female patients, ranging in age from 47 to 82 years) were treated by percutaneous sclerotherapy under ultrasonographic guidance. The volume of the cysts before and after the sclerotherapy and the percentage change in volume were calculated in order to evaluate the response to therapy, which was classified as either complete regression (invisible), nearly complete regression ( 50 volume%). RESULTS: The follow-up period ranged from 6 to 36 months (mean 28 months). Eighteen cysts (90%) regressed completely (n=11, 55%) or near-completely (n=7, 35%). Partial regression was obtained in one patient (5%) and there was no regression in one patient (5%). No significant complications were encountered. CONCLUSION: The holmium-166-chitosan complex seems to be useful as a new painless sclerosing agent for the treatment of renal cysts with no significant complications.

The image features of multilocular cystic nephroma / 中华放射学杂志

Objective To explore the image features of multilocular cystic nephroma and its correlative differential diagnosis. Methods Eight cases of multilocular cystic nephroma were retrospectively analyzed by comparing the imaging findings with surgical and pathological results. Results In all 8 cases, multilocular cystic nephromas were unilateral and circumscribed by thick capsules. These lesions ranged in diameter from 2. 5 cm to 7. 5 cm. The lesions were entirely composed of locules and septa without solid nodules. These locules did not communicate with each other. The septa of these lesions were clear in 2 cases, partly clear in 4 cases, and not very clear in 2 cases. All lesions were better detected on enhanced scans than on non-enhanced ones. Four of 8 cases also underwent MR scan, which presented low signal intensity on T1WI and high signal intensity on T2WI. The Interlocular septa was demonstrated much better with MM than with CT. Histopathology proved that the capsule and septa of the lesions were lined by cuboidal or flattened epithelial cells. Conclusion Multilocular cystic nephroma is a rare disease of the kidney. CT and MRI scanning are valuable in the diagnosis of multilocular cystic nephroma, but the imaging features are not specific enough to differentiate benign multilocular cystic nephroma from multilocular cystic renal cell carcinoma.

Cystic renal cell carcinoma (report of 12 cases) / 中华泌尿外科杂志

Objective To study the diagnosis and treatment of cystic renal cell carcinoma. Methods 12 cases of cystic renal cell carcinoma have been identified. Imaging studies showed no specific evidence of malignance and the preoperative diagnosis was a complex cystic mass in all but 2.All the 12 cases had been surgically explored,intraoperative pathological examination being undertaken in 9,8 of them demonstrating a malignant cystic renal clear cell carcinoma.Radical nephrectomy was carried out in 7,simple nephrectomy in 3,partial nephrectomy in 1 and one cyst unroofed. Results All the 12 cases were confirmed as cystic renal clear cell carcinoma on pathology.All the patients have been followed up for a mean of 39.5 months and the overall results were excellent with no evidence of cancer recurrence or metastasis. Conclusions Intraoperative pathological examination should be performed in suspected cases of cystic renal cell carcinoma.The prognosis is fair for cystic renal clear cell carcinoma.Nephrectomy or partial nephrectomy is indicated.

CONCOMITANCE OF CARCINOMA AND CYST IN THE SAME KIDNEY / 解放军医学杂志

To improve the diagnosis of concomitance of cancer and cyst in the same kidney, a retrospective review of the imaging results of 10 patients with cystic renal cancers confirmed by surgery and pathologic study was performed. Excretory urography showed an avascular mass suggestive of a cyst. Ultrasonography revealed a cystic mass with thinkened and irregular walls,but it was unable to distinguish between a complicated and an extensively necrotic cancer.On CT scans,irregular cystic wall and definite early enhancement in solid component were observed.In some of the patients,there were mural nodules,septum and calcification. Some scans may show an almost cystic appearance,but one or more CT scans always showed some dense neoplastic tissue.This study indicated irregular and thickened cystic wall and septum,mural nodules and early enhancement of solid component were the characteristic findings for the CT diagnosis.This suggestive CT pattern must be particularly searched for at the base of the cyst,but may also be present in the periphery of the cyst.

Multicystic renal cell carcinoma:a clinicopathologic study with comparison of it with renal clear cell carcinoma undergoing cystic change / 解放军医学杂志

Objective Multicystic renal cell carcinoma(MCRCC)appears to be a distinct subtype of renal cell carcinoma with characteristic gross and microscopic features.To explore the clinical and pathological features of MCRCC in order to find out its difference from renal clear cell carcinoma undergoing cystic change(RCCCC),and to propose prognosis criteria for therapeutic modalities.Methods From 1999 to 2003 32 patients were identified to have renal carcinoma,and they received radical or partial nephrectomy in the authors' institution.The pathological diagnosis was either MCRCC(n=21)or renal cell carcinoma associated with features of cystic changes(n=11).All specimens were reviewed histologically by two independent pathologists.The clinicopathologic and follow-up prognosis data on MCRCC and RCCCC were collected for study.Results 21 patients with MCRCC were 17 men and 4 women.The mean age at the time of surgery was 49 years(range 37 to 67 years).15 MCRCC patients with follow-up data were still alive with a mean follow-up time of 61 months(ranged 31 to 73)and no evidence of recurrence and metastasis was discovered.The mean survival time for 7 of the 11 patients with RCC was 32 months(ranged 18 to 63).There was significant difference in survival time between the two groups(P