摘要
目的探讨透明细胞乳头状肾细胞癌(clear cell papillary renal cell carcinoma,CCPRCC)的临床病理学特征、免疫表型、诊断及鉴别诊断。方法回顾性分析8例CCPRCC的临床资料,进行组织病理形态学和免疫组化观察,并复习相关文献。结果8例患者男性6例、女性2例,平均发病年龄49岁。6例发生于左肾,2例发生于右肾,其中6例经体检发现。肿瘤大体界限清楚,镜下由管状、乳头状、腺泡状及囊状结构组成,肿瘤细胞胞质透明,细胞核大小较一致,部分细胞核远离基底膜而位于腔缘。免疫表型:肿瘤细胞表达PAX-8、CK7、Vimentin、CyclinD1、CA9;CA9呈杯口状阳性模式。Ki-67介于2%~10%;其中6例表达CK(H),5例表达GATA3,4例弱表达CD10,2例弱表达AMACR;CD117、TFE-3均阴性。术后平均随访23个月均未见复发及转移。结论CCPRCC是一种肾脏惰性上皮性肿瘤,诊断主要依靠特征性的组织学形态和免疫组化,与其他肾细胞癌鉴别具有临床意义。
Objective To investigate the clinicopathological features,diagnosis,differential diagnosis,immunophenotype of clear cell papillary renal cell carcinoma.Methods The clinical data of 8 cases of clear cell papillary renal cell carcinoma were analyzed retrospectively,histopathological morphology and immunohistochemical findings were analyzed,and related literatures were reviewed.Results Eight patients were 6 males and 2 females,and the mean age of onset was 49 years.Six cases all occurred in the left kidney and two in the right kidney,six of which were found by physical examination.The tumor was well defined,and composed of tubular,papillary,acinar and vesicular and cystic structures.The tumor cells had a transparent cytoplasm,the nucleus size was relatively consistent,and part of the nucleus was located away from the basement membrane at the cavity margin.Immunophenotypically,tumor cells expressed PAX-8,CK7,vimentin,cyclinD1 and CA9;CA9 staining showed a positive cup-mouth pattern.Ki-67 ranged between 2 and 10%;6 of these cases expressed CK(H),5 of these cases expressed GATA3,4 of these cases weakly expressed CD10,2 cases weakly expressed AMACR;and all cases were negative for CD117 and TFE-3.No recurrence or metastasis occurred for the average postoperative follow-up of 23 months.Conclusion CCPRCC is a renal inert epithelial tumor whose diagnosis relies mainly on characteristic histological morphology and immunohistochemistry,with clinical significance for discrimination from other renal cell carcinomas.
作者
蒋樟英
出树强
吴义娟
晋龙
黄种心
JIANG Zhang-ying;CHU Shu-qiang;WU Yi-juan;JIN Long;HUANG Zhong-xin(Department of Pathology,Fuzhou Hospital of Traditional Chinese Medicine,Fuzhou 350001,China;Department of Pathology,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China;Fujian Medical College of Fujian Medical University/Department of Pathology,Fujian Provincial Hospital,Fuzhou 350001,China)
出处
《诊断病理学杂志》
2022年第9期834-837,共4页
Chinese Journal of Diagnostic Pathology
基金
福建省自然科学基金面上项目(2019J01182)
关键词
肾细胞癌
透明细胞乳头状肾细胞癌
临床病理分析
Renal cell carcinoma
Clear cell papillary renal cell carcinoma
Clinicopathological analysis
