Comparative analysis of the MSCT and pathological characteristics between sarcomatoid renal cell carcinoma and renal clear cell carcinoma / 实用放射学杂志

ABSTRACT

Objective To explore the MSCT and pathological features of sarcomatoid renal cell carcinoma (SRCC)and to improve the diagnostic accuracy in differentiating SRCC from renal clear cell carcinoma (RCCC).Methods The MSCT findings and pathological features of 19 patients with SRCC and 213 patients with RCCC were reviewed retrospectively.Results On CT imaging,the average diameter of SRCC (65.95 mm±10.75 mm)was significantly larger than that of RCCC (51.88 mm±14.69 mm)(P=0.01);Of 19 SRCC,11 showed hemorrhage,necrosis and cystic degeneration and 1 showed calcification on unenhanced CT scan,while 9 of 213 RCCC showed calcification,there was no statistical difference between the two groups (P=0.07).In addition,10 cases of SRCC had slow and prolonged enhancement while 198 cases of RCCC had a contrast-enhancement pattern of "fast-in-and-fast-out",there was statistically significant difference between the two groups in CT enhancement mode (P＜0.05).SRCC had a high degree of malignancyin 19 cases,there were 4 cases with involvement of surrounding viscera,4 cases with perirenal effusion or hydronephrosis,5 cases with lymph node enlargement,7 cases with tumor thrombus of renal vein or inferior caval vein and 4 cases with pulmonary metastasis.Pathologically, 11 SRCC (57.89%)contained sarcomatoid component and 17 cases (89.47%)was positive for Vimentin.Conclusion Compared with RCCC,SRCC demonstrates certain characteristics signs at MSCT examination.SRCC is generally larger mass,heterogeneous and continuous ehhancement on the contrast scanning.The diagnosis of SRCC should be considered especially when the lesion has signs of invasiveness or metastatic.