肾脏黏液性小管状和梭形细胞癌临床病理观察

The clinicopathologic observation of mucinous tubular and spindle cell carcinoma of the kidney

目的:探讨肾脏黏液性小管状和梭形细胞癌的临床病理特点及鉴别诊断要点。方法:对肾脏粘黏性小管状和梭形细胞癌进行临床病理学分析及免疫组化的研究。结果:肿瘤境界清楚,切面灰白。镜下肿瘤与周围肾组织境界清楚,由紧密排列的、小而狭长、相互构通的小管构成。小管由立方和梭形细胞组成,可见平滑肌瘤样的梭形细胞灶。肿瘤间质黏液样。免疫组化示肿瘤细胞CK、EMA、CD15和VIM(+),CD10(-)。结论:肾脏黏液性小管状和梭形细胞癌是一种低度恶性的肾肿瘤,肿瘤细胞核圆形或梭形,异型性很小,可能来源于远端肾单位。

Objective： To investigate the clinicopathologic characteristics and the essentials of differentail diagnosis of mucinous tubular and spindle cell carcinoma （MTASCC） of the kidney. Methods： We made clincopathologic analyses of MTASCC and carried out its immunohistochemical studies in the light of medical literautres. Results： The tumor was well-clrcumscrlbed with a grey-whlte cut surface. Under the microscope was seen a clear boundary between the tumor and its peripheral renal tissues,which was composed of closely-arranged, small but long and nrrow, and mutually-connected tubules. The tubules were made up of cuboidal and splndle-shaped cells, with leimyoma-like cell foci seen in them. The stroma of tumors were mucoid. The immunohistorchemical study showed tumor cells CK positive. Conclusion：MTASCC of the kidney is a distinctive low- grade renal neoplasm probably arising from distal nephron.The nucleus of tumor cells are round or spindle with less atypia.