肾上腺皮质嗜酸细胞性肿瘤临床病理分析  

Clinicopathological features of adrenocortical oncocytic neoplasms

作　　者：闫广宁 李静 喻玲 叶丹丽 曾伟鹏 宗嘉雯 王卓才 YAN Guang-ning;LI Jing;YU Ling;YE Dan-li;ZENG Wei-peng;ZONG Jia-wen;WANG Zhuo-cai(Department of Pathology,General Hospital of PLA Southern Theatre Command,Guangzhou 510010,China)

机构地区：[1]中国人民解放军南部战区总医院病理科,广州510010

出　　处：《诊断病理学杂志》2023年第10期948-951,964,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的分析肾上腺皮质嗜酸性细胞肿瘤(ACONs)的临床病理特征,探索良恶性判别标准。方法收集2007—2021本院收治的ACONs根治手术标本17例,总结患者的临床及病理学特征,进行免疫组化及特殊染色实验,并查阅相关文献。结果患者临床症状不典型,肿瘤为单发肿块,包膜完整,肿瘤细胞呈腺泡状或实性片状排列,间质有丰富的毛细血管网。大部分肿瘤细胞大小较一致,体积大、多角形、上皮样,胞质丰富、明显嗜酸性。胞核圆形,有小而清晰的核仁,部分肿瘤细胞异型性较明显。肿瘤细胞表达Syn、Melan-A、α-Inhibin,不表达CgA,Ki-67增殖指数1%~30%。Lin-Weiss-Bisceglia评分5例为恶性,6例为恶性潜能未定,6例为良性。Helsinki评分恶性3例,交界性1例,良性有13例。网状纤维评分明显缺失4例,少量或无缺失13例。结论ACONs罕见,良恶性判别标准尚有争议,预后需LWB评分、Helsinki评分及网状纤维评分等多种方式综合评估。Objective To investigate the clinic-pathological features and the diagnostic criteria of malignant adrenocortical oncocytic neoplasms(ACONs).Methods Tumor samples of ACONs between 2007 to 2021 from our hospital were collected,and the clinical and pathological data were analyzed.Immunohistochemistry and reticular fiber staining were conducted on these samples.Results Patients with ACONs were vague clinical presentation.Tumors were solitary with intact capsule.Tumor cells were arranged in acinar or solid patches,with abundant capillary networks in the stroma.These cells were similarly enlarged in volume,polygonal and epithelioid shaped,rich in acidophilic cytoplasm.The nuclei were round with small and syllable nucleoli.Some tumor cells were apparently atypia.ACONs cells were positive for Syn,Melan-A,α-Inhibin,negative for CgA.Ki-67 index were 1%-30%.Using Lin-Weiss-Bisceglia score system,5 were malignant,6 were undetermined malignant potential,and 6 were benign.As to Helsinki score,13 were benign,1 was borderline,and 3 were malignant.Besides,13 of them were scored as no or few absence,while 4 of them were obviously absence,under reticular fiber scores system.Conclusion ACONs are rare,which malignant diagnostic criteria are still controversial.Prognosis prediction may rely on comprehensive assessment of these score systems and reticular fiber staining.

关 键 词：肾上腺皮质肿瘤 嗜酸细胞 Lin-Weiss-Bisceglia Helsinki 网状纤维 

分 类 号：R736.6[医药卫生—肿瘤]