左中腎出現實性血管團塊，需要進一步檢查嗎？-泌尿科

Q: 左中腎出現實性血管團塊，需要進一步檢查嗎？

<p>Dear Claire：I’m sorry to tell you of my opinion about your condition. The Ultrasound report, mentioned to have a hypoechoic solid mass with vascularity at the mid portion of left kidney, may be mor

solid mass with vascularity in left middle kidney？

Dead Dr.Pan,I’’ve got an Ultrosound lab report about two weeks ago and they suggest me to take the CT Urogram to check out what’’s the solid mass with vasularity there in my left kidney. I need your comment on it and how bad it can be so I can make a decision to tell my father or not and where I can go under the medical care. Thanks a lot for your help. Here comes the Lab report,Indications: 25-year-old female with hepatitis B. Please evaluate.Findings:The liver is slightly coarsened in echo texture. The liver measures14.1 cm in longest dimension. No focal mass lesions are seen. Thereis no evidence of intra- or extrahepatic biliary dilatation. Thecommon bile duct measures 3 mm. The gallbladder is normal withoutgallstones, gallbladder wall thickening or pericholecystic fluidcollections.The kidneys were measured 10.4 cm on the right and 10.1 cm on theleft. There is no evidence of hydronephrosis, mass, stones orperinephric fluid collections. There is a hypoechoic mass in the midportion of the left kidney measuring 1.9 x 1.8 x 1.4 cm in diameter.This appears to be a solid mass as internal vascularity isidentified.The visualized portions of the pancreas and the spleen are normal inechogenicity.Conclusion:1. Coarsened liver echo texture.2. Hypoechoic mass in the mid portion of the left kidney.Recommend correlation with CT urogram.

Claire Wu，20~29歲女性，詢問日期：2004/04/07

潘正欽醫師回覆-泌尿科

Dear Claire:I’m sorry to tell you of my opinion about your condition. The Ultrasound report, mentioned to have a hypoechoic solid mass with vascularity at the mid portion of left kidney, may be more favored as a renal cell carcinoma, but benign cyst or other benign renal tumor can’t be excluded absolutely. And the CT or MRI examination is indicated for the next step.I don’t known where you are now. But I think that you should be better to discuss with your family about it, then you decide where you will receive further examinations & medical care.

回覆日期：2004/04/07

彙整補充說明

根據您提供的超音波檢查報告，左腎中部出現一個實性血管團塊，這是一個需要進一步檢查的情況。
報告中提到的「hypoechoic mass」指的是一個低回聲的腫塊，並且有內部血管化的現象，這可能暗示著腫瘤的存在。
雖然這個腫塊的大小為1.9 x 1.8 x 1.4公分，並不算特別大，但由於其特徵，醫生建議進行CT尿路造影（CT Urogram）以進一步評估。

在腎臟的腫塊中，可能的診斷包括良性腫瘤（如腎血管平滑肌脂肪瘤）或惡性腫瘤（如腎細胞癌）。
腎血管平滑肌脂肪瘤通常是良性的，且在許多情況下不需要立即手術，尤其是當腫瘤小於4公分且無症狀時。
然而，腎細胞癌則需要更為謹慎的處理，因為其可能會擴散並對健康造成威脅。

在這種情況下，進一步的CT掃描不僅能提供腫塊的詳細影像，還能幫助醫生評估腫瘤的性質、大小及其與周圍組織的關係。
這對於確定後續的治療方案至關重要。
若CT結果顯示腫瘤為惡性，則可能需要考慮手術切除或其他治療方式。

至於告訴家人，這是一個個人決定。
考慮到檢查結果的潛在嚴重性，與家人分享這些資訊可能有助於獲得他們的支持和理解，並共同決定後續的醫療步驟。

在選擇醫療機構方面，建議尋找有腎臟科或泌尿外科專家的醫院，這樣可以確保您獲得專業的評估和治療。
醫院的選擇也可以根據醫生的專業背景、醫院的設備及其在腎臟疾病方面的聲譽來決定。

總結來說，左腎的實性血管團塊需要進一步的CT檢查以確定其性質，並根據結果制定相應的治療計劃。
及早進行檢查和治療是非常重要的，這樣可以提高治療的成功率並減少潛在的健康風險。
希望您能夠儘快安排檢查，並在醫療專業人員的指導下進行後續的處理。
祝您健康！