肾上腺嗜酸细胞型皮质癌临床病理观察

Oncocytic adrenocortical carcinoma:a clinicopathological analysis

目的报道2例肾上腺嗜酸细胞型皮质癌,分析其临床病理特征。方法对2例肾上腺嗜酸细胞型皮质癌进行组织形态学、免疫组化和电镜研究,并复习相关文献。结果肾上腺嗜酸细胞型皮质癌多见于中、青年,无明显性别倾向。肿瘤切面灰白、灰黄色,常有坏死,瘤细胞弥漫分布,胞质强嗜酸性,核明显异型;免疫标记显示Inhibin-α+/-,Melan-A和Syn(+),Ki-67<5%。电镜示肿瘤细胞充满线粒体。结论肾上腺嗜酸细胞型皮质癌非常罕见,病理形态学观察及免疫组化标记为其明确诊断的依据,可能为低度恶性肿瘤。

Objective To report two cases of oncocytic adrenocortical carcinoma and to investigate the clinicopathological characteristics. Methods Histological observation, immunohistochemical staining and nltrastructural studies were conducted and related literatures were reviewed. Results Oncocytic adrenocortical carcinoma mainly occurred in young or middle- aged adults and showed similar sex ratio. The cut surfaces were white and yellow with necrosis. The tumor cells were exclusively oncocytic with a diffuse arrangement. Nuclear atypia was identified. Tumor cells were positive or negative for inhibin-α and immunoreactivity for Melan-A and Syn were strongly positive. Both tumors had low proliferative indices of less than 5%. Uhrastructural studies showed that tumor cells were filled with mitochondria. Conclusion Oncocytic adrenocortical carcinoma is extremely uncommon, whose definite diagnosis should be based on the histopathological and exclude other tumors, and it might be a low-grade malignancy.