肾源性腺瘤临床病理观察及预后分析  

Clinicopathological observation and prognosis analysis of nephrogenic adenoma

作　　者：赵利敏[1] 冯战启[2] 李晟磊[3] 白睿华[4] 王志永[1] ZHAO Limin;FENG Zhanqi;LI Shenglei;BAI Ruihua;WANG Zhiyong(Department of Pathology,First People's Hospital of Zhengzhou,Zhengzhou 450004,China;不详)

机构地区：[1]郑州市第一人民医院病理科,郑州450004 [2]郑州市第一人民医院泌尿外科,郑州450004 [3]郑州大学第一附属医院病理科 [4]河南省肿瘤医院病理科

出　　处：《现代泌尿生殖肿瘤杂志》2025年第2期79-82,88,共5页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的 探讨肾源性腺瘤(NA)的临床病理学特征、免疫表型、诊断及预后。方法收集5例NA患者的临床病理资料,采用HE及免疫组织化学染色进行病理学观察并复习相关文献。结果 患者平均年龄65.2岁;4例病变位于膀胱,1例位于左侧输尿管;2例有尿路上皮癌手术史,2例分别有膀胱、输尿管结石手术史,1例有前列腺电切手术史,临床以复查发现肿物或出现尿路症状前来就诊;HE染色低倍镜下呈小管状、乳头状或囊状排列,间质纤维组织增生及炎细胞浸润,高倍镜下细胞大小较一致,呈立方形或鞋钉状,伴轻度异型性,细胞核呈圆形或椭圆形,细胞质呈嗜酸性或透明空泡状,未见核分裂像及坏死。5例患者肿瘤细胞CK7、Pax-8、HNF-1β均阳性,GATA-3及P504S部分阳性,Ki-67(5%+),CK20、P63、Napsin A、CEA均阴性。5例患者均进行了手术切除,随访5例患者均无复发(分别随访45、26、23、10、1个月)。结论 NA属于较为少见的良性肿瘤样病变,往往伴有结石、感染或有泌尿道肿瘤手术史,由于病变较小或认识不足易误诊为其他良、恶性肿瘤,诊断须结合病史、组织形态及免疫组化综合分析。Objective To investigate the clinicopathological features,immunohistochemistry,diagnosis and prognosis of nephrogenic adenoma(NA).Methods The clinical and pathological data of 5 patients with NA were collected.Histological observation was carried out by HE staining and immunohistochemistry,and relevant literature was reviewed.Results The patients,average age was 65.2 years old.Four lesions were located in the bladder and 1 in the left ureter.Two patients had a history of surgery for urothelial carcinoma,two patients had a history of surgery for bladder and ureteral calculus respectively,and one case had a history of surgery for prostate resection surgery.The clinical manifestations were tumor recurrence or urinary symptoms.Under low magnification,HE-stained slides exhibited small tubular,papillary or cystic arrangement,stromal fibroblast hyperplasia and inflammatory cell infiltration.Under high magnification,the cells were relatively uniform in size,cuboidal or spiked,with mild atypia.The nuclei were round or oval,and the cytoplasm was eosinophilic or transparent vacuolar,without nuclear division or necrosis.The tumor cells from 5 patients were positive for CK7,Pax-8,HNF-1β,partially positive for GATA-3 and P504S,and negative for CK20,P63,NapsinA,CEA.All 5 patients underwent surgical resection.During follow-up period of 1,10,23,26,45(months),respectively,no recurrence was found in any of the patients.Conclusions NA is a rare benign tumor-like lesion that often accompanied by stones,infection or a history of urological tumor surgery.It is easily misdiagnosed as other benign or malignant tumors due to its small size or lack of recognition.The diagnosis should be based on a comprehensive analysis of history,histopathology and immunohistochemistry.

关 键 词：膀胱肿瘤 肾源性腺瘤 组织来源 预后 

分 类 号：R737.1[医药卫生—肿瘤]