wilms tumor examination, Wilms tumor diagnosis
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Common examinations for Wilms tumor
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- Plain abdominal radiographs and lumbar nuclear medicine for the abdomen often...
- Abdominal CT abdomen Gastrointestinal Pathology Tumor Health Care digestion abdominal CT role ...
- Chest plain film chest - chest film adaptation...
1. Blood routine usually has mild anemia and hemoglobin is lower than normal. But there are also a few who have an increase in red blood cells, which may be related to the increase in erythropoietin.
2. Blood test kidney function is normal, plasma protein is reduced. The sedimentation rate of erythrocytes generally increases by 15-90mm/h, and the sedimentation rate of extremely large advanced tumors increases more significantly, which is considered to be an indicator of poor prognosis.
3. Chromosome examination In patients with aniridia-ilms tumor syndrome, the 11th pair of chromosomes is missing in the short arm region.
4. Many people have hematuria and proteinuria in urine microscopy, but most cancer cells cannot be found in urine.
5. Bone marrow puncture can be done for those who are not easily distinguished from neuroblastoma.
1. The appearance of the kidney on plain film of urinary system disappeared, and soft tissue masses with clear edges were seen, and a few cases were scattered with fine spot-like calcifications.
2. Urography includes renal artery and vein angiography. Renal artery angiography shows that the blood vessels in the kidney are pushed or straightened, tumor blood vessels appear, renal veins are developed early, the distribution of contrast agent is uneven, renal veins are thickened and tumor thrombosis is blocked. This examination found that 2/3 of the affected side renal pelvis and renal calyces were squeezed, displaced, elongated, deformed or destroyed; 1/3 of the affected side kidneys were compressed, the renal pelvis was filled with tumors or renal blood vessels were embolized and did not develop. , Or only a little contrast agent enters the renal pelvis. When the tumor is large, the ureter on the affected side shifts to the midline.
3. B-ultrasound B-ultrasound is very sensitive in identifying cystic or solid masses, which can provide diagnostic clues for mixed cystic and solid Wilms tumor.
4. In addition to CT scans that can show huge kidney masses, because there are often hemorrhage, necrosis, and cystic changes in the tumor, the masses are often heterogeneous, and even form lesions dominated by giant cystic masses, with thick and inconsistent cyst walls. Rule, 15% of cases may have calcification. CT scan is the most effective way to identify solid or cystic, and to find other organ diseases. Exclude whether the contralateral kidney is involved, and differentially diagnose hydronephrosis, renal cystic disease, adrenal tumor and hematoma. The most common metastatic site of Wilms tumor is the lung. Chest X-ray and lung CT scan can be used to rule out metastasis. Other examinations can be determined according to clinical needs, such as bone scan and liver scan or bone marrow examination.
5. The puncture biopsy tumor occurs from embryonic kidney tissue. It is a malignant mixed tumor composed of epithelium and stroma. The tumor tissue includes glands, nerves, muscles, cartilage, fat, etc. The cut surface is gray-yellow, with cystic degeneration, flaky hemorrhage and calcification, and there is no obvious boundary with normal kidney tissue. The tumor destroys normal kidney tissue, deforms the renal pelvis and calyces, and rarely invades the renal pelvis. The route of metastasis is the same as that of kidney cancer. Bilateral Wilms tumors account for 5% to 10%. Histopathological examination showed that the tumors were of different sizes, with thin and brittle pseudocapsules, and the cut surface was fish-like
, Light yellow or gray, necrosis, bleeding, clear or bloody fluid in scattered pseudocysts.
Needle biopsy should be avoided when a neoplastic mass is suspected on the waist of a child to avoid tumor dissemination. Surgical exploration is still necessary.
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