嫌色细胞型肾细胞癌3例的临床病理特点及文献复习  

Clinicopathologic characteristics and literature review of three cases of chromophobe renal cell carcinoma

作　　者：黄晓峰[1] 张远强[2] 戴晓汶[3] 李向党[1] 黄梅[1] 方丽[3] 杨家骥[1] 王春梅[1] 

机构地区：[1]第四军医大学基础部电子显微镜中心,陕西西安710033 [2]第四军医大学基础部组织学与胚胎学教研室,陕西西安710033 [3]解放军第117医院病理科,浙江杭州310013

出　　处：《第四军医大学学报》2003年第12期1120-1123,共4页Journal of the Fourth Military Medical University

摘　　要：目的 :研究嫌色细胞型肾细胞癌 (CRCC)的临床病理特点 .方法 :采用常规HE染色光镜观察、胶体铁染色、免疫组织化学染色和透射电镜观察 .结果 :患者年龄分别为6 2、6 3和 6 7(平均 6 4 )岁 ,均为男性 .主诉为腰部酸胀 ,无明显血尿和腰部包块 .所有肿瘤分期均为T0 N0 M0 .组织学上 ,肿瘤细胞为多变的网状透明胞质的大细胞构成 .根据网状化胞质的程度和分布 ,肿瘤细胞可分为 3种类型 .细胞的超微结构特征是在网状化的区域存在大量小泡 ,似乎是CRCC的特征性结构 .小泡可能起源于线粒体外膜的外突 .胶体铁染色阳性也是CRCC的特征之一 .免疫组织化学研究显示肿瘤对CKpan、CK19、上皮膜抗原和波形蛋白有不同程度的阳性 ,S 10 0蛋白阴性 .15～ 2 6mo的随访表明生存良好 .结论 :这些发现进一步确证CRCC是肾细胞癌的一种特殊亚型 。AIM: To investigate the clinicopathologic characteristics of chromophobe renal cell carcinoma (CRCC). METHODS: The routine HE staining, colloidal iron staining, immunohistochemistry and transmission electron microscopy were used. RESULTS: Three male patients age was 62, 63 and 67 (averaged 64) years respectively. Major presenting complaints was flank discomfort. Hematuria and flank mass were not obvious. All tumors were staged as T 0N 0M 0. Histologically, the carcinomas were composed of large cells with variably reticulated, translucent cytoplasm. The tumor cells could be divided into three types according to the extent and distribution of reticulated cytoplasm. Ultrastructurally, these reticulated areas were characterized by the presence of large numbers of microvesicles. The origin of the vesicles appeared from outpouchings of the outer mitochondrial membrane. CRCC was also characteristically positive for colloidal iron. Immunohistochemical studies revealed that the tumors were variably positive for cytokeratins, epithelial membrane antigen and vimentin , but negative for S 100. Follow up (15～26 mo) of patients revealed well survival. CONCLUSION: These findings further confirm the concept that chromophobe renal cell carcinoma is a special subtype of renal cell carcinoma, in which presence of microvesicles is a characteristic morphologic feature.

关 键 词：癌 肾细胞 超微结构 微泡免疫组织化学 显微镜检查 电子 

分 类 号：R737.11[医药卫生—肿瘤]