1例甲状腺样滤泡性肾细胞癌临床病理特征分析  

Clincicopathologic characteristics analysis of a case of thyroid-like follicular renal cell carcinoma

作　　者：石文雅 王娜娜[1] 常文丽 司航 刘素素 张骞[1] SHI Wenya;WANG Nana;CHANG Wenli;SI Hang;LIU Susu;ZHANG Qian(Department of Pathology,Binzhou Medical University Hospital,Shandong Binzhou 256600,China)

机构地区：[1]滨州医学院附属医院病理科,山东滨州256600

出　　处：《现代肿瘤医学》2025年第6期960-968,共9页Journal of Modern Oncology

基　　金：山东省自然科学基金(编号:ZR2015HL085);山东省医药卫生科技发展项目(编号:202201040792);滨州医学院科研计划(编号:BY2020KJ06)。

摘　　要：目的:探讨甲状腺样滤泡性肾细胞癌(thyroid-like follicular renal cell carcinoma,TLFRCC)的临床病理特征及诊疗方式。方法:收集1例TLFRCC临床资料,行HE染色、免疫组化检测,并结合国内外文献报道的41例分析TLFRCC临床病理特征。结果:1例男性患者,76岁,病变部位为右侧,肿瘤直径2.6 cm。镜下观察:界清,有包膜,肿瘤细胞呈现大小不一的甲状腺滤泡样结构,滤泡内充满嗜酸性胶质样物,部分区域呈实性片状排列。肿瘤细胞形态表现为柱状和立方形,细胞核呈圆形,核异型性不明显,核仁不明显,未见核分裂象。免疫组化结果:CK、Vimentin、E-cadherin、EMA、PAX-8、CK19均阳性,其中CK7(弥漫强阳性)和SDHB(浆+),而CA-IX、CD10、P504s、CD117、Ksp-cadherin、TFE、Tg、TTF-1、CK20、RCC、ALK、Syn、CgA均阴性,Ki-67增殖指数约1%~2%。结论:TLFRCC是一种罕见的高分化的恶性肿瘤,镜下可见甲状腺样滤泡性结构,诊断需结合临床表现、影像学检查及病理特征,目前手术切除是合适的治疗方式。Objective:To explore the clinicopathologic features of thyroid-like follicular renal cell carcinoma(TLFRCC),including diagnosis and treatment.Methods:One case of clinical data of TLFRCC was collected and examined by HE staining and immunohistochemistry.The clinicopathologic features of thyroid-like follicular renal cell carcinoma were analyzed in combination with 41 cases reported in domestic and foreign literatures.Results:A 76-year-old male patient was diagnosed with thyroid-like follicular renal cell carcinoma on the right side.The tumor diameter was 2.6 centimetre and had envelope and clear boundary under the microscopic.The tumor cells showed different sizes of thyroid follicle-like structure filled with eosinophilic glia and some areas were solid sheet arrangement.The morphology of tumor cells was columnar and cuboidal.The nucleus was round and the nuclear atypia was not obvious,also was the nucleolus.Nuclear division was not observed under the microscope.Immunohistochemical results indicated that tumor cells were positive for CK,Vimentin,E-cadherin,EMA,PAX-8 and CK19,including CK7(strong positive)and SDHB(plasma+).While negative results were as follows:CA-IX,CD10,P504s,CD117,Ksp-cadherin,TFE,Tg,TTF-1,CK20,RCC,ALK,Syn and CgA.The proliferation index of Ki-67 was about 1%~2%.Conclusion:TLFRCC is a rare and highly differentiated malignant tumor with thyroid-like follicular structure under the microscope.The correct diagnosis should be combined with clinical manifestations,imaging examination and pathological features.At present,nephrectomy is the best treatment.

关 键 词：滤泡性 肾细胞癌 诊断 免疫组织化学 

分 类 号：R737.11[医药卫生—肿瘤]