伴破骨细胞样巨细胞肾肿瘤2例及文献复习

Renal tumor with osteoclast-like giant cells: 2 cases report and review of the literatures

目的 探讨伴破骨细胞样巨细胞肾肿瘤 (RT OGC)的临床病理特点。方法 观察 2例RT OGC的病理形态学改变和免疫组织化学检测 ,并结合文献进行讨论。结果 肾盂移行细胞乳头状癌型 1例 ,破骨细胞样巨细胞与移行细胞癌相连接 ;肾肉瘤样癌型 1例 ,破骨细胞样巨细胞在肉瘤样成分周围分布或与肉瘤样成分混杂。免疫表型 :破骨细胞样巨细胞CD6 8、Vim、α1 ACT均阳性 ,CK、EMA均阴性。结论 RT OGC是少见的肾恶性上皮性肿瘤的一个亚型 ,破骨细胞样巨细胞起源于间叶组织的单核巨噬细胞系统 ,是机体对肿瘤的反应 。

Purpose To study the clinicopathological features of renal tumors with osteoclast-like giant cells (RT-OGC). Methods Two cases of RT-OGC were investigated morphologically and immunohistochemistry. Results One case was papillary transitional cell carcinoma of renal pelvis, in which osteoclast-like giant cells and the carcinoma abutted directly on each other. The other case was the renal sarcomatoid carcinoma, in which osteoclast-like giant cells were close to the edges of sarcomatoid components or intermixed with them. Immunohistochemistry, the osteoclast-like giant cells were positive for CD68. Vim,α1-ACT and negative for CK, EMA. Conclusions RT-OGC is a rare subtype of renal malignant epithelial tumors, which should be differentiated from carcinosarcomas and giant cell tumors of bone. The osteoclast-like giant cells are derived from mononuclear phagocyte system of mesenchyme, which is reactive infiltration to the neoplasm.