Juxtaglomerular cell tumor：how to identify this rare disease by ultrasound?

Abstract Purpose：To study the value of ultrasound in the diagnosis of juxtaglomerular cell tumor (JGCT). Methods: From January 2005 to July 2020, fifteen patients diagnosed as JGCT by surgical pathology in Peking Union Medical College Hospital were collected. All patients underwent preoperative ultrasound examination. The clinical, laboratory, ultrasound, computed tomography (CT), surgical, and pathological features of the patients were analyzed retrospectively. Results: The 15 patients were 5 males and 10 females with a median age of 29 years (10~72 years). 14 of them had hypertension and one had normal blood pressure. The tumors were all solitary, with a median diameter of 1.5 cm (0.9-5.9 cm). Among the fifteen patients, eleven were corrected detected by preoperative ultrasound, and four were missed. There was a significant difference in tumor size (2.64±1.48 cm vs. 1.23±0.21 cm) and whether the tumor protruded outward (9/11 vs. 0/4) between the ultrasound-detected group and the ultrasound-missed group (p=0.010, p=0.011). Of the 11 tumors detected by ultrasound, four were extremely hypoechoic, two were hypoechoic, three were isoechoic, and two were hyperechoic. Color Doppler showed no blood flow in five tumors no more than 2cm, and mild blood flow in six tumors more than 2cm. Conclusions: JGCT is rare, and has characteristic clinical manifestations. Diagnosis should be suspected in case of secondary hypertension, particularly in young women, if no renal vascular cause is found. Ultrasound, combined with clinical manifestations, was helpful for the diagnosis.