肾肉瘤样癌误诊为肾滑膜肉瘤一例  

A case of sarcomatoid renal cell carcinoma misdiagnosed as renal synovial sarcoma

作　　者：赵晓婷 张丽萍 王洋 熊立岩 刘丹 王翠芳 Zhao Xiaoting;Zhang Liping;Wang Yang;Xiong Liyan;Liu Dan;Wang Cuifang(Department of Pathology,Shenyang DIAN Medical Laboratory Co.,Ltd.,Shenyang 110141,China;Department of Pathology,The People’s Hospital of Zhangwu,Fuxin 123200,China)

机构地区：[1]沈阳迪安医学检验所有限公司病理科,沈阳110141 [2]彰武县人民医院病理科,阜新123200

出　　处：《中国组织化学与细胞化学杂志》2020年第3期260-263,共4页Chinese Journal of Histochemistry and Cytochemistry

摘　　要：目的探讨肾肉瘤样癌组织学表现及免疫表型特点,提高对肾肉瘤样癌的认识及诊断。方法通过HE染色、免疫组织化学染色和FISH基因学检测对1例肾肉瘤样癌进行诊断,并复习相关文献进行讨论。结果癌成分包含高级别透明细胞肾细胞癌,核级别4级,肉瘤样成分由非特异性高级别梭形细胞组成。肉瘤样成分侵犯主肾静脉。CD31和CD34显示血管腔隙阳性。同一肿瘤内可见高级别癌,这提示梭形细胞成分为肉瘤样转化。结论本例患者第一时间误诊为肾滑膜肉瘤,确诊后更改为肾肉瘤样癌。Objective To explore the histological characteristics and immunophenotye of sarcomatoid renal cell carcinoma and improve the the understanding and diagnosis of sarcomatoid renal cell carcinoma.Methods A case of sarcomatoid renal cell carcinoma was diagnosed by HE staining,immunohistochemistry and FISH,and the relevant literature was reviewed for discussion.Results The cancer component contains high-grade clear cell renal cell carcinoma,nuclei are grade 4 and sarcoma-like component is composed of non-specific high-grade spindle cells.Sarcoma-like components invade the main renal vein.CD31 and CD34 showed positive vascular space.High-grade cancer can be observed in the same tumor,suggesting that the spindle cell component is transformated from sarcoma-like component.Conclusion In this case,the patient was first misdiagnosed as a renal synovial sarcoma,while diagnosed as sarcomatoid renal cell carcinoma after confirmation.

关 键 词：肾肉瘤样癌 肾滑膜肉瘤 病理诊断 

分 类 号：R737.11[医药卫生—肿瘤]