肾血管平滑肌脂肪瘤10例临床病理观察

Clinical pathological analysis of 10 patients with renal angiomyolipoma

目的探讨肾血管平滑肌脂肪瘤（RAML）的临床病理特征。方法结合文献分析讨论10例RAML的临床病理资料及免疫组化染色结果。结果 10例RAML年龄30~53岁,平均42岁,男女之比为2.3：1。均为混合型,弥漫表达Melan-A、SMA,HMB45呈散在阳性。结论①肾血管平滑肌脂肪瘤为良性肿瘤,构成该肿瘤的基本成分是平滑肌、血管和脂肪;②由于肾血管平滑肌脂肪瘤常出现平滑肌细胞不同程度的异型性,致使该肿瘤组织结构复杂多变,导致诊断困难;③平滑肌是本病唯一可靠的诊断性成分,并特征性地表达MelanA、SMA、HMB45,是确立诊断的主要依据。

Objective To investigate the clinical pathological features of renal angiomyolipoma（RAML）.Methods In line with literature,the clinical data of 10 RAML patients and results of immunohistochemistry were discussed.Results Ten RAML patients,aged between 30 and 50 with a mean age of 42 and the ratio of male to female being 2.3：1,were scattered positive expression of Melan-A,SMA,HMB45 in tissue of RAML.Conclusion ① RMML constitutes of smooth muscle,blood vessels and adipose tissue.② As smooth muscle cells in the kidney angiomyolipoma often show different degrees of atypia,and the structure of RAML is complex so that it is difficult to diagnose.③ Smooth muscle with characteristic expression of Melan-A,HMB45,and SMA is the main basis for diagnosis of RAML renal.