Das papilläre Nierenzellkarzinom: Vergleich von CT und Pathomorphologie

Zusammenfassung.

Ziel: Analyse der CT-Morphologie des papillären Nierenzellkarzinoms (pNZK) unter Berücksichtigung seines pathomorphologischen Erscheinungsbildes. Material und Methode: Präoperative CT-Untersuchungen von 10 Patienten mit histologisch gesichertem pNZK wurden im Konsensusverfahren von zwei erfahrenen Radiologen ausgewertet. Das computertomographische Erscheinungsbild wurde mit der Pathomorphologie korreliert. Ergebnisse: Computertomographisch hatten 9/10 Tumoren runde, glatte und scharf begrenzte Ränder. Diese Tumoren wiesen ein hypodenses Zentrum auf, welches histologisch nekrotischem Tumorgewebe entsprach. Diese zentrale Nekrose war von einem Rand vitalen Tumorgewebes umgeben, der sich computertomographisch als girlandenförmig kontrastmittelanreichernder Rand darstellte. Ein Tumor bestand aus mehreren Tumorknoten und war polyzyklisch begrenzt, jedoch gegenüber dem umgebenden Nierengewebe scharf abgrenzbar. Schlussfolgerungen: pNZK haben ein einheitliches computertomographisches Erscheinungsbild, das gut mit der Pathomorphologie korreliert.

Papillary Renal Cell Tumor: Comparison of CT and Gross Morphology.

Objective: To analyze the CT appearance of papillary renal cell tumor (pRCT) under consideration of gross pathology. Material and Methods: Preoperative CT-scans of 10 patients suffering from pRCT were re-evaluated by two experienced radiologists. CT appearance was correlated to gross morphology. Results: On CT, 9/10 tumors were depicted as rounded, well circumscribed and sharply delineated masses. These tumors presented a hypodense central area correlating to necrosis in gross pathology. The central area of necrosis was surrounded by vital tumor tissue, presenting as a serpiginous, contrast-enhancing margin on CT. One tumor was polycyclic due to multiple tumor nodules, but sharply demarcated towards the surrounding renal tissue. Conclusions: pRCT presents a quite unique CT appearance similar to its gross pathology.

Schlüsselwörter:

Nierentumor, CT - Nierentumor, Diagnose - Nierenzellkarzinom

Key words:

Kidney neoplasms, CT - Kidney neoplasms, diagnosis - Carcinoma, renal cell

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