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患者,男,43岁。因单位体检发现右肾占位性病变,于我院CT检查提示为右肾错构瘤。患者无腰腹部不适感,无尿频、尿急,无血尿。体检:生命体征平稳,营养中等,腹部膨隆。右上腹可触及巨大包块,无压痛、反跳痛;双肾区无叩击痛;输尿管走行区无压痛。CT检查见右肾有一巨大占位性病变,大小约20 cm×11.5 cm,密度不均匀,其内可见脂肪密度及条索状纤维结构;左肾形态尚可,未见异常密度影;双侧肾盂及输尿管未见明显扩张。双肾ECT:双肾总GFR为69.7 ml/min,其中左肾GFR为36.4 ml/min,右肾GFR为33.3 ml/min。结合患者病史及影像学特点,诊断为右肾巨大错构瘤。手术取右肋缘下切口,将患肾切除。术后病理检查为肾错构瘤;输尿管切缘泌尿上皮乳头
Patient, male, 43 years old. Due to the unit examination found that the right renal space-occupying lesions, CT examination in our hospital prompted the right renal hamartoma. Patients without abdominal discomfort, no urinary frequency, urgency, no hematuria. Physical examination: stable vital signs, moderate nutrition, bulging belly. The right upper quadrant can reach a huge mass, no tenderness, rebound tenderness; no percussion pain in the renal area; ureteral walking area without tenderness. CT examination showed a large mass lesion in the right kidney with a size of about 20 cm × 11.5 cm. The density was not uniform, and the density of fat and the shape of the cord-like fibers were visible. The shape of the left kidney was acceptable with no abnormal density. No significant expansion of the renal pelvis and ureter. Nephrotic ECT: Both kidneys had a total GFR of 69.7 ml / min, with GFR of 36.4 ml / min in the left kidney and 33.3 ml / min in the right kidney. Combined with the patient’s history and imaging features, the diagnosis of a huge right hamartoma. Surgical removal of the right costal incision, the nephrectomy. Postoperative pathological examination of renal hamartoma; ureter incision urinary epithelial nipple