| 摘要: |
| 目的 探讨肾脏混合性上皮间质肿瘤(mixed epithelial and stromal tumor of the kidney，MESTK)的影像学表现、临床病理学特点及诊治方法。方法 收集3例罕见的肾脏混合性上皮间质肿瘤患者的临床资料，患者均为男性，年龄分别为20岁、46岁和68岁。3例患者均进行了彩超及CT影像学检查并进行了手术治疗。总结MESTK的影像学表现、病理学特点及诊治方法。结果 3例患者影像学检查示单侧肾脏直径约3.5～9 cm的囊实性占位，增强CT检查病灶强化不均匀，可见明显强化的实质成分或分隔。3例患者分别于全麻下行左肾部分切除术、根治性右肾切除术和根治性右肾切除术，术后病理示肿瘤大体观呈复杂囊实性或多房囊性；镜下肿瘤组织中均可见到上皮成分及间叶成分，上皮形成腺样结构，部分伴囊性扩张，间质中可见平滑肌成分或向平滑肌方向分化；免疫组化染色：平滑肌肌动蛋白（smooth musle actin，SMA）、结蛋白（Desmin）和波形蛋白（Vimentin）阳性，2例雌激素受体（estrogen receptor，ER）和孕激素受体（progesterone receptor，PR）阴性。病理诊断为肾脏混合性上皮间质肿瘤。术后分别随访2～5年均未见肿瘤复发转移。结论 肾脏混合性上皮间质肿瘤影像学表现缺乏特异性，但具有独特的组织病理学特征，男性罕见，手术治疗后预后良好。 |
| 关键词: 肾肿瘤 混合性上皮间质肿瘤 诊断 病理 |
| DOI：10.11724/jdmu.2016.06.12 |
| 分类号:R737.11 |
| 基金项目:基金项目:复旦大学附属中山医院青年基金项目（2014ZSQN31） |
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| Imaging and clinicopathological features in three mixed epithelial and stromal tumors of the kidney in men |
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LU Ji-dong1, LIU Kai2, LIN Zong-ming1, GUO Jian-ming1, SHI Yuan3, LIANG Liang2
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1.Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China;2.Department of Radiology, Zhongshan Hospital, Fudan University Shanghai Institute of Medical Imaging Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai 200032, China;3.Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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| Abstract: |
| Objective To study the imaging and pathological features as well as treatments of mixed epithelial and stromal tumor of the kidney (MESTK).Methods Three cases of MESTK in men (20, 46, 68 years old respectively) were analyzed, including the clinical manifestations, imaging and pathological features as well as treatments.Results In all cases, CT showed a solid and cystic mass (3.5-9 cm) with heterogeneous enhancement or enhancement of septa located in the lefr or right renal. All cases were treated with partial or all nephrectomy. The tumors all had a complicated solid and cystic appearance on section grossly. Microscopically, the tumors were composed of a mixture of epithelial and stromal components, consisting of glands and cysts, as well as the differentiation of smooth muscle cells in the stromal components. Immunohistochemical staining revealed that it was positive for smooth musle actin (SMA) , Desmin and Vimentin when two cases showed negative for estrogen receptor (ER) and progesterone receptor (PR). There was no evidence of recurrence or metastasis in 2 years to 5 years after operation in all cases.Conclusion MESTK, which arises mostly in adult females, has distinct histopathological features. Most of them showed benign behavior after surgeries. |
| Key words: kidney neoplasms mixed epithelial and stromal tumor diagnosis pathology |
