肾原发性破骨细胞样巨细胞瘤1例报道及文献复习

Primary osteoclast-like giant cell tumor of kidney:a case report and review of literature

目的探讨肾原发性破骨细胞样巨细胞瘤(OGCT)的临床病理特征和生物学行为。方法对1例肾原发性OGCT进行临床病理和免疫组化观察及文献复习。结果老年女性,无痛性血尿1个月,CT示左肾盂占位。切除标本为红色息肉样肿物,突出于左肾盂和肾盏内,息肉宽基底与肾盏处实质相连,肿瘤由单核间质细胞和破骨细胞样巨细胞组成,瘤细胞CD68、Vim、S100和α1ACT(+),CK(-)。结论肾原发的OGCT是一种罕见肿瘤。其恶性程度应结合组织结构特点、浸润、转移等生物学行为因素综合考虑。该瘤尚可伴随某些恶性肿瘤出现。

Objective To explore the clinicopathological features and biological behavious of primary osteoclast-like giant cell tumor (OGCT) of the kidney. Methods The clinicopathological changes and immuneohistochemical findings in one case of the tumor were observed with review of the related literature. Results The patient was a 67-year-old female who developed painless hematuria for a month. Computered tomographic scan demonstrated a mass in the left renal pelvis. The resected specimen showed a red polypous neoplasm in the left renal pelvis and an upper calix. Its size was 4.5?cm×1?cm×1?cm. The neoplastic base was connected with the parenchyma of the renal calix. Histologically, the tumor was composed of mononuclear stromal cells and osteoclast-like giant cells, which displayed immunoreactivity for CD68, vimentin, alpha-1-antitrypsin and S-100, but not for cytokeration. Conclusions Primary osteochlast-like giant cell tumor of the kidney is extremely rare. Its malignant grade depends upon the histological features and the biological behavious of neoplastic invasion and metastasis. The tumor may accompany with other malignancies.