25例肾血管平滑肌脂肪瘤的临床病理观察  

Clinicopathologic features of renal angiomyolipoma:a study of 25 cases

作　　者：郭梅[1] 赵一电 杨海军[1] 李军扩[1] 

机构地区：[1]安阳市肿瘤医院病理科,河南安阳455000

出　　处：《现代肿瘤医学》2014年第5期1140-1142,共3页Journal of Modern Oncology

摘　　要：目的:探讨肾血管平滑肌脂肪瘤(RAML)的临床病理特点及诊断与鉴别诊断。方法:回顾性分析经术后病理证实的25例RAML患者的临床表现、形态特征及免疫表型特点。结果:肿瘤长径2-20cm,平均8.5cm,除去1例伴发对侧肾脂肪瘤外其余24例均为单病灶。18例有症状,其中14例腰腹胀痛,4例有血尿,7例无症状者于体检或因其他疾病影像学检查时偶然发现。病理检查经典型者24例,由血管、平滑肌和脂肪组织呈不同比例构成。术前76.2%(16/21)的患者B超提示RAML,78.3%(18/23)患者CT扫描提示RAML。术中冰冻9例,8例明确诊断RAML,1例延迟诊断,术后病理诊断为上皮样型RAML。结论:影像学检查对于RAML有较高的特征性。术前进行影像学检查,绝大多数患者可被提示或者明确诊断为RAML。病理切片辅以免疫组化检查对RAML的诊断和鉴别诊断有决定性意义。Objective：To investigate the diagnosis and differential diagnosis of renal angiomyoliPoma（RAML）by analyzing their clinicoPathological features. Methods：The clinical and Pathological features of 25 cases of RAML were retrosPectively analyzed. Results：Of 25 cases there were 8 males and 17 females,age ranged from 20 to 69 years（me-dian age：42. 8 years）. 18 Patients Present with some symPtoms：14 cases with waist Pain and 4 cases hematuria,while 7 were asymPtomatic and detected as an incidental finding on imaging examination. On gross examination,the tumors ranged from 2cm to 20cm in maximum diameter（mean size：8. 5cm）. Most of cases were single lesion（96% ,24 / 25） excePt one case accomPanied with liPoma of the contralateral kidney. 76. 2% of Patients（16 / 21）and 78. 3% of Pa-tients（18 / 23）were diagnosed as RAML by B - ultrasound examination or CT scan resPectively before surgery. eisto-logically,24 cases were diagnosed as classic RAML mainly comPosed of blood vessles,smooth muscle and fat in differ-ent ProPortions,while only one was diagnosed as ePithelioid RAML with the delayed diagnosis by intraoPerative frozen section. Conclusion：It＇s helPful to undergo imaging examination for diagnosis of RAML. The majority of cases were di-agnosed by imaging method. BioPsy suPPlemented by immunohistochemistry is of significance in the diagnosis and dif-ferential diagnosis of RAML.

关 键 词：肾脏肿瘤 诊断 鉴别 免疫组织化学 

分 类 号：R737.11[医药卫生—肿瘤]