肾原发性平滑肌肉瘤2例及文献复习  

Primary leiomyosarcoma of the kidney:2 cases report and literature review

作　　者：章宜芬[1] 黄志勇[1] 周祀侨[1] 周强[1] 

机构地区：[1]南京大学医学院附属鼓楼医院病理科,南京210008

出　　处：《临床与实验病理学杂志》2001年第6期459-462,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的 :探讨原发于肾脏的平滑肌肉瘤的临床病理学特点、诊断、治疗、组织发生及预后诸因素。方法 :2例均行B超、CT或MRI检查 ,均进行病肾根治性切除术 ,其中 1例术后失访 ,另 1例术后未进行任何治疗。对 2例肾平滑肌肉瘤进行常规HE、组织化学及免疫组织化学染色观察。结果 :未进行任何辅助治疗的患者于手术 1年后死亡。 2例显微镜下表现、组织化学及免疫组织化学染色均显示平滑肌源性肿瘤的特点。结论 :肾原发性平滑肌肉瘤少见 ,临床诊断较困难 ,但有其病理特征 ,依靠肾切除标本的病理检查 ,配以组织化学染色和免疫组织化学染色可确诊。复习文献 ,该肿瘤恶性度高 ,且位置深 ,一般发现已属晚期 ,故预后甚差。化疗、放疗效果均不理想 ,手术切除病肾是唯一可行方法。Purpose To report two cases of leiomyosarcoma of the kidney. The clinical features, diagnosis and therapeutic aspects, histogenesis as well as the prognostic factors of this tumor were reviewed. Methods The clinical diagnosis was confirmed by ultrasonic examination, CT or MRI. Both the patients underwent radical nephrectomy, one patient's follow up was lost, and the other one received no chemotherapy or radiotherapy postoperatively. Two specimens were stained with hematoxylin and eosin(HE), histochemical and immunohistochemical methods. Results The patient without adjuvant therapy died 1 year after the operation. The features of H E, histochemical and immunohistochemical staining showed that the tumor was originated from smooth muscle. Conclusions Leimyosarcoma of the kidney is an uncommon malignant mesenchymal tumor. It is difficult to make the diagnosis for clinicians doctor. The tumor has its pathological features, so a definite diagnosis can be made with the pathological examination of the kidney. This tumor is high malignant with a poor prognosis. The treatment of choice is by radical nephrectomy.

关 键 词：肾肿瘤 平滑肌肉瘤 病理学 诊断 治疗 

分 类 号：R737.11[医药卫生—肿瘤]