肾嫌色细胞癌25例临床病理分析

Chromophobe renal cell carcinoma: A clinicopathologic study of 25 cases

目的探讨肾嫌色细胞癌的临床病理学特点及预后。方法对25例肿瘤组织进行光镜、免疫组化及组织化学观察,其中3例进行电镜研究。结果25例肾嫌色细胞癌的肿瘤细胞多呈巢状,周围细胞较大,胞质呈空泡网状,中央细胞较小,胞质红染,细胞分布不均,中央密,外周疏,常可见双核细胞;免疫组化AE1/AE3和CK7(+),vimentin(-);电镜可见瘤细胞内有多少不等的胞质微囊泡。25例中3例伴肉瘤样癌成分。22例存活,3例死亡。结论肾嫌色细胞癌病理学特征明确,临床预后好,伴肉瘤样癌成分者预后较差。

Objective To investigate the pathologic features of chromophobe renal cell carcinoma, diagnosis and prognosis. Methods 25 cases of chromopbobe renal cell carcinoma were studied by routine stain, immunohistochemistry, Hales colloidal iron stain and 3 of them by electron microscopy. Results The tumor cells were arranged in large sheets, nests or tubuloalveolae separated by delicate fibrous septa. Cells in center of nests were smaller than the periphery, and cell borders were prominent. The cytoplasm was markedly eosinophilic, finely granular, or translucent reticulated. Double nuclei were frequent. Immunohistochemical staining for AE1/AE3 and CK7 was positive. Vimentin was negative. Uhrastructural study showed variable numbers of microvesicle in cytoplasm. The sareomatoid transformation was found in 3 cases （ 12% ）. 22 cases were survived, and 3 cases were died. Conclusion Chromophobe renal cell carcinoma has distinct morphologies, and diagnosis is easy with better prognosis, but the patient with sarcomatoid transformation has an extremely poor prognosis.