肾嗜酸细胞腺瘤临床病理分析  

The Clinical and Pathological Analysis of Renal Oncocytoma

作　　者：张竹青[1] 赵俊军[1] 李平[1] 范晓明 ZHANG Zhuqing;ZHAO Junjun;LI Ping(Department of Pathology,Affiliated Municipal Central Hospital of Dalian Medical University,Dalian City,Liaoning Province 116033)

机构地区：[1]大连医科大学附属中心医院病理科,辽宁省大连市116033

出　　处：《医学理论与实践》2021年第2期187-189,共3页The Journal of Medical Theory and Practice

摘　　要：目的:探讨肾嗜酸细胞腺瘤的临床病理学特点、诊断、鉴别诊断和预后。方法:采用免疫组化法检测3例嗜酸细胞腺瘤中不同抗体的表达,分析其病理学形态,收集随访资料并复习相关文献。结果:3例肾嗜酸细胞腺瘤患者,镜下:肿瘤细胞呈巢状、管状、腺泡状,胞浆嗜酸性、颗粒状,核圆形,规则,其中1例有肾被膜侵袭,细胞核有非典型性,未见核分裂象,间质水肿、透明化。免疫表型:CD117、E-Cadherin及PAX-8均阳性,P504s灶状阳性,CK7在中央瘢痕区阳性,CK胞浆(+),CD10、Vimentin及CA-Ⅸ均阴性。手术切除肿瘤后随访15个月~3年,均未见复发及转移。结论:肾嗜酸细胞腺瘤是肾脏较少见的良性上皮性肿瘤,可通过免疫组化标记与具有相似形态学特征的恶性肿瘤相鉴别,治疗常选择保留肾单位的肿瘤切除术,预后良好。Objective:To analyze the clinicalpathological characteristics,differential diagnosis and prognosis of renal oncocytoma.Methods:Immunohistochemical staining results were detected,pathomorphologic features were analyzed in 3 cases of renal oncocytomas,and clinical follow-up datas were collected with review of the relevent literature.Results:These tumors of 3 patients of renal oncocytomas exhibited different structures such as nests,tubular and alveolar with eosinophilic,granular cytoplasm,nuclei were round and regular,invision of renal fibrous capsule,cellular atypia and edematous or hyalinized stroma were existed in one case without motitic activity.Immunohistochemiscally,the tumor cells were positive for CD117,E-Cadherin,and PAX-8,locally positive for P504s,the staining for CK7 were observed in the central scar area,but negtive for CD10,Vimentin and CA-Ⅸ.All patients were alive with no recurrence and metastasis during the follow-up(range 15~36 months).Conclusion:Renal oncocytomas is rare benign renal neoplasms that cannot be certainly distinguished from renal cell carcinoma.The combination of morphological characteristics with immunohistochemical findings could be help to the correct differential diagnosis.Renal oncocytomas usually exhibits favorable prognosis afrer preserving nephron-sparing surgery.

关 键 词：肾肿瘤 嗜酸细胞腺瘤 免疫组织化学 

分 类 号：R737.11[医药卫生—肿瘤]