how to diagnose and differentiate Wilms tumor-Wilms tumor is easy to confuse the disease
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Differential diagnosis of Wilms tumor
1. Abdominal lumps and abdominal distension appear with hydronephrosis, but the lumps are cystic and move up and down with breathing, without obvious anemia and weight loss. Intravenous urography showed that the renal pelvis and calyces were dilated or the affected kidney was not developed. B-mode ultrasound showed large liquid dark areas, each liquid dark area communicated with each other, and the renal cortex became thin. CT examination has watery density shadow and enlarged renal pelvis and calyces, and the renal cortex becomes thin, which can be diagnosed as hydronephrosis. MRI examination can show the renal pelvis, ureteral dilation, and water accumulation on the transverse image, coronal or sagittal image. Radionuclide renal function dynamic imaging is mainly used to reflect renal function. Hydronephrosis is shown as a radioactive defect area of the location and shape of the renal pelvis and calyces.
2. Polycystic kidneys are manifested by bilateral abdominal masses, which are at a later age and have renal dysfunction such as proteinuria. Cystic masses can be palpable in both kidneys, which follow breathing activity. Plain radiographs of urinary tract generally have no calcification; urography, renal pelvis and calyces have multiple arc-shaped impressions, or they are stretched or elongated due to compression. B-mode ultrasound and CT examination showed that the shadows of the kidneys were enlarged, and the renal cortex was occupied by multiple large and small cysts, and the fluid in each cyst could not communicate with each other.
3. Retroperitoneal neuroblastoma mostly occurs in infants and young children, manifested as abdominal masses. But the course of the disease is developing rapidly. Urography, B-mode ultrasound, and CT examination showed that the kidneys were compressed and displaced, but the morphology of the renal pelvis and calyces remained unchanged.
4. The abdominal mass of retroperitoneal teratoma is similar to it. But the tumor grows slowly and the whole body is in good condition. Irregular calcified plaques are common in plain urinary tract X-ray films. Imaging examinations show that the kidney is compressed and displaced, and the renal pelvis and calyces are normal.
The differential diagnosis of abdominal masses in children should include hydronephrosis, multicystickidney, neuroblastoma, teratoma, and Wilms tumor.
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