肾上腺皮质嗜酸细胞瘤临床病理观察

Adrenocortical oncocytoma.a clinicopathologic observation

目的探讨肾上腺皮质嗜酸细胞瘤的临床病理特点及鉴别诊断。方法对4例肾上腺皮质嗜酸细胞瘤患者的组织病理学及免疫组化结果进行观察分析,结合文献进行讨论。结果肿瘤均位于肾上腺皮质内,包膜完整,切面灰褐色及灰黄色,无出血及坏死灶。光镜下瘤细胞大部分呈弥散实性分布,小部分呈梁索及腺泡状排列。肿瘤细胞间有纤细的纤维间隔,其中有少量的淋巴细胞集聚;血管血窦丰富。免疫组化:本组4例,肿瘤细胞黑色素瘤抗原-1(Mart-1)、抑制素α抗体(Inhibin-α)、波形蛋白(VIM)4例阳性、突触素(Syn)2例阳性,CD56及p53 3例阳性,嗜铬素A(CgA)、S-100 4例均呈阴性。结论肾上腺皮质嗜酸细胞瘤少见,可伴有功能改变,其形态和免疫组化提示可能为一种高危性皮质肿瘤。

Objective to evaluate the adrenocortical oncocytoma clinicopathologic features and differential diagnosis.Methods histopathologic features and immunohistochemical findings of the tumor were observed and discussed with review of the literatures.Results The tumors with well capsule,aspect greyish brown and greyish yellow were located in the adrenal cortex.Hemorrhage and necrosis were not seen.Microscoppically,the majority of tumor cells were diffusly distributed in solid,the others were arranged in cord and glandular patterns.With some lymphocytes infiltrated the cells were separated by fibrous conective tissue septu.Vascular sinusoids were abundant. Immunohistochemistry：This group of 4 cases,tumor cells Mart-1,Inhibin-α,Calretin,Vimentin were positive in 4cases,Syn in 2 cases,CD56 and P53 in 3 cases,CgA,S-100 4 cases were negative.Conclusion the rare adrenocortical oncocytoma may be associated with functional changes.By combination the morphology and immunohistochemistry adrenocontical oncocytoma may be a high-risk tips cortical tumors.