肾管状囊性癌一例并文献复习  

A case of tubulocystic carcinoma of kidney and literature review

作　　者：郭嫦媛[1] 曹鹏[1] 薛学敏[1] 王冰凝[1] 管考鹏[2] 关有彦[2] 郑闪[1] 

机构地区：[1]中国医学科学院肿瘤医院病理科,北京100021 [2]中国医学科学院肿瘤医院泌尿外科,北京100021

出　　处：《肿瘤研究与临床》2015年第12期831-834,共4页Cancer Research and Clinic

摘　　要：目的 探讨肾管状囊性癌（TC）的临床病理学特征、诊断及鉴别诊断方法。方法 对1例TC患者标本行HE和免疫组织化学染色，并复习相关文献。结果 患者为43岁男性，因B型超声检查发现右肾上极占位2个月入院，行右肾部分切除术。肿物位于肾实质内，大体呈灰白色，实性，大小1.5 cm×1.5 cm×1.0 cm，质细，与周围组织界线欠清。显微镜下观察：肿瘤呈浸润性生长，由排列紧密的小管状及囊状结构组成，被纤细的纤维化间质分隔。管腔及囊壁被覆单层扁平、立方及靴钉样细胞，胞质丰富、嗜酸性，核仁明显，类似于Fuhrman 3级的细胞核特征。免疫表型呈细胞角蛋白阳性，CD10^＋＋＋，P504S^＋＋＋，低Ki-67增殖指数。术后随诊6个月，无肿瘤复发及转移。结论 TC是一类特殊的肾细胞癌亚型，显微镜下呈现特征性的管状、囊状结构，细胞核分级高但核分裂象罕见，诊断时需与其他肾囊性病变相鉴别。TC呈惰性生物学行为，较少出现复发及远处转移。Objective To investigate the tubulocystic carcinoma （TC） of kidney in diagnosis and differential diagnosis, clinical and pathological features. Methods A case of TC was performed with HE and immunohistochemical staining, with review of the related literature. Results A man of 43 years old, who was found an occupying in the upper pole of the right kidney by B ultrasound, was performed ill-circumscribed of the right kidney. A gray solid ill-circumscribed mass was found within the renal parenchyma,which was sized of 1.5 cm × 1.5 cm × 1.0 cm. Microscopically, the tumor showed an invasive growth, and that it was composed of small tubular and vesicular structure closely spaced with slender fibrosis mesenchymal. The epithelial cells lining the tubules and cysts were flattened, cuboidal and hobnail cells, with abundant eosinophilic cytoplasm and obvious nucleolus of Fuhrman grade 3. The tumor showed positive of cytokeratin, CD10^＋＋＋ and P504S^＋＋＋, with low Ki-67 labeling index. Postoperative follow-up of 6 months, the patient showed no tumor recurrence and metastasis. Conclusions TC is a special subtype of renal cell carcinoma, with a tubular and cystic structure, high nuclear grade and rare mitotic. The differential diagnosis mainly includes other renal cystic lesions. The biological behavior of TC is indolent with less recurrence and distant metastasis.

关 键 词：肾肿瘤 管状囊性癌 免疫组织化学 诊断 鉴别 预后 

分 类 号：R737.11[医药卫生—肿瘤]