肾脏黏液性管状和梭形细胞癌临床病理学观察

Mucinous tubular and spindle cell carcinoma of kidney:a clinicopathological study

目的 探讨肾脏黏液性管状和梭形细胞癌的临床病理学特征、免疫表型及鉴别诊断。方法 应用常规病理、免疫组化方法观察 1例肾脏黏液性管状和梭形细胞癌并复习相关文献。结果 肿物与周围肾组织分界清楚 ,组织学特点是排列呈管状的上皮样细胞 ,片状的梭形细胞和黏液性间质 ,无明显核的异型性 ,缺乏坏死。免疫组化 :CK、EMA、vimentin阳性 ,SMA、desmin、S 10 0蛋白、HMB4 5等阴性。结论 肾脏黏液性管状和梭形细胞癌是WHO新确定的一类罕见的低度恶性肾上皮性肿瘤 ,预后较好 ,要与后肾腺瘤。

Purpose To explore the clinicopathologic features, immunophenotype and differential diagnosis of mucinous tubular and spindle cell carcinoma of the kidney. Methods A case of mucinous tubular and spindle cell carcinoma of kidney was studied with conventional histopathological, immunohistochemical stains and review of the literature. Results The tumor was well circumscribed without pseudocapsule. Microscopically, the tumor consisted of cuboidal cells showing a tubular growth pattern. These areas were blended into foci showing a solid growth pattern and had more spindled appearance. There was prominent extracellular mucin. The neoplastic cells were positive for CK, EMA and vimentin, but negative for SMA, desmin, S-100 and HMB45. Conclusions Mucinous tubular and spindle cell carcinoma of kidney is a rare novel form of renal neoplasia in the WHO classification. The tumor is low-grade malignant and should be differentiated from metanephric, sarcomatoid and collecting duct carcinoma.