多房性囊性肾癌一例报告及文献复习  

Multilocular cystic renal cell carcinoma：a case report and literature review

作　　者：鲁力[1] 马建辉[1] 李长岭[1] 

机构地区：[1]中国协和医科大学中国医学科学院肿瘤医院泌尿外科,北京100021

出　　处：《中华泌尿外科杂志》2009年第6期397-400,共4页Chinese Journal of Urology

摘　　要：目的提高多房性囊性肾癌的诊治水平。方法多房性囊性。肾癌患者1例，男，49岁。体检B超偶然发现右肾下极多囊性肿物1个月。囊内无回声区，其间混杂低回声区；CT检查右肾下极见多囊性低密度病变，边界清楚、光整，内见薄壁分隔，增强扫描分隔可见强化；MRI检查示右肾下极多囊性病变．增强扫描囊壁可见强化。行右肾部分切除术，完整切除肿瘤。结果病理报告：肾被膜下见多房状肿物．大小约3．0cm×2．0cm×2．0cm，囊壁光滑，腔内含清亮的浆液性及血性液体，囊壁厚约0．1～0．2cm，与肾周脂肪粘连。镜下多数囊腔内衬单层或复层立方状透明细胞，细胞核小而圆，位于细胞中央，无明显核仁；有的囊腔内衬扁平上皮细胞或无内衬上皮，偶见由透明细胞覆盖的小乳头；囊腔间隔由胶原纤维组成，部分间隔内可见灶状透明细胞，但未形成肉眼可见的结节。病理诊断：多房性囊性肾癌。术卮随访20个月未见复发和转移。结论多房性囊性肾癌是肾癌的一种罕见亚型，发病率低，是一种完全由囊腔构成的肿瘤；影像学检查可提供直接咴据，确诊需依靠病理学检查．外科手术治疗预后良好。Objective To discuss the diagnosis and outcome of multilocular cystic renal cell carcinoma. Methods The clinic data of 1 case of multilocular cystic renal cell carcinoma were reviewed with its clinical manifestation, imaging, pathology and therapy in our hospital. The male patient aged 49 was incidentally found to have a right renal tumor. The CT scan showed a multilocular cystic tumor in the low pole of the right kidney with a clear outline. The thin septa were found in the tumor, which were enhanced in the enhancement CT scan. The enhancement MRI showed the cystic wall was enhanced. Results The patient received a partial nephrectomy as his treatment. The pathological characteristics were as following： the multilocular cystic tumor was about 3 cm× 2 cm× 2 cm with clear serosity in it. The cystic wall was smooth with the width of 0.1--0.2 cm. Most of the cystic cavities were covered by monostratified or stratified cubic clear cells, and some were covered by squamous epi thelium or no epithelium at all. The septum was composed of collagen fiber, and clear cells were found in it. The clear cells form small collections but do not form expansile nodules. The final pathological diagnosis was multilocular cystic renal cell carcinoma. The follow-up was 20 months, without local re- currence or distant metastasis was found. Conclusions Multilocular cystic renal cell carcinoma （MCRCC） is a rare variant of renal cell carcinoma with a good prognosis. MCRCC is an uncommon tumor of the kidney composed of multiple cysts with clear cells in the septa indistinguishable from grade I renal cell carcinoma. Most patients are asymptomatic and the tumors are discovered inciden tally. The preoperative diagnosis of MCRCC immediately depends on imaging studies. Pathology is the key to diagnosis.

关 键 词：多房性囊性肾细胞癌 临床研究 文献复习 诊治水平 

分 类 号：R686[医药卫生—骨科学]