多囊性肾细胞癌临床病理分析  

Clinical and pathological analysis of multi-cystic renal cell carcinoma

作　　者：冯晓云 侯国胜 徐康宁 

机构地区：[1]乌鲁木齐市友谊医院病理科,新疆乌鲁木齐830000

出　　处：《新疆医学》2016年第2期170-173,共4页Xinjiang Medical Journal

摘　　要：目的探讨多房性囊性肾细胞癌（MCRCC）的临床病理特点。方法对5例多房性囊性肾细胞癌进行临床特点,形态学和免疫组织化学比较。结果 5例患者中男性3例,女性2例,年龄39~57岁,平均年龄48岁,术后随访8~60个月,均无复发或转移。临床上多为体检发现,临床无明显症状。形态学检查：肾脏轮廓正常,肿物境界清楚,似有包膜,直径2.5~3.7cm。切面见大小不等,互不相通的囊腔,其内充满浆液性或血性液体,未见坏死组织。镜下观察：瘤组织由多个大小不一的囊腔构成,大部分囊腔内衬单层透明细胞,少部分为双层上皮细胞;间隔内可见小灶状透明细胞,其间血管丰富,未见坏死。细胞呈扁平状或肥胖状,胞浆透明或淡染,细胞核小而圆,染色质深染。5例肿瘤细胞Fuhrman核分级均为I级,均无血管浸润和包膜侵犯。免疫组织化学染色：5例肿瘤细胞CK、Vimentin、EMA、LCK、CK8均呈强阳性表达,CD10、CD68均为阴性。结论多房性囊性肾细胞癌有独特的病理改变,是一种少见的肾细胞癌组织学亚型,经过积极地治疗预后良好,免疫组化标记CK、Vimetin、EMA、LCK、CK8均呈强阳性表达,CD10、CD68则呈阴性表达。Objective To investigate clinical and pathological features about the multi-cystic renal cell carcinoma（MCRCC）. Methods5 cases undergoing multilocular cystic renal cell carcinoma were compared about clinical characteristics,chemical comparative mor-phology and immunohistochemistry. Results Those 5 patients including 3 males and 2 females whose age were 39 to 57 years andmean age was 48 years,were followed up for 8 to 60 months. No recurrence or metastasis were found in 5 patients. Most of them werediagnosised through normal clinical examination with no obvious clinical symptoms. Morphological examination showed that renal con-tour was normal,the boundary of lump was clear with kidney capsule and diameter of the lump was 2.5~3.7cm. Furthermore,some dif-ferent sizes and isolated cavities can be seen at the section,which were filled with serous fluid or blood. No necrotic tissue can be seenduring examination. In microscopic observation,tumor tissue was constituted by some different sizes of cavities. Most lumps ownedlined single clear cell,but small part of lump owned double epithelial cell;small focal transparent cells could be seen,and there wererich blood vessels during the interval without necrosis. The morphology of cells were like flat or obese,and cytoplasm were transparentor lightly stained. Nucleus were small and round. chromatin were deeply stained. Tumor cells in five cases were at I level throughFuhrman nuclear grade. There were no vascular invasion and capsular invasion. Immunohistochemistry results showed that CK,Vime-tin,EMA,LCK,CK8 in 5 cases were positive expression while CD10 and CD68 were negative expression. Conclusion Multilocularcystic renal cell carcinoma has an unique pathological changes,which is a rare histologic subtypes of renal cell carcinoma. But progno-sis is good after active treatment,immunohistochemical markers including CK,Vimetin,EMA,LCK,CK8 showed strong expressionwhile CD10 and CD68 were negative expression.

关 键 词：多房性囊性肾细胞癌 病理特点 免疫组织化学 

分 类 号：R365[医药卫生—病理学]