摘要
目的探讨并分析伴异源性成分输尿管小细胞神经内分泌癌的临床病理特征、治疗及预后。方法采用影像学、HE染色切片、免疫组织化学染色及临床资料分析病例并复习相关文献。结果巨检发现近肾门处输尿管黏膜面有1个隆起型肿块,大小4.50 cm×4.50 cm×2.00 cm,切面灰白实性质软;HE染色显示肿瘤细胞呈裸核状,见腺癌成分及横纹肌母样细胞;免疫组织化学显示,肿瘤细胞弥漫表达突触素(SYN)、波形蛋白(Vimentin)、不同程度表达细胞角蛋白(CK)、肌调节蛋白(MyoD1)、白细胞分化抗原(CD)56、肌浆蛋白(Myogenin),Ki-67增殖指数约60%。上皮膜抗原(EMA)、Friend白血病病毒综合因子-1(Fli-1)、ETS相关基因(ERG)、CD99、S-100、转导蛋白样分裂增强因子-1(TLE-1)、内皮转录因子-3(GATA-3)、平滑肌肌动蛋白(SMA)、嗜铬素A(CGA)均呈阴性。腹部CT显示右侧中上段输尿管管腔扩张,其内见团块状软组织影3.10 cm×2.90 cm。患者随访4个月死亡。结论异源性成分输尿管小细胞神经内分泌癌为高侵袭性肿瘤,临床预后较差,晚期靶向治疗可有所缓解。
Objective To investigate and analyze the clinicopathological features,treatment and prognosis of ureteral small cell neuroendocrine carcinoma complicating heterogenic components.Methods The imagiology,HE section,immunohistochemical staining and clinical data analysis were adopted to analyze the data and the related literatures were reviewed.Results The autopsy found that a protuberant mass existed in the mucous surface of ureter near the renal hilum,size 4.50 cm×4.50 cm×2.00 cm,the section was gray-white with soft nature;the HE staining showed the tumor cells revealed the naked nucleus shape,with adenocarcinoma components and rhabdomyoblast-like cells;the immunohistochemistry showed the tumor cells diffusely expressed SYN and Vimentin,expressed CK,MyoD1,CD56 and Myogenin in different degrees,the Ki-67 proliferation index was about 60%.EMA,Fli-1,ERG,CD99,S-100,TLE-1,GATA-3,SMA and CGA were negative:the abdominal CT showed that the right middle and upper segment of ureter lumen was dilated,and the internal mass soft tissue shadow was 3.10 cm×2.90 cm.The patient was followed up for 4 months and died.Conclusion Ureteral small cell neuroendocrine carcinoma with heterologous components is a highly invasive tumor with poor clinical prognosis,and the targeted therapy in the late stage may have somewhat remission.
作者
尹闻科
宋晓艳
YIN Wenke;SONG Xiaoyan(Teaching and Researching Section of Pathology,North Sichuan Medical College,Nanchong,Sichuan 637000,China;Department of Pathology,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000,China;Nanchong Oriental Hospital,Nanchong,Sichuan 637000,China)
出处
《重庆医学》
CAS
2020年第3期463-466,共4页
Chongqing medicine
关键词
小细胞神经内分泌癌
异源性成分
临床病理诊断
治疗
预后
small cell neuroendocrine carcinoma
heterologous components
clinicopathological diagnosis
therapy
prognosis
