【摘要】 目的探讨肾脏黏液性管状和梭形细胞癌的临床病理学特点。方法分析3例肾脏黏液性管状和梭形细胞癌的临床特点、组织形态及免疫表型(CD10、CK7、EMA、P504S、Vimentin),并复习相关文献。结果 3例黏液性管状和梭形细胞癌中,男1例,女2例,年龄39~57岁,平均48岁,肿瘤最大直径4.2~9.0cm,平均5.9cm,术后随访18~44个月,均无复发及转移。肿瘤大体切面为实性、灰白色,无包膜,但与周围肾组织分界清晰。镜下观察肿瘤组织包括由立方细胞紧密排列构成的狭长小管结构及梭形细胞两种成分,且两种成分交错分布,可以见到过渡区域,其中1例缺乏梭形细胞区域,2例背景中可见黏液样基质,1例可见透明细胞、乳头状结构及泡沫细胞。免疫组化染色显示3例肿瘤CK7、EMA、P504S均呈阳性表达,1例CD10呈阳性表达,2例Vimentin呈弱阳性表达。结论肾脏黏液性管状和梭形细胞癌是一种低度恶性的多形性肿瘤,组织形态学谱系较宽,由小管状结构和梭形细胞两种成分以不同比例构成,可以缺乏其中一种成分,也可缺乏黏液样基质,有些病例可见灶状透明细胞、乳头状结构。免疫表型上对于近端肾单位及远端肾单位的标记均可表达。更多还原

【Abstract】 Objective To explore the clinical and pathologic features of the mucinous tubular and spindle cell carcinoma(MTSCC) of kidney.Methods The clinical features,tissue morphology and immunophenotypes(including CD10,CK7,EMA,P504S and Vimentin) of 3 cases of MTSCC were analyzed,and the related literature was reviewed.Results Among the 3 MTSCC patients,1 was male and 2 were females,aged from 39 to 57 years with a mean age of 48.The diameter of tumors ranged from 4.2cm to 9.0cm with a mean of 5.9cm.The 3 patients were followed-up for 18 to 44 months,and no recurrence or metastasis was found.Under general observation,the tumor was well-circumscribed,without capsule,and the cut surface was solid and grayish-white.Light microscopy showed that the tumor was composed of tightly packed,small,elongated tubules with transition to spindle cell components,while in 1 case it lacked spindle cell area;mucinous stroma was seen in 2 cases,and clear cells,papillary structures and foam cells were seen in 1 case.Immunohistochemical staining showed that CK7,EMA and P504S were positive in 3 cases,CD10 was positive in 1 case and Vimentin was weakly positive in 2 cases.Conclusions MTSCC is a low-grade and polymorphic tumor with a wide histological spectrum,consisting of tubules and spindle cells(may lack one of them,or lack of mucinous stroma),coupled with clear cells and papillary structures in some cases,and expresses the markers of proximal and distal nephron.更多还原