多房性囊性肾细胞癌16例临床病理分析

Multilocular cystic renal cell carcinoma: a clinicopathologic analysis of 16 cases

目的:探讨多房性囊性肾透明细胞癌(multilocular cystic renal cell carcinoma,MCRCC)的临床病理特征、组织发生、诊断与鉴别诊断、治疗及预后。方法:回顾性分析2006年1月-2011年3月间我院收治并诊断的16例囊性肾透明细胞癌病例的临床病理特点,并结合相关文献进行复习。结果:男性14例,女性2例,发生于左右肾各8例。临床无明显症状,大部分为体检发现肾脏占位性病变而入院,部分有腰酸腰部胀痛表现。术后病理诊断为囊性肾细胞癌。结论:囊性肾透明细胞癌临床上单靠影像学不易被确诊,确诊需依赖术中快速冰冻病理、常规石蜡病理和免疫表型结果。需与透明细胞癌囊性变,单纯性肾囊肿,先天性多囊肾,多房囊肿性肾瘤,肾混合性上皮间质瘤相鉴别。

Objective：To explore the clinicopathologic characteristics, histogenesis, diagnosis and differential di-agnosis of multilocular cystic renal cell carcinoma （MCRCC）. Methods ： Sixteen cases of MCRCC were reported and the literature was reviewed. Results： The seventeen cases occurred in 2 women and 14 men ,31 to 73 years old （me-dian 43y） ,and left kidney 8 cases, right kidney 8 cases. No overt symptom, most of the patients were discovered in health examination. Conclusion： It is difficulty to diagnozl MCRCC only by imageology. Final diagnosis should com- bine freezing pathological diagnosis and normal pathological diagnosis and the result of immunohistochemistry. The MSFT is extremely rare, as diagnosis mainly rely on its pathological morphology ,immunohistochemical profiles. Differ-ential diagnosis includes renal cyst lesion, such as cystis degeneration of renal clear cell carcinoma, simple cyst of kid-ney, congenital polycystic kidney, multilocular cystic renal tumor, mixed epithelial and stromal tumor of the kidney.