BACKGROUND Retroperitoneal lymph node dissection(RPLND)plays a diagnostic,therapeutic,and prognostic role in myriad urologic malignancies,including testicular carcinoma,renal cell carcinoma(RCC),and upper urinary trac...BACKGROUND Retroperitoneal lymph node dissection(RPLND)plays a diagnostic,therapeutic,and prognostic role in myriad urologic malignancies,including testicular carcinoma,renal cell carcinoma(RCC),and upper urinary tract urothelial carcinoma.RCC represents 2%of all cancers with approximately 25%of patients presenting with advanced disease.Clear cell RCC(CCRCC)is the most common RCC,accounting for 75%-80%of all RCC.CASE SUMMARY A 71-year-old man presented with a history of benign prostatic hypertrophy.He was asymptomatic without any hematuria,pain,or other urinary symptoms.A computed tomography(CT)scan of the abdomen and pelvis showed a 1.8 cm left retroperitoneal lymph node.There was no evidence of renal pathology.A core biopsy was performed of the left para-aortic lymph node.Although the primary tumor site was unknown,the morphological and immunohistochemical features were most consistent with CCRCC.A RPLND was performed which revealed a single mass 5.5 cm in greatest dimension with extensive necrosis.The retroperitoneal lymph node was most compatible with CCRCC.A nephrectomy was not conducted as a renal mass had not been detected on any prior imaging studies.The patient did not receive any type of adjuvant therapy.The patient underwent surveillance with serial CT scans with contrast of the chest,abdomen,and pelvis for the next 5 years,all of which demonstrated no recurrent or metastatic disease and no evidence of retroperitoneal adenopathy.CONCLUSION Our unique case emphasizes the therapeutic role of metastasectomy in metastatic CCRCC even in the absence of primary tumor in the kidneys.展开更多
目的探讨快速现场评价(rapid on site evaluation,ROSE)指导下的颈部淋巴结细针穿刺(fine needle aspiration,FNA)与常规FNA在效果和安全性上的差异。方法选取2013年10月至2018年10月阜阳市人民医院拟行颈部淋巴结FNA的病人84例,采用随...目的探讨快速现场评价(rapid on site evaluation,ROSE)指导下的颈部淋巴结细针穿刺(fine needle aspiration,FNA)与常规FNA在效果和安全性上的差异。方法选取2013年10月至2018年10月阜阳市人民医院拟行颈部淋巴结FNA的病人84例,采用随机数字表法分为ROSE组和常规组,对穿刺针数、穿刺是否明确诊断、穿刺并发症进行观察。结果ROSE组总体明确诊断率(97.6%比81.0%)、并发症发生率(7.1%比23.8%)、穿刺进针次数[(1.24±0.58)次比(1.90±0.58)次]均优于常规组(P<0.05);对于长径小于1cm或位于IV区的淋巴结,ROSE组在明确诊断率上优于常规组;淋巴结位于IV区的病人,ROSE的并发症发生率优于常规组。结论应用ROSE技术有助于提高颈部淋巴结FNA的成功率和安全性。展开更多
文摘BACKGROUND Retroperitoneal lymph node dissection(RPLND)plays a diagnostic,therapeutic,and prognostic role in myriad urologic malignancies,including testicular carcinoma,renal cell carcinoma(RCC),and upper urinary tract urothelial carcinoma.RCC represents 2%of all cancers with approximately 25%of patients presenting with advanced disease.Clear cell RCC(CCRCC)is the most common RCC,accounting for 75%-80%of all RCC.CASE SUMMARY A 71-year-old man presented with a history of benign prostatic hypertrophy.He was asymptomatic without any hematuria,pain,or other urinary symptoms.A computed tomography(CT)scan of the abdomen and pelvis showed a 1.8 cm left retroperitoneal lymph node.There was no evidence of renal pathology.A core biopsy was performed of the left para-aortic lymph node.Although the primary tumor site was unknown,the morphological and immunohistochemical features were most consistent with CCRCC.A RPLND was performed which revealed a single mass 5.5 cm in greatest dimension with extensive necrosis.The retroperitoneal lymph node was most compatible with CCRCC.A nephrectomy was not conducted as a renal mass had not been detected on any prior imaging studies.The patient did not receive any type of adjuvant therapy.The patient underwent surveillance with serial CT scans with contrast of the chest,abdomen,and pelvis for the next 5 years,all of which demonstrated no recurrent or metastatic disease and no evidence of retroperitoneal adenopathy.CONCLUSION Our unique case emphasizes the therapeutic role of metastasectomy in metastatic CCRCC even in the absence of primary tumor in the kidneys.
文摘目的探讨快速现场评价(rapid on site evaluation,ROSE)指导下的颈部淋巴结细针穿刺(fine needle aspiration,FNA)与常规FNA在效果和安全性上的差异。方法选取2013年10月至2018年10月阜阳市人民医院拟行颈部淋巴结FNA的病人84例,采用随机数字表法分为ROSE组和常规组,对穿刺针数、穿刺是否明确诊断、穿刺并发症进行观察。结果ROSE组总体明确诊断率(97.6%比81.0%)、并发症发生率(7.1%比23.8%)、穿刺进针次数[(1.24±0.58)次比(1.90±0.58)次]均优于常规组(P<0.05);对于长径小于1cm或位于IV区的淋巴结,ROSE组在明确诊断率上优于常规组;淋巴结位于IV区的病人,ROSE的并发症发生率优于常规组。结论应用ROSE技术有助于提高颈部淋巴结FNA的成功率和安全性。
