原发性肾脏滑膜肉瘤临床病理特征和治疗(1例报告并文献复习)  

Clinicopathological features and treatment of primary renal synovial sarcoma(1 case report and literature review)

作　　者：杨其欣 王无娇 王德林[1] 高飞[1] 罗生军[1] 翁宏庆 吴小候[1] 陈在贤[1] YANG Qixin;WANG Wujiao;WANG Delin;GAO Fei;LUO Shengjun;WENG Hongqing;WU Xiaohou;CHEN Zaixian(Department of Urology ,First Affiliated Hospital of Chongqing Medical University ,Chongqing 400016,China;First Clinical College,Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院泌尿外科,400016 [2]重庆医科大学第一临床学院,400016

出　　处：《重庆医学》2018年第19期2552-2555,共4页Chongqing medicine

基　　金：重庆市卫生与计划生育委员会适宜技术推广项目(2015jstg001);重庆市社会事业与民生保障科技创新专项(cstc2016shmsztzx130001)

摘　　要：目的讨论原发性肾脏滑膜肉瘤(PRSS)的临床病理学特征及治疗措施。方法回顾性分析重庆医科大学附属第一医院泌尿外科2016年6月25日收治的1例PRSS患者的临床资料,讨论该病的临床病理学特征及治疗方法。结果患者为33岁男性,行开放性左肾癌根治术,通过术后病理检验证实为左肾PRSS,免疫组化提示Vim(+)、FLT-1(+)、Ki-67 50%(+)、Bcl-2(+)、TLE-1(+)、CD99弱(+)、CD56(+)、myoglobin(-)、CK(-)、NSE(-)、Desmin(-)、WT-1(-)、EMA(-)、Syn(-)、CgA(-)、Syn(-)、CK19(-)、CK8(-)、CK18(-)。术后患者拒绝进一步化疗,术后4个月复查彩超提示手术部位复发,共生存9个月。结论 PRSS临床表现、体征及影像学表现不典型,病理学特征为梭形细胞、上皮细胞以及病理性核分裂象,免疫组织化学TLE-1(+)具有重要意义,手术治疗为主要治疗方式。Objective To discuss the clinicopathological features and treatment measures of primary renal synovial sarcoma（PRSS）.Methods The retrospective analysis was performed on the clinical data of 1 case of PRSS treated in the urological department of the First Affiliated Hospital of Chongqing Medical University on June 25,2016.The clinicopathological features and treatment method of this disease was discussed.Results The patient was male aged 33 years old,and treated by open left kidney radical nephrectomy.Postoperative pathological analysis verified left PRSS,and immunohistochemistry indicated Vim（＋）,FLT-1（＋）,Ki-67 50%（＋）,Bcl-2（＋）,CD56（＋）,TLE-1（＋）,CD99 weak（＋）,myoglobin（-）,CK（-）,NSE（-）,Desmin（-）,WT-1（-）,EMA（-）,Syn（-）,CgA（-）,Syn（-）,CK19（-）,CK8（-）and CK18（-）.The patient refused further chemotherapy,and the color ultrasound examination at postoperative 4 months indicated the recurrence of operative site,and the case survived for 9 months.Conclusion The clinical manifestations,signs and imaging features of PRSS were atypical,and the pathological features are spindle cells,epithelial cells and pathological nuclear disaggregation.Immunohistochemical TLE-1（＋）has an important significance and surgical treatment is the main treatment mode.

关 键 词：肉瘤 滑膜 肾 切除术 间叶组织肿瘤 

分 类 号：R737.11[医药卫生—肿瘤]