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Atipična renalna cista koja imitira bubrežni karcinom: prikaz slučaja

Nataša Rakonjac ,
Nataša Rakonjac
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Nenad Janeski ,
Nenad Janeski
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Svetlana Kocić ,
Svetlana Kocić
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Aleksandra Cvijović ,
Aleksandra Cvijović
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Jovana Latov-Bešić ,
Jovana Latov-Bešić
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Vladimir Čotrić ,
Vladimir Čotrić
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Aleksandar Mandarić ,
Aleksandar Mandarić
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Mirko Vasilski
Mirko Vasilski
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Published: 01.12.2017.

Biochemistry

Volume 34, Issue 3 (2018)

pp. 1602-1607;

https://doi.org/10.5937/matmed1801602r

Abstract

Atipične ciste bubrega klasifikovane kaoBosniak III ili IV sususpektne na malignitet ali je u nekimslučajevima teško uspostaviti pravu dijagnozu uprkos savremenim radiološkim metodama i predložiti odgovarajući terapijski pristup. Evaluiramo slučaj komplikovane hemoragične bubrežne ciste kod 73 –godina starog pacijenta. Pacijent je primljen u našu bolnicu na dalju evaluaciju zbog nespecifičnih bolova u leđima i trbuhu i zbog hroničnih urinarnih infekcija. Ultrazvukom su verifikovane bilateralne ciste bubrega od kojih neke sa gustim sadržajem. Nakon CT pregleda jedna od tih cista je klasifikovana kao Bosniak II F, zbog diskretne opacifikacije zida ciste u jednom segmentu, dok je MR nalaz ukazao na suspektnu malignu leziju, pri čemu je opisana restrikcija difuzije intraluminalno, što ukazuje na prisustvo solidnog dela, te je pacijent nefrektomisan. Patohistološki pregled je verifikovao inflamiranu hemoragičnu cistu bez prisustva malignih ćelija. Atipična cista bubrega može odgovarati komplikovanoj cisti sa infekcijom ili krvarenjem, ali takođe i cističnom tumoru. Radiološki pregled često nije dovoljan za jasnu diferencijaciju. Lažno negativne biopsije kod cističnih promena su vrlo izvesne i često je neophodno izvršiti hiruršku intervenciju za preciznu dijagnozu.

Keywords

bubreg,

maligna cista,

atipična cista,

nefrektomija

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