甲状腺样滤泡性肾细胞癌4例临床病理分析  

Characteristics of thyroid-like follicular renal cell carcinoma:a clinicopathologic analysis of four cases

作　　者：连婧[1] 王丽霞[1] 马海霞[1] 王晓娟[1] 王奇峰 

机构地区：[1]山西省肿瘤医院病理科,太原030013 [2]复旦大学附属肿瘤医院病理科,上海200032

出　　处：《诊断病理学杂志》2018年第2期108-111,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨甲状腺样滤泡性肾细胞癌(TLFRCC)的临床病理特点。方法收集4例TLFRCC临床资料,对手术标本采用HE染色及免疫组化检测进行病理形态特征观察,并复习相关文献进行临床病理特征分析。结果本组4例TLFRCC中,男性3例,女性1例,年龄37~66岁,病变均位于单侧肾,左肾3例,右肾1例。其中2例为住院手术治疗患者,肿瘤最大径分别为4 cm和2 cm。2例外院会诊病例均未提供肿块大小。镜检:肿瘤细胞排列成大小不一的甲状腺滤泡样结构,部分滤泡被拉长呈不规则形或流产乳头状结构,滤泡样结构内可见嗜酸性甲状腺胶质样物,内衬单层立方形、柱状细胞,核异型性不明显,未见明显核分裂象。免疫组化:肿瘤细胞TTF1、TG呈(-),CD10、vimentin、PAX8、CK7、P504S和CD117呈不同程度(+)。4例随访15~25个月,均未发生肿瘤进展。结论 TLFRCC是一种肾原发的较罕见的上皮性低度恶性肿瘤。病理确诊需要通过结合临床病史、影像学检查及免疫组化标记综合评价。Objective To study the clinicopathologic features of thyroid-like follicular renal cell carcinoma. Methods Clinical data were collected in four patients with thyroid-like follicular renal cell carcinoma. HE and immunohistochemistry were carried out in surgically removed specimen to analyze the pathological morphological characteristics with review of related literature. Resuls The patients aged 37-66 years,with three males and one female. The tumors occurred in the unilateral kidney with three in the left and one in the right. Tumor maximum diameters of two surgically-removed were 4 cm and 2 cm,respectively. Another 2 case were consultation cases and not provided tumor size. Microscopically,most of tumor cells arranged in thyoid follicular pattern in different sizes,with irregular shape or miscarriage papillary structure in partial enlongated follicular pattern. The follicule-like structure was filled with eosinophilic colloid-like material,lined by a single layer of cuboidal or columnar cells,with not obvious atypia,and rare mitosis. Immuohistochemical staining showed that tumor cells were negative for thyroid transcription factor1（ TTF1） and thyroglobulin（ TG）,and positive in different degree for CD10,Vimentin,PAX8,CK7,P504 S and CD117. Three patients were followed up for 15-25 months,showing no tumor progression. Conclusions Thyroid-like follicular renal cell carcinoma is a low-grade primary renal epithelial malignant tumor. The pathological diagnosis needs comprehensive evaluation by combining its clinical history,imaging examination and immunohistochemical markers.

关 键 词：甲状腺样 肾细胞癌 鉴别诊断 预后 

分 类 号：R737.11[医药卫生—肿瘤]