肾集合管癌3例临床病理分析  

Collecting duct carcinoma of kidney:three cases report

作　　者：毛玉萍[1] 印洪林[1] 张彤 杨聪颖[3] 陆珍凤[1] 孙桂勤[1] 周晓军[1] 

机构地区：[1]南京军区南京总医院病理科 [2]江苏肿瘤医院病理科,南京210002 [3]连云港市第二人民医院病理科,江苏连云港222002

出　　处：《诊断病理学杂志》2004年第4期218-220,I057,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的　探讨肾集合管癌的临床病理特征。方法　对 3例外科治疗的肾集合管癌进行临床、组织学、免疫组化及超微结构观察 ,并结合文献复习。结果　本病发病年龄 35～ 4 2岁 ,临床无特殊症状 ,影像学检查提示肾细胞癌。病理上肿瘤主要位于肾髓质内 ,组织学瘤细胞呈管状、管状乳头状结构 ,胞质透明或颗粒状 ,核大 ,核仁清晰 ,典型的肿瘤细胞呈靴钉样 ,间质纤维增生 ,多量淋巴细胞浸润并有肿瘤旁集合管上皮细胞的异型增生。免疫组化显示CK(AE3)、EMA和vimentin(+) ,CD10、CEA、CK7和CK2 0 (- )。结论　肾集合管癌是一种少见的起源于集合管上皮的恶性肿瘤 ,肿瘤呈管状、乳头状排列 ,细胞呈靴钉状伴间质的纤维增生和炎细胞反应 。Objective To study the clinicopathologic characteristics of renal collecting duct carcinoma (CDC). Methods The clinical data,histopathologic changes and immunohistochemical finding were studied with review of the literature in 3 cases of CDC,in which one case was examined by electro-microscopy. Results The ages of the patients ranged from 35～42 years old.The clinical symptom of the patients displayed unspecific changes. Histological changes suggested renal cell carcinoma.Pathologically,the lesion located in renal medulla.The histological changes of the tumor showed prominent tubular or tubulopapillary structures,and the tumor cells displayed a granular or clear cytoplasm,a large nuclei and a predominant nucleolus,and some of them displayed a hobnail-like cells with desmoplastic stromal reaction and a large number of lymphoid cells infiltration.Simultaneously,the tubular epithelial atypical hyperplasia in site was observed in the adjacent renal medullary.Immuniohistochemically,the tumorous cells displayed a positive for CK(AE3),EMA,and vimentin,but a negative for CD10,CEA,CK7 and CK20. Conclusion Collecting duct carcinoma of kidney is a rare malignant tumor which derives from the renal collecting duct epithelial cells.It is characteristic that the tubular or papillary pattern is apparent with a hobnail-like tumorous cells formation and the desmoplastic stromal reaction. Differentiation from the papillary carcinoma and the renal medullary carcinoma of kidney should be considered when the diagnosis of the lesion is made.

关 键 词：肾集合管癌 肿瘤 临床病理分析 间质 乳头状 肾髓质 纤维增生 核仁 组织学 胞质 

分 类 号：R737.11[医药卫生—肿瘤] R736.1[医药卫生—临床医学]