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患者男性,68岁.因无病性持续性肉眼血尿四月余于92.4.8入院.患者无膀胱刺激症状,尿中时有片状血块,B超示左肾下极2×2cm实质性占位,呈低回声向肾外突出,肾盂无明显占位;膀胱镜检查发现左输尿管口有淡红色烟雾状血尿喷出,膀胱内无占位.IVU及左上尿路逆行造影未见明显充盈缺损;CT平扫示左肾下极较低密度区,强化扫描后肾实质与低密度区之间的CT值差增大,但肾盂内未见占位.尿瘤细胞二次阳性,六次阴性,诊为左肾肿瘤.于92.5.9在硬膜外麻醉下行根治性左肾切除术,术中见肿瘤于肾上极外侧,直径3cm,切面呈黄白色,未突破肾包膜,肾盂粘膜上有一片粟粒样小结节,范围约1×1.5cm~2,术后病理回报:左肾下
Male patient, 68 years old due to non-persistent persistent gross hematuria more than 92.4.8 in April admitted to hospital patients with no symptoms of bladder irritation, when there is lamellar blood in the urine, B ultrasound shows the left subphrosis 2 × 2cm substantial Bit, was low echo to the renal pelvis, renal pelvis was no significant placeholder; cystoscopy found that the left ureteral orifice with a light red smoke-like hematuria ejected, bladder no placeholder.IVU and left upper urinary tract retrograde angiography no obvious filling defect ; CT scan showed the lower left kidney lower density area, enhanced scan between the renal parenchyma and low density area of the CT value difference increased, but no place in the renal pelvis. Urinary tumor cells were second positive, six negative , Diagnosed with left kidney tumors .92.5.9 in the epidural anesthesia underwent radical nephrectomy, surgery see the tumor in the kidney on the very lateral, diameter 3cm, yellowish white section, did not break the renal capsule, renal pelvis On a piece of miliary nodules, the range of about 1 × 1.5cm ~ 2, postoperative pathological findings: left kidney