Ductus-Bellini-Karzinom
Ductus-Bellini-Karzinom
(Sammelrohrkarzinom) in der Computertomographie axial und coronar bei einem 80-jährigen am unteren Pol der linken Niere. Der Tumor ist multipel ossär metastasiert.
Ductus-Bellini-Karzinom
(Sammelrohrkarzinom) in der Computertomographie axial bei einem 80-jährigen am unteren Pol der linken Niere. Der Tumor ist multipel ossär metastasiert (rechtes Bild).
Extrarenal
multiorgan metastases of collecting duct carcinoma of the kidney: A case series. A 55-year-old man with autopsy-confirmed collecting duct carcinoma and pulmonary, liver, and lymph node metastases. A. Computed tomography scan shows an enlarged right kidney and an ill-defined mass (arrows). B. Early phase computed tomography reveals slow and heterogeneous enhancement of the lesion. C. Delayed phase computed tomography reveals slow and heterogeneous enhancement of the lesion. D. Computed tomography scan through the upper lung shows multiple cavitary lesions (arrows). E. Autopsy specimen reveals hemorrhagic nodules with central cavities (arrows) in both lungs. F. Enhanced computed tomography shows a low-attenuation area (arrow) with minimal enhancement in S4 of the liver. G. Autopsy specimen demonstrates a mass in S4 (arrow) with hemorrhagic and necrotic changes. H. Enhanced computed tomography shows a marginally enhanced nodule in the para-aortic area. I. Gross examination reveals a lymph node with central necrosis (arrow).
Extrarenal
multiorgan metastases of collecting duct carcinoma of the kidney: A case series. A 70-year-old man with autopsy-confirmed collecting duct carcinoma and bony metastases. A. Unenhanced computed tomography shows a poorly defined medullary tumor with infiltrative growth. The renal contour is intact. B. Early phase enhanced computed tomography scan reveals mild enhancement of the lesion. C. Delayed phase enhanced computed tomography scan reveals mild enhancement of the lesion. D. Computed tomography shows osteolytic (thin arrows) and osteosclerotic lesions (thick arrows) in the ilium and sacrum. E. Photomicrograph (×200, hematoxylin and eosin stain) demonstrates osteosclerotic changes (thin arrows) and tumor cells (thick arrows). F. Photomicrograph (×200, hematoxylin and eosin stain) shows osteolytic changes (thin arrows) and tumor cells (thick arrows).
Imaging
analysis of 13 rare cases of renal collecting (Bellini) duct carcinoma in northern China: a case series and literature review. a Case 8: coronal enhanced CT image shows a left kidney collecting ductal carcinoma (CDC). The tumor involves the renal cortex, medulla, and renal pelvis. The boundary is unclear (arrows). b Case 12: coronal unenhanced CT image shows a right kidney mass-type CDC. The tumor compresses the surrounding renal cortex and medulla. The boundary is obvious, and is considered the compressed renal cortex (arrows)
Imaging
analysis of 13 rare cases of renal collecting (Bellini) duct carcinoma in northern China: a case series and literature review. a Case 3: axial unenhanced CT image shows a significant increase in the volume of the left kidney CDC. The left medulla is unclear. The lesions are mainly solid components (arrows). b Case 6: axial unenhanced CT image shows mixed density in the left kidney and a clear cystic low-density lesion with a clear border (arrows)
Imaging
analysis of 13 rare cases of renal collecting (Bellini) duct carcinoma in northern China: a case series and literature review. a Case 10: axial unenhanced T2WI image shows that the left kidney CDC signal is lower than that of the normal renal parenchyma. The renal pelvis and renal medulla are unclear (arrow). b Axial unenhanced fat-saturated T2WI image shows a slightly lower signal than that of the normal renal parenchyma (arrow)
Imaging
analysis of 13 rare cases of renal collecting (Bellini) duct carcinoma in northern China: a case series and literature review. Case 5: axial unenhanced/enhanced CT image of the CDC shows that the right renal medulla is unclear. The internal density is uneven with light-moderate delayed enhancement (arrows)
Imaging
analysis of 13 rare cases of renal collecting (Bellini) duct carcinoma in northern China: a case series and literature review. Case 5: right kidney of collecting ductal carcinoma. Volume rendering images (a) and maximum intensity projection images (b) of arterial contrast-enhanced CT show the pressure from the right renal artery (arrows)
Imaging
analysis of 13 rare cases of renal collecting (Bellini) duct carcinoma in northern China: a case series and literature review. Case 11: a PET/CT images of renal CDC show significant concentration in the left kidney area with a maximum SUV of 14.9 (arrow). b PET/CT and simulated X-ray fusion images show significant concentration in the left kidney region with a maximum SUV of 14.9 (arrow). c Case 3: PET/CT image shows increased metabolism of the left renal CDC with extensive systemic metastases including mediastinal, retroperitoneal lymph node metastasis, homolateral adrenal gland, bilateral lungs, bilateral pleura, right ribs, left scapula, and right side pubic symphysis (arrows)
Imaging
analysis of 13 rare cases of renal collecting (Bellini) duct carcinoma in northern China: a case series and literature review. Case 6: a axial enhanced CT image shows left renal CDC. Axial arterial phase image showing multiple retroperitoneal enlarged lymph nodes with marginal mild enhancement (arrows). b Axial delayed phase image shows further strengthening, which is similar to renal CDC (arrows)
Das Sammelrohrkarzinom der Niere, auch Ductus-Bellini-Karzinom, ist eine seltene (ca. 1%) Form des Nierenzellkarzinoms, welche von den Zellen der Sammelrohre ausgeht. Es zeichnet sich durch eine besondere Aggressivität mit entsprechend schlechter Prognose aus.
Epidemiologie
Diese Form des Nierenkarzinoms tritt vorzugsweise im zweiten bis vierten Lebensjahrzehnt auf und betrifft damit typischerweise jüngere Patienten als die häufigeren anderen Karzinome der Niere. Männer sind häufiger betroffen als Frauen.
Radiologische Merkmale
Aufgrund der Seltenheit des Ductus-Bellini-Karzinoms sind die radiologischen Kriterien nicht so umfassend untersucht wie bei anderen Nierentumoren. Es finden sich solide Formen oder solide und zystische Anteile. Der medulläre Anteil der Niere kann maskiert sein. Insgesamt wird häufiger eine medulläre Lage bei kleineren Tumoren mit erhaltener äußerer Nierenkontur beobachtet. Die Kontrastmittelanreicherung in der CT ist heterogen und eher gering ausgeprägt. Vereinzelt wurden kleine, sandartige Verkalkungen gefunden. Im PET-CT (F18-FDG) findet sich eine deutliche metabolische Aktivität, so dass sich die häufig schon zum Diagnosezeitpunkt vorhandene Metastasierung mit dieser Methode zeigen lässt.
Siehe auch:
Assoziationen und Differentialdiagnosen zu Ductus-Bellini-Karzinom: 
Transitionalzellkarzinom
des Nierenbeckens
