肾脏后肾腺瘤1例报告并文献复习  

Metanephric Adenoma:A Case Report and Review of Literatures

作　　者：余强国[1] 甘艺平[1] 孙伟桂[1] 宋小松[1] 范照应[1] 肖玮琳[1] 郭智俊[2] 邹伟[2] 周慕珩[3] 吴秋良[4] 

机构地区：[1]广州医学院附属广佛医院泌尿外科,广东南海528251 [2]广州医学院附属广佛医院病理科 [3]中山大学附属一院病理科 [4]中山大学附属肿瘤医院病理科

出　　处：《临床泌尿外科杂志》2011年第1期44-46,共3页Journal of Clinical Urology

摘　　要：目的:探讨后肾腺瘤的临床病理学特征,提高对后肾腺瘤的认识。方法:分析1例29岁女性后肾腺瘤患者的临床病理资料,并结合相关文献进行讨论。结果:患者因腰部不适行B超检查发现右肾肿瘤,16层螺旋CT诊断为右肾肿瘤(良性可能大),行肾肿瘤剜除术,术中见肿瘤被膜完整,切面色灰白,质地均匀,术中冷冻切片诊断为乳头状肾细胞癌,随即行肾癌根治术。镜下肿瘤细胞呈腺样或乳头状排列,并有砂粒体。免疫组化:NSE(+)、Ki67、Vim为阳性。病理诊断:右肾后肾腺瘤。随访22个月,未见肿瘤复发。结论:后肾腺瘤术前难以依据影像学特征明确诊断,术前肿瘤穿刺活检结合免疫组化对明确诊断可能是一种可行的选择,更重要的是,了解其临床及病理特点有助于该肿瘤的准确诊断。后肾腺瘤的治疗多采取保留肾单位的手术,但由于其生物学行为及细胞起源的不确定性,术后长期随访观察是必需的。Objective： To explore the clinicopathological characteristics of metanephric adenoma （MA）. Methods： To analyze the clinical and pathological data of a 29 years old girl with metanephric adenoma and review relative literatures. Results： The tumor was incidentally detected by ultrasound （US）, and diagnosed as right renal tumor（benignT） by 16 slice spiral CT examination. Exenteration of right renal tumor was performed. The tumor measuring 3×3×2.7 cm had integrity tegument, homogeneous and a grey cutting surface. It was diagnosed as papillary renal cell carcinoma by frozen-section examination during operation. Radical nephrectomy of right renal was performed immediately. Histopathologically, the tumor cell formed a adenoid or papillary pattern and contained psammoma bodies, lmmunohistologically, they were positive for NSE, Ki67 and vimentin. Pathological diagnosis was metanephric adenoma. Follow-up data of 22 months were available and without recurrence. Conclusions： It is difficult to get the final diagnosis of metanephric adenoma only by imaging characters. A preoperative diagnostic biopsy combining with immnohistochemical staining technique may be a feasible choice to make a definite diagnosis. It is more important to understand its clinicopathological characteristics that are helpful for an accurate diagnosis. Nephron-sparing surgery is.eligible for the treatment of MA. Considering the uncertainty of the biological behavior and cellular origin of MA,a long-term active surveillance is necessary.

关 键 词：肾肿瘤 后肾腺瘤 病理学 

分 类 号：R737.11[医药卫生—肿瘤]