嗜酸性实性和囊性肾细胞癌4例临床病理分析  

Eosinophilic solid and cystic renal cell carcinoma:a clinicopathological analysis of 4 cases

作　　者：黄莹[1] 王天云 奎翔 李汝懿 孙成鹏 华结 王燕[1] HUANG Ying;WANG Tian-yun;KUI Xiang;LI Ru-yi;SUN Cheng-peng;HUA Jie;WANG Yan(Department of Pathology,the Second Affiliated Hospital of Kunming Medical University,Kunming 650500,China)

机构地区：[1]昆明医科大学第二附属医院病理科,昆明650000

出　　处：《诊断病理学杂志》2024年第5期396-399,404,共5页Chinese Journal of Diagnostic Pathology

基　　金：昆明医科大学2023年教育教学研究项目(2023-JY-Y-030);2023年昆明医科大学研究生创新基金项目(2023S088)。

摘　　要：目的探讨嗜酸性实性和囊性肾细胞癌(ESC RCC)的临床病理学特征。方法通过收集4例ESC RCC的临床资料,完成HE染色及免疫组化分析,并复习相关文献。结果男性2例,女性2例,发病年龄54~62岁,左右肾发病率均等。4例均因腰部不适入院,2例伴有肉眼血尿、尿痛,均手术切除治疗,随访6~33个月,1例死亡,3例未见复发及转移。肿瘤肉眼大小约1.8~4.5 cm,呈灰褐色质软囊壁样或突出型肿块。镜下肿瘤细胞以囊性、乳头状排列为主,胞质含嗜碱或嗜酸性颗粒物,细胞核圆形染色深,核仁明显,见多核或巨核细胞。免疫组化均表达CK20、CKL、PAX-8等,CK7均为阴性。结论ESC RCC是一种整体生物学行为惰性、预后较好的新型肾脏肿瘤,需充分掌握其病理特点,鉴别其他恶性肾肿瘤对临床治疗有积极意义。Objective To investigate the clinicopathological features of eosinophilic solid cystic renal cell carcinoma(ESC RCC).Methods Clinical data of 4 cases of ESC RCC were collected and completed HE staining and immunohistochemistry,also reviewed the relevant literature.Results There were 2 males and 2 females,the onset age was 54-62 years old,and the incidence of left and right kidneys was equal.Four cases were hospitalized due to lumbar discomfort,2 cases were accompanied by gross hematuria and dysuria,and all the cases were treated by surgical resection and followed up for 6-33 months.It showed that 1 case was died,but no recurrence or metastasis was found in the other 3 cases.The gross size of neoplasm was about 1.8-4.5 cm,and they had a soft capsule wall or protruding mass with grayish brown section.Microscopically,the tumor cells were mainly cystic and papillary,and the cytoplasm contained basophilic or eosinophilic particles.The nuclei were round and deeply stained,the nucleoli wss obvious,and multinucleated or megakaryocytes were found.Immunohistochemical expression of CK20,CKL,PAX-8 was positive,CK7 was negative.Conclusion ESC RCC is a new type of renal tumor with inert biological behavior and good prognosis.It is necessary to fully grasp its pathological characteristics,and it has a positive significance to distinguish it from other malignant renal tumors for clinical treatment.

关 键 词：嗜酸性实性和囊性肾细胞癌 结节性硬化症 临床病理 预后 免疫组织化学 

分 类 号：R737.11[医药卫生—肿瘤]