肾素瘤1例临床病理及文献复习

Reninsecreting tumor of the kidney: a case report and literature review

目的：阐述肾素瘤的病因，病理特征及鉴别诊断要点。方法：对1例肾素瘤进行大体、光镜、免疫组化及电镜观察，并复习有关文献。结果：肾素瘤包膜完整，光镜下酷似血管外皮瘤；免疫组化，部分细胞vimentin呈阳性反应，瘤组织的腺样及乳头样结构区瘤细胞cytokeratin呈阳性反应。电镜下瘤细胞胞浆内可见多量圆形分泌颗粒及棱形和梯形结晶样物。结论：肾素瘤是发生于变更的背小球入球小动脉血管平滑肌细胞的罕见良性肿瘤，明确诊断必须结合临床、病理形态及电镜观察。

Purpose To report clinicopathologic characteristics and differential diagnosis of reninsecreting tu-mor of the kidney. Methods To study feature of reninsecreting tumor by light microscope, electron microscopeand immunohistochemistry, and review literature. Results Light microscopically, histological change of tumor isvery like a hemangiopericytoma. Immunohistochemically, vimentin(+ ), CK(+ ). Electronmicroscopically, theconspicuous ultrastructural feature is the presence of secretion granules and rhomboidshape crystal-like structuresin tumor cell. Conclusion Reninsecreting tumor of the kidney is a benign tumor of juxtaglomerular cell of thekidney, the diagnosis shall combine with clinic, pathological and typical morphological characteristics of electronmicroscope.