【摘要】 目的探讨肾黏液性管状梭形细胞癌的临床病理特征、诊断要点及鉴别诊断。方法应用常规病理、免疫组化对1例肾黏液性管状梭形细胞癌进行观察、随访并复习相关文献。结果患者女性,45岁。体检偶然发现左肾占位。大体检查见肾实质内有一个灰白色、界限清楚的类圆形结节,偏髓质分布,直径4 cm,质地略脆,均匀一致;镜下见肿瘤细胞主要呈现两种结构:①类似于肾集合管的细管状结构,细胞单层立方排列;②类似于平滑肌瘤的梭形细胞结构;两种细胞均未见核分裂象;背景中显著黏液变性,并见多灶性淋巴细胞、浆细胞、泡沫细胞聚集浸润。免疫组化:EMA、CK7和Vim(+),CK34βE12、CD15(-),CgA弱(+),NSE和Syn(-)。随访6个月患者恢复良好。结论肾黏液性管状梭形细胞癌是一种低度恶性、预后较好的肾上皮性肿瘤,正确诊断及鉴别诊断对临床具有重大的指导价值。更多还原

【Abstract】 Objective To study the clinical and pathologic features,main diagnostic points and differential diagnosis of mucinous tubular and spindle cell cacinoma(MTSCC) in kidney.Methods A case of MTSCC of the kidney was studied by using microscopy and immunohistochemical stains,with review of the relevant literature.Results The patient was a 45-year-old woman.There was an occupying lesion that was occasionally found when health examination.Grossly,the tumor was well-circumscribed and round,grey white on cut surface,and most of this 4 cm tumor located in the medulla.Microscopically,the tumor was predominantly composed of two structures: one was elongated tubules like renal collecting duct with small cubical cells with eosinophilic cytoplasm,and the another was cordlike growth with spindle cells like those in highly cellular leiomyoma.There were no mitotic figures in these two kinds of cells.There were much myxoid droplet in the stroma,and also more lymphoid cells,plasmocytes and foam cells infiltration.The tumor was immunoreactive for EMA,CK7,Vim,also weakly immunoreactive for CgA,but not for CK34βE12,CD15,NSE,Syn.Follow-up for six months revealed that the patient recovered well.Conclusion MTSCC of kidney is a low_grade epithelial lesion,with favourable prognosis.Correct diagnosis and differential diagnosis are very useful to clinical management.更多还原