肾球旁细胞瘤1例及文献复习

Juxtaglomerular cell tumor: A case report and literature review

目的:分析肾球旁细胞瘤的临床病理特征、鉴别诊断、生物学行为及预后因素。方法:报道1例肾球旁细胞瘤,通过光镜和免疫组织化学观察其组织病理学特点及免疫学表型特征,并结合临床资料复习相关文献。结果:本例肾球旁细胞瘤患者为女性,55岁,临床无高血压病史,无血钾降低。经肾肿瘤根治术,肉眼检查见肿瘤位于肾上极,大小3.8cm×3.7cm×3.5cm,与周围组织界限清楚。光镜下肿瘤组织呈弥漫性排列,部分区域呈不规则小梁状结构,似血管球瘤样,部分区域似血管外皮瘤样结构,间质内富含薄壁小血管,可见小血管壁玻璃样变性并呈簇状分布,另见大量淋巴细胞浸润。免疫组化示肿瘤细胞表达Vimentin、CD34。结论:肾球旁细胞瘤是一种罕见的良性肿瘤,临床表现缺乏特异性,诊断依靠病理学检查。该肿瘤少部分病例为恶性潜能未定,间质内大量淋巴细胞浸润与愈后关系尚不完全确定。

Objective： To investigate the clinicopathological characteristics,differential diagnosis,biological behavior,and prognosis of juxtaglomerular cell tumor arising in the kidney. Methods： The histopathological characteristics and immunohistochemical features of a case of juxtaglomerular cell tumor of the kidney were observed,and the related literatures were reviewed. Results： The patient was a 55-year-old female without a history of hypertension. Her serum examination showed that the level of potassium was normal. Grossly,a tumor with the size of 3. 8cm × 3. 7cm ×3. 5cm was found in the upper pole of the kidney,and the boundary was clear. Microscopically,the tumor cells were solid or nested. Some cells arranged in irregular trabecular similar to glomus tumor,and the others were similar to the structure of hemangiopericytoma. Small thin-walled blood vessels were easily found in the stroma. Immunohistochemically,the tumor cells were positive for maker（ Vimentin and CD34）. Conclusion： Juxtaglomerular cell tumor was a rare benign tumor,but few cases belong to malignant potential tumor. It was no specificity in clinical manifestations.The diagnosis rely on the histopathological characteristics and immunohistochemical features.