4例嗜酸性实性和囊性肾细胞癌临床病理特征  

Eosinophilic solid and cystic renal cell carcinoma:a clinicopathological analysis of four cases

作　　者：李晓玲 蔡珊珊[2] 张文娟 沈金辉 Li Xiaoling;Cai Shanshan;Zhang Wenjuan;Shen Jinhui(Department of Pathology,the Second Hospital of Longyan,Longyan 364000,China;Department of Pathology,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China;Department of Pathology,Zhangzhou Municipal Hospital,Zhangzhou 363000,China)

机构地区：[1]龙岩市第二医院病理科,364000 [2]福建医科大学附属第二医院病理科,泉州362000 [3]漳州市医院病理科,363000

出　　处：《中华肿瘤杂志》2021年第9期955-958,共4页Chinese Journal of Oncology

摘　　要：目的探讨嗜酸性实性和囊性肾细胞癌(ESC RCC)的临床病理特征和预后。方法收集2017—2019年龙岩市第二医院、福建医科大学附属第二医院和漳州市医院诊治的4例ESC RCC患者的临床病理资料,采用免疫组化方法检测不同抗体的表达情况,探讨其诊断及鉴别诊断。结果4例ESC RCC患者,男2例,女2例,年龄31~51岁,平均年龄40岁。肿瘤由实性区与大小不等的巨囊和微囊混合组成,囊腔衬覆具有丰富嗜酸性胞质的鞋钉样细胞;实性区呈弥漫片状、密集的腺泡状或巢状排列,局灶呈岛状、管状,混有少量的组织细胞和淋巴细胞。肿瘤细胞胞质丰富、嗜酸性,其内可见明显的细或粗颗粒,部分胞质内可见嗜酸性小球,部分区域可见胞质内空泡。免疫组化结果示,肿瘤细胞表达CK20(3/3,2例散在阳性,1例斑驳状强阳性)、Vimentin(4/4),CD10散在细胞阳性(4/4),Actin、HMB45、Melan-A、CD117和CK7均为阴性,Ki-67增殖指数约为1%。获得随访的2例患者无病生存时间分别为18和24个月。结论ESC RCC具有独特的组织形态学表现,CK20(+)、CK7(-)有助于其诊断;ESC RCC具有共同的分子核型改变,支持其为独特的肿瘤实体。患者总体预后良好。Objective To study the clinicopathological characteristics and prognosis of eosinophilic solid and cystic renal cell carcinoma(ESC RCC).Methods The clinical pathologic data of 4 cases of ESC RCC diagnosed and treated from 2017 to 2019 at the Second Hospital of Longyan City,the Second Affiliated Hospital of Fujian Medical University,and the Zhangzhou Municipal Hospital were collected.The expression of different antibodies was detected by immunohistochemistry,and the diagnosis and differentiate diagnosis were investigated.Results The 4 ESC RCC cases included 2 males and 2 females,the average age of these patients was 40 years,ranged from 31 to 51 years.The tumors were composed of solid area mixed with giant vesicles and microcapsules of varying sizes.The cyst cavity was lined by neoplastic cells with voluminous eosinophilic cytoplasm and hobnail arrangement.The solid area appeared as diffuse flaky,dense acinar or nested arrangement,the local area was island-shaped and tubular,mixed with a small amount of histiocytes and lymphocytes.Neoplastic cells contained voluminous eosinophilic cytoplasm with obvious fine or coarse particles,eosinophilic globules in part of the cytoplasm,and intracytoplasmic vacuoles in some areas.Immunohistochemical results showed that tumor cells were CK20 expressed(3/3,2 cases were sparsely positive and 1 case was patched strongly positive),Vimentin(4/4)and CD10(4/4)sparsely positive,while Actin,HMB45,Melan-A,CD117 and CK7 were negative in all cases.Ki-67 proliferation index was about 1%.Two cases were followed up and the progression free survival were 18 and 24 months,respectively.Conclusions ESC RCC has unique histomorphological manifestations,CK20(+)and CK7(-)are helpful for its diagnosis,and it has common molecular karyotype changes,supporting it as a unique tumor entity.The overall prognosis of the patient is good.

关 键 词：肾肿瘤 嗜酸性实性和囊性肾细胞癌 临床病理特征 免疫组化 

分 类 号：R737.11[医药卫生—肿瘤]