肾细胞癌胃转移的临床病理学特征分析及文献复习  

Gastric metastases from renal cell carcinoma:a clinicopathological analysis and review of literature

作　　者：任风梅 刘芳 张慧 解建军 张洁 李玉军[2] REN Feng-mei;LIU Fang;ZHANG Hui;XIE Jian-jun;ZHANG Jie;LI Yu-jun(Department of Pathology,Qingdao Chengyang People’s Hospital,Qingdao 266109,China;Department of Pathology,the Affiliated Hospital of Qingdao University Medical College,Qingdao 266000,China)

机构地区：[1]青岛市城阳区人民医院病理科,山东青岛266109 [2]青岛大学医学院附属医院病理科,山东青岛266000

出　　处：《诊断病理学杂志》2022年第8期741-744,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨肾癌胃转移的临床特征、病理学形态、免疫组化特点及鉴别诊断。方法回顾性分析1例肾癌胃转移患者的临床资料并复习国内外相关文献。结果患者男性,84岁,因乏力、贫血就诊,CT及胃镜检查均显示胃底隆起性病变,病理活检示固有层内弥漫片状或巢状增生的肿瘤细胞,细胞形态温和,核小、核膜不规则,可见核仁,胞质透明或嗜酸,免疫组化表达CK、EMA、PAX-8、CD10及CAⅨ。结合患者17年前因肾透明细胞癌行右肾切除术史,病理诊断为胃转移性肾细胞癌。结论肾癌胃转移非常罕见,细胞形态相对温和,加上肾细胞癌的诊断到发现胃转移的平均时间较长,影像学和内镜表现无特殊性,因此病理诊断中极易误诊和漏诊,全面了解病史对正确的病理诊断至关重要。Objective To investigate the clinical,morphology,immunohistochemical features and differential diagnosis of gastric metastases from renal cell carcinoma.Methods The clinical data of a patient were analyzed retrospectively and the related literatures were reviewed.Results The patient was male and 84 years old.He was admitted to the hospital with severe fatigue and anemia.Both CT and endoscopy revealed a raised lesion in the fundus of the stomach.Histologically,the lesion demonstrated a bland cell proliferation forming sheet or nest within the lamina propria.The tumor cells had clear or eosinophilic cytoplasm,small nuclei,nuclear membrane irregularity,and occasional small pinpoint nucleoli.Immunohistochemically,the tumor cells exhibited immunoreactivity for CK,EMA and other RCC markers,such as PAX-8,CD10 and CAⅨ.Combined with the patient’s history who underwent radical nephrectomy for clear cell renal cell carcinoma(CCRCC)17 years ago,the pathological diagnosis was gastric metastases from renal cell carcinoma.Conclusion Gastric metastases from renal cell carcinoma is very rare.Tumor cells are relatively mild.In addition,the long time has passed from nephrectomy until the appearance of gastric metastases and without special image and endoscopy appearance,which is easily misdiagnosed.A comprehensive understanding of medical history is very important for correct pathological diagnosis.

关 键 词：肾细胞癌 胃转移 临床病理学 免疫组织化学 预后 

分 类 号：R737.11[医药卫生—肿瘤]