肾上皮样血管平滑肌脂肪瘤2例及文献复习  

Epithelioid angiomyolipoma of the kidney:a report of two cases and literature review

作　　者：王小龙[1] 魏海霞[2] 韩哲[3] 赵杰[3] 姚欣[1] 

机构地区：[1]天津医科大学附属肿瘤医院泌尿肿瘤科,天津市肿瘤防治重点实验室,天津市300060 [2]天津市南开区王顶堤医院妇产科 [3]天津医科大学基础医学院

出　　处：《中国肿瘤临床》2013年第4期229-232,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨肾上皮样血管平滑肌脂肪瘤(epithelial angiomyolipoma,EAML)的临床病理特征,进一步认识本疾病。方法:回顾性研究2002年7月至2012年8月2例肾EAML患者的临床及病理资料并进行随访,结合复习文献,对其临床病理特点、生物学行为及预后进行分析。结果:2例患者都为女性,平均年龄47.5岁,均为左肾EAML。无明显阳性体征,2例在B超和CT均发现肾占位,其中1例CT强化不均匀,1例增强检查呈渐进性强化,延迟期强化程度略减低。分别行左肾部分切除术和根治性左肾切除术。组织形态学的主要特征均呈明显的上皮样分化。结论:分析结果提示:EAML生物学行为与经典型肾AML不同特征在于浸润性生长方式、细胞学异型性,CT对其诊断有重要意义,但病理结合免疫组化能够确诊,手术是主要的治疗方法,其预后大多数良好。Objective： This study aimed to analyze the histopathological and immunohistological characteristics, biologic behaviors, and prognosis of two cases of recurrent renal epithelioid angiomyolipoma （EAML）. Methods： Two cases of EAML were identified between July 2002 and August 2012 in our institute. Review of literature, as well as observation and analysis of clinical pathological features, biological behavior, and prognosis, was conducted. Results： The two cases involved in this study were both females whose average age was 47.5. The EAML both occurred on the patients＇ left kidney. Through computed tomography （CT） one of them was found to show non-uniform enhancement. Enhanced CT showed progressive strengthening and slight reduction in size. Partial nephrectomy of the left kidney and radical left nephrectomy were used for treatment. The epithelioid cells were arranged in nests or in sheets; the epithelioid cells were large with round or polygon shape. Conclusion： he primary difference between epithelioid AML and classic AML of the kidney is the manifestation of rare biological behaviors of invasive proliferation and histological features of atypical hyperplasia. CT is important in making a definite diagnosis by pathology and immunohistochemistry. Surgery is the main treatment method, and no standard prognosis exists to date.

关 键 词：肾脏 上皮样血管平滑肌脂肪瘤 诊断 治疗 预后 

分 类 号：R737.11[医药卫生—肿瘤]