肾混合性上皮和间质肿瘤临床病理观察

Mixed epithelial and stromal tumour of the kidney： a elinicopathologieal observation

目的探讨肾混合性上皮和间质肿瘤的临病理特点和免疫表型。方法对1例肾混合性上皮和间质肿瘤的临床、病理组织学及免疫表型进行观察并复习文献。结果患者女性，49岁，左腰部不适1年余。B超与CT检查均显示左肾下极实性肿物，行左侧肾切除术。大体见位于肾下极肿物18cm×12cm×8cm，切面呈黄白色结节状，与肾实质分界清，质韧。镜下肿瘤构成复杂。散在的微囊和小管内衬单层或复层立方上皮，区域形成粗大的乳头状结构。间质细胞密集区与稀疏区交替存在，细胞呈短梭形或卵圆形。上皮细胞CKpan和Vimentin（＋），间质细胞ER、PR、Actins和Desmin（＋）。结论肾混合性上皮和问质肿瘤是一种少见的良性肿瘤。组织学上以不等量增生的腺上皮和不同排列方式的梭形细胞问质成分混合构成为特征，是一种独立的肾疾病，手术切除预后良好。

Objective To investigate the elinicopathologieal features and immunohistochemistry of mixed epithelial and stromal tumour of the kidney. Methods One ease of mixed epithelial and stremal turnout was studied by using clinical analysis, histopathology and immunohistoehemistry, with review of relevant literature. Results The patient was a 49 - year - old woman with pain in left flank for a year. A solid mass was presented in ultrasound and CT. The left kidney excision was performed. Grossly, there was a well circumscribed mass in the underneath kidney, 18cm 12cm 8cm. Section was yellow -white, nodular and firm. The tumor constitution was complex. The cysts and the glands were lining monolayer or multiple cubic epithelium, and the thick papillate structure. The stremal eell compact district and the sparse area existed alternately, the cell assumed short spindle - shaped or the egg circular. The epithelial component was positive for CKpan, Vimenfin, and stremal component was positive for ER, PR, Actins, and Desmin. Conclusions Mixed epithelial and stremal tumor of the kidney is recognized to be a kind of rare benign neoplasm. In the histology take the isometric preliferation＇s gland epidermis and the different arrangement wayg spindle - shaped in tereetlular substance ingredient mix constitution as the characteristic.. It is independent entity with better prognosis after surgical removal.