肾脏嗜酸细胞瘤的诊治分析(附三例报告及文献复习)

Diagnosis and treatment of renal oncocytoma(report of 3 cases and review of literature)

目的探讨肾脏嗜酸细胞瘤的临床、病理、免疫组化特性、诊治方法及预后,以提高对该病的诊治水平。方法报告经治3例嗜酸细胞瘤患者的临床资料,并结合文献复习进行分析。肿瘤分别位于右肾中上部、左肾上极和左肾肾盂旁,肿瘤大小分别约5.3cm×4.5cm、8.2cm×4.7cm、6.0cm×4.8cm。术前均诊断为肾癌而行肾癌根治术。结果肿瘤边界清楚,切面呈棕黄色,质地均匀,无出血及坏死灶。光镜下肿瘤细胞呈圆形或类圆形,细胞均匀一致,排列呈腺泡状或实性片状,胞质含有许多嗜酸性颗粒,细胞无明显异型性和核分裂相。随访10～35个月,均存活。结论肾脏嗜酸细胞瘤在临床症状、体征及影像学方面无明显特异性表现,确诊须依靠组织病理学检查以及免疫组化等方法。确诊后治疗以保留肾脏手术为宜,因肿瘤中可能含有恶性成分,术后密切随访很重要。

Objective To evaluate the pathologicaI,immunohistochemical and clinical features of renal oncocytoma,and to investigate its diagnosis,treatment and prognosis. Methods The clinical data of 3 cases with renal oncocytoma were reported and discussed with literature reviewed. The 3 tumors＇size was 5.3 cm×4.5 cm.8.2 cm×4.7 cm、6.0cm×4.8 cm,respectively. All cases underwent nephrectomy. Results The tumors were well-circumscribed,homogeneous and brown in color without haemorrhage and necrosis. On light microscopy, there was strong eosinophilic cytoplasm with granules, the tumor cells being tubular or adenoid in pattern with no necrosis and very rare or no mitosis. No recurrence or metastasis was reported during 10 to 35 months follow-up. Conclusions It has no specific features on the aspects of symptom, physical sign and imaging. The diagnosis should be established on histopathologic and immunohistocbemical studies. Nephron-sparing surgery should be done if the diagnosis is established,and the follow-up is important because the tumor may be combined with malignancy tissues.