肾嗜酸细胞腺瘤8例临床病理分析
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摘要
目的探讨肾嗜酸细胞腺瘤的临床病理特征、免疫组化表型、鉴别诊断及预后。方法回顾性分析8例肾嗜酸细胞腺瘤的临床资料、组织学特点、免疫组化结果并复习相关文献。结果患者有6例为女性,2例为男性,年龄为40～81岁,平均年龄(55.3±13.6)岁;肿瘤直径2.1～8.5 cm,平均直径(4.1±1.8)cm。免疫组化结果显示:CD117阳性(8/8),CK7阳性(0/8),CK(H)阳性(0/8),CD10局灶阳性(3/8),Vimentin阳性(0/8),AMACR阳性(1/8),Ki-67(2%～5%),胶体铁染色阳性(0/8)。结论肾嗜酸细胞腺瘤是一种罕见的肾脏良性肿瘤,预后极好,肾脏肿瘤穿刺活检是术前明确诊断肾嗜酸细胞腺瘤的唯一方法,结合术中冰冻检查结果,治疗上推荐保留肾单位的肿瘤切除术,正确诊断具有重要的临床意义。
Objective To explore the clinicopathological features,immunohistochemical phenotype, differential diagnosis and prognosis of renal oncocytoma. Methods The clinical data, histopathological feature and immunohistochemical phenotype of 8 cases of renal oncocytoma were retrospectively reviewed and related literatures were reviewed. Results Six females and two males patients, with age ranging from 40 to 81 years, mean age is(55.3±13.6) years, tumor diameter sized 2.1 to 8.5 cm, mean diameter is(4.1±1.8) cm. Immunohistochemistry results showed that CD117 positive(8/8), CK7 positive(0/8), CK(H) positive(0/8), CD10 focal positive(3/8),Vimentin positive(0/8), AMACR positive(1/8), Ki-67(2% ～ 5%), colloidal iron positive staining(0/8). Conclusion Renal oncocytoma is a benign renal epithelial tumor with excellent prognosis. Renal tumor biopsy is the only method for the clear diagnosis of RO before surgery. Combined with the results of intraoperative frozen section analysis, it is recommended to preserve nephron-sparing surgery, correct diagnosis is of great significance for clinical treatment.
Objective To explore the clinicopathological features,immunohistochemical phenotype, differential diagnosis and prognosis of renal oncocytoma. Methods The clinical data, histopathological feature and immunohistochemical phenotype of 8 cases of renal oncocytoma were retrospectively reviewed and related literatures were reviewed. Results Six females and two males patients, with age ranging from 40 to 81 years, mean age is(55.3±13.6) years, tumor diameter sized 2.1 to 8.5 cm, mean diameter is(4.1±1.8) cm. Immunohistochemistry results showed that CD117 positive(8/8), CK7 positive(0/8), CK(H) positive(0/8), CD10 focal positive(3/8),Vimentin positive(0/8), AMACR positive(1/8), Ki-67(2% ～ 5%), colloidal iron positive staining(0/8). Conclusion Renal oncocytoma is a benign renal epithelial tumor with excellent prognosis. Renal tumor biopsy is the only method for the clear diagnosis of RO before surgery. Combined with the results of intraoperative frozen section analysis, it is recommended to preserve nephron-sparing surgery, correct diagnosis is of great significance for clinical treatment.
引文
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[11]Marconi L,Dabestani S,Lam TB,et al. Systematic Review and Meta-analysis of Diagnostic Accuracy of Percutaneous Renal Tumour Biopsy.[J]. Eur Urol,2016,69(4):660-673.
[12]Bahouth Z,Halachmi S,Meyer G,et al. The natural history and predictors for intervention in patients with small renal mass undergoing active surveillance[J]. Adv Urol,2015(2015):692014.
[13]姬文莉,岳娜,陈海霞,等.肾嗜酸细胞腺瘤侵袭性的病理特征分析[J].临床与实验病理学杂志,2016,32(6):648-651.
[2]Richard PO,Jewett MA,Bhatt JR,et al. Adult urology:active surveillance for renal neoplasms with oncocytic features is safe[J]. J Urol,2016,195(3):581-586.
[3]Biswas B,Wahal SP,Gulati A. Renal oncocytoma:A diagnostic dilemma on cytology[J]. J Cytol,2014,31(1):59-60.
[4]刘志敏.多层螺旋CT对肾嗜酸细胞腺瘤的诊断价值[J].中国继续医学教育,2016,8(10):38-39.
[5]吴永芳,王晶晶,许春伟,等.肾嗜酸细胞腺瘤临床病理分析并文献复习[J].解放军医药杂志,2015,27(2):94-97,106.
[6]叶勇忠,孙柯,王照明,等.肾脏嗜酸细胞腺瘤16例临床病理及免疫表型分析[J].现代实用医学,2015,27(7):928-929,封3页.
[7]Ng KL,Morais C,Bernard A,et al. A systematic review and meta-analysis of immunohistochemical biomarkers that differentiate chromophobe renal cell carcinoma from renal oncocytoma[J]. J Clin Pathol,2016,69(8):661-671.
[8]于双妮,肖雨,赵大春,等. 86例肾嫌色细胞癌与33例嗜酸细胞腺瘤的临床病理特征的比较分析[J].诊断病理学杂志,2018,25(10):673-679.
[9]Liu S,Lee S,Rashid P,et al. Active surveillance is suitable for intermediate term follow-up of renal oncocytoma diagnosed by percutaneous core biopsy[J]. BJU Int,2016,118(3):30-34.
[10]Choi JH,Kim JW,Lee JY,et al. Comparison of computed tomography findings between renal oncocytomas and chromophobe renal cell carcinomas[J]. Korean J Urol,2015,56(10):695-702.
[11]Marconi L,Dabestani S,Lam TB,et al. Systematic Review and Meta-analysis of Diagnostic Accuracy of Percutaneous Renal Tumour Biopsy.[J]. Eur Urol,2016,69(4):660-673.
[12]Bahouth Z,Halachmi S,Meyer G,et al. The natural history and predictors for intervention in patients with small renal mass undergoing active surveillance[J]. Adv Urol,2015(2015):692014.
[13]姬文莉,岳娜,陈海霞,等.肾嗜酸细胞腺瘤侵袭性的病理特征分析[J].临床与实验病理学杂志,2016,32(6):648-651.