肾嗜酸细胞腺瘤的临床病理分析

Clinicopathologic analysis of renal oncocytoma

关键词:  肾肿瘤  肾嗜酸细胞腺瘤  免疫组化

Key words:  kidney tumor  renal oncocytoma  immunohistochemistry

摘要:

［目的］探讨肾嗜酸细胞腺瘤的临床病理特征、免疫学表型及鉴别诊断要点。［方法］对2例肾嗜酸细胞腺瘤进行临床资料、大体、光镜观察，免疫组化染色，并文献复习。［结果］肾嗜细胞腺瘤2例，患者均为老年男性，肾脏单发实性占位病变，包膜不完整，界清，棕红色，质中等硬，其一可见中央星状瘢痕。光镜下，肿瘤组织由大小不一的巢状结构组成，伴有少量腺管，周围有纤细的血管纤维分隔。瘤细胞单一，圆形或多边形，有明显的嗜酸性胞浆，核圆，居中，未见核分裂象。2例均见局灶核异型，并见单细胞及小灶状坏死。免疫组化：两者均表达CK、E-cadherin、CD117，不表达CD10、Vimentin，其中1例CK7胞质阳性。［结论］肾嗜酸细胞腺瘤是比较少见的良性肿瘤，掌握其临床病理形态特征及免疫表型是正确诊断及鉴别诊断的关键。

Abstract:

［Objective］To further study the clinicopathologic features、immunohistochemical expression differential diagnosis of renal oncocytoma.［Methods］Two cases of renal oncocytoma were observed with clinical data analysis, gross and microscopic examinations, immunohistochemical stains, as well as review of the related literature.［Results］Both of the 2 patients were old man. The unilateral mass was found with clearly circumscribed, but lack of capsule, homogeneous consistency, dark-brown color. One of them showed a central scar.Microscopically, the tumors were composed of solid nests the classcical structure and small amount of tubules surrounded by vascular-fibrous stroma. The tumor cells were uniform, round or polygonal with moderate to abundant granular eosinophilic cytoplasm.The nucleus was round, centrally-placed, with the absence of mitotic activity. Both of them locally showed hyperchromatic and pleomorphic, as well as minimal necrosis.Immunohistochemical staining showed that CK、E-cadherin and CD117 were positive, but CD10 and Vimentin were negative in 2 cases. One of them showed positive staining of CK7.［Conclusion］Renal oncocytoma is not a common benign tumor. It is essential to master its clinicopathologic features and immunohistochemical expression for the differential diagnosis.