【摘要】 目的探讨乳头状肾细胞癌实性亚型(SPRCC)1例的临床病理特征、免疫表型、鉴别诊断以及临床预后。方法对1例SPRCC病例进行显微镜下HE切片观察组织学特征,采用EnVision法染色观察其免疫表型并与其它类型肾细胞肿瘤进行鉴别诊断。结果 SPRCC组织学特点为肿瘤细胞排列呈实性片状、小管状、囊状,乳头状结构很少或几乎看不到,肿瘤细胞呈立方形,胞浆嗜酸性,细胞核大小较一致,核仁不明显,WHO/ISUP分级较低,大部分为1级,少部分为2级。免疫表型示CKpan、CK7、CK8/18、CK19、P504S、CD10、EMA、PAX-8以及Vimentin均表达,而RCC、WT-1、CK20、CD57、Syn、CD56、CgA、CD117、Desmin、SMA、Myogenin、S-100、E-cadherin均不表达,Ki-67阳性指数很低。结论SPRCC镜下特点不同于经典型乳头状肾细胞癌,具有独特的结构特点,而免疫表型又与经典型的乳头状肾细胞癌几乎表达一致,通过HE观察与免疫组化的鉴别诊断相结合,以帮助明确诊断。更多还原

【Abstract】 Objective To explore the clinicopathological features,immunophenotype,differential diagnosis and clinical prognosis in one case of solid variant of papillary renal cell carcinoma(SPRCC).Methods Cancer tissues from one case of SPRCC were examined by HE staining under a microscope to observe the histological features. The immunophenotype was observed with EnVision staining. The differential diagnosis was performed with other types of renal cell tumors. Results The histologic feature of SPRCC is that the tumor cells were arranged in solid lamellae,small tubes and sacs,and the papillary structure was rare or almost invisible. The tumor cells are cubic,eosinophilic cytoplasm. The size of the nucleus is consistent,the nucleolus is not obvious The WHO/ISUP grade is low. Most of them are grade 1,and a few of them are grade 2.Immunophenotypes show that CKpan,CK7,CK8/18,CK19,P504 S,CD10,EMA,PAX-8 and Vimentin are all expressed,while RCC,WT-1,CK20,CD57,Syn,CD56,CgA,CD117,Desmin,SMA,Myogenin,S-100,E-cadherin are not expressed.Ki-67 positive index is very low. Conclusion The characteristics of SPRCC under the microscope are different from the classic papillary renal cell carcinoma,with unique structural characteristics. The immunophenotype is almost the same as the classic papillary renal cell carcinoma. To help determine the diagnosis,immunohistochemistry and HE staining should be applied simultaneously.更多还原