肾脏集合管癌的临床病理观察  

Clinicopathologic features of collecting duct carcinoma of the kidney—report of 5 case and review of literature

作　　者：黄英杰 李昌水 葛荣 刘创峰 王德尚 

机构地区：[1]宁波市临床病理诊断中心组织病理诊断三部,鄞州第二医院,浙江宁波315031

出　　处：《中国癌症杂志》2013年第9期733-736,共4页China Oncology

摘　　要：背景与目的:肾脏集合管癌少见,不足肾脏恶性肿瘤的1%,肿瘤侵袭性强,超过50%的患者在首次诊断时已经发生转移。集合管癌的诊断常很困难,往往需要排除性诊断。本研究观察肾脏集合管癌的临床病理学特点、免疫组化特征,探讨其病理诊断及鉴别诊断。方法:收集5例肾脏集合管癌的患者资料,进行病理组织学观察,免疫组织化学染色(EnVision法)检测CK19、CAM5.2、CK7、Vimentin、CD10、P63和PaX-8。结果:肾脏集合管癌临床症状以血尿、腹痛、腹块为主;肿瘤主要起源于肾脏中央区的髓质,组织学以不规则的腺管状或管状乳头状结构,伴炎性纤维组织增生性间质为主要形态学表现;免疫组化检测结果显示,5例肾脏集合管患者中,CK19、CAM5.2、PaX-8均为阳性表达,2例Vimentin存在阳性表达、1例CK7阳性表达,CD10、P63表达均为阴性。结论:肾脏集合管癌的病理诊断主要依靠病理组织学形态,以及使用免疫组化进行排除性的鉴别诊断。Background and purpose： Collecting duct carcinomas of the kidney are a rare malignant tumor accounting for 〈1% of renal malignancies. It is associated with aggressive nature and more than 50% of patients have metastatic disease at the time of initial diagnosis. The diagnosis of collecting duct carcinoma is often difficult and to some extent is one of exclusion. This study aimed to study the clinicopathologic features of collecting duct carcinoma of the kidney. Methods： We retrieved the data of five cases of collecting duct carcinomas of the kidney from pathology files, and determined the expressions of CK19, CAMS.2, CK7, Vimentin, CDI0, P63 and PAX-8 by pathohistological observation and immunohistochemical examination. Results： The most common symptoms were blood urine, bellyache and abdomen mass. The tumor originated from the medulla of the kidney central zone. Histologically, the tumors demonstrated irregular tubular or papillary architecture with the stroma of inflammatory cells and fibrous tissue proliferation, lmmunohistochemically, the tumor ceils were positive for CK19（5/5）, CAM5.2（5/5）, PaX- 8（5/5）, Vimentin（2/5）, CK7（1/5）, and negative for P63, CD10. Conclusion： The correct diagnosis in collecting duct carcinomas of the kidney is based on characteristic morphological features and immunophenotype labeling.

关 键 词：肾脏集合管癌 免疫组化 病理诊断 鉴别诊断 

分 类 号：R737.11[医药卫生—肿瘤]