肾孤立性纤维瘤临床病理特征及诊断

Clinicopathologic features and diagnosis of solitary fibrous tumor of the kidney

目的：探讨肾孤立性纤维瘤（SFT）的临床病理特征及诊断。方法：结合文献复习,对2000年1月～2010年12月我院病理确诊的7例肾SFT患者的临床资料、影像学特征、病理结果进行回顾性分析。结果：7例患者CT平扫提示肾内等密度或低密度软组织圆形或卵圆形肿物,增强有轻中度强化。7例均行根治性肾切除术。肿瘤平均直径10.9（7～19）cm,镜下肿瘤细胞呈束状、旋涡状或不规则状排列,免疫组化CD34、CD39、Vimentin阳性,5例病理确诊为良性肾SFT,2例低度恶性。术后平均随访33.6（24～46）个月,无复发及转移。结论：肾SFT临床罕见,预后好,确诊依靠病理组织学及免疫组化检查。根治性肾切除术和术后长期随访是防止复发和转移的关键。

Objective：To investigate clinicopathologic features and diagnosis of solitary fibrous tumor（SFG）of the kidney.Method：Clinical data,imaging features,pathology of seven cases with SFG of the kidney were retrospectively analyzed in our hospital from January 2000 to December 2010,and literature was reviewed.Result：All the masses of seven cases were round or ovoid.These smoothly marginated masses were isodensity or lower density on plain CT scans,which showed mild-moderate nonhomogeneous enhancement in contrast-enhanced CT scans.All the patients underwent radical nephrectomy.Microscopic examination showed that tumors were composed of bland spindle-shaped cells and dense collagenous bands,with fascicular,irregular,or haphazard arrangements.Immunohistochemical study revealed positive CD34,CD39,Vimentin staining in all cases.The pathological diagnosis confirmed five cases suffered from benign SFG of the kidney and two cases experienced low grade malignancy.The mean follow-up period was 33.6（24-46）months.There was no recurrence or metastasis.Conclusion：SFG of the kidney is an uncommon tumor,which has good prognosis.The definite diagnosis is confirmed by histopathology and immunochemistry examination.Radical nephrectomy and long-term follow-up after operation offer the keys to avoiding recurrence and metastasis.