肾母细胞瘤临床细胞病理学分析  

Clinical cytopathological analysis of nephroblastoma

作　　者：李琼林[1] 康劲松[2] 李建木[1] 许玉兰[1] 

机构地区：[1]湖北省仙桃市第一人民医院儿科,湖北仙桃433000 [2]华中科技大学同济医学院附属同济医院病理科,湖北武汉430030

出　　处：《实用临床医药杂志》2013年第13期166-168,共3页Journal of Clinical Medicine in Practice

摘　　要：目的探讨肾母细胞瘤(Wilms瘤)的临床表现、细胞病理学特征,提高临床上对该瘤的识别水平。方法分析经组织病理学确诊的2例肾母细胞瘤的临床表现、细胞病理学特征及免疫表型,并结合相关文献进行讨论。结果例1,男,4岁,左腋下及右腹股沟可触及黄豆大小淋巴结各1枚;腹部隆起可触及包块,细胞病理学检查:针吸标本为血性颗粒状,镜下见猩红色均质物背景,较多小圆形肿瘤细胞,少许小梭形细胞;细胞病理学诊断:小细胞型肿瘤(考虑肾母细胞瘤)。例2,女,3岁半,未触及浅表淋巴结肿大;腹部可触及包块,细胞病理学检查,送检标本为鱼肉状,镜下见均质物背景,见大量弥漫排列的小圆形细胞,少许梭形细胞,可见细胞呈"菊花团"样;细胞病理学诊断:未分化恶性肿瘤(考虑肾母细胞瘤)。结论运用细胞病理学诊断小儿肾母细胞瘤较为少见,需要积累经验,还应注意与神经母细胞瘤、Ewing肉瘤、胚胎性横纹肌肉瘤、非霍奇金淋巴瘤进行区分与鉴别。Objective To analyze the clinical and cellular pathology characteristics of nephroblastoma（Wilms tumor） and increase the clinical understanding to this disease.Methods Two cases of Wilms tumor were retrospectively analyzed in terms of clinical symptoms,pathological characteristics and immunohistochemistry.The discussion was based on relevant literature that has been reviewed.Results Case 1,a 4-year-old boy,palpable soft left axilla and inguinal lymph nodes each with soya bean size.Cellular pathology： Fine needle aspiration specimen showed bloody grandular with homogeneous scarlet background,including many small round tumor cells and a few small spindle cells.Cellular pathology diagnosis： small cell tumor（considered Wilms tumor）.Case 2,a 3-and-half-year-old female patient,untouched superficial lymph nodes;papable abdominal mass.cellular sample showed homogeneous fabric background with many diffuse small round cells and a few spindle cells,some cells showed rossette arrangement,which was diagnosed as undifferentiated malignant tumor（Wilms tumor suspected）.Conclusion The application of pathology in diagnosis of neuroblastoma is still rare.More experience should be accumulated.It is important to differentiate neuroblastoma with Ewing sarcoma,rhabdomyosarcoma and non-Hodgkin′s lymphoma.

关 键 词：肾母细胞瘤 临床 细胞病理学 

分 类 号：R361[医药卫生—病理学]