肾脏神经内分泌癌1例报告并文献复习

Neuroendocrine carcinoma of the kidney:1 case report and review of the literature

目的通过分析肾脏神经内分泌癌(neuroendocrine carcinoma,NEC)的临床病理特征、免疫表型、治疗方式及预后,提高对该类肿瘤的认识和诊疗水平。方法分析我科1例肾脏NEC的临床表现、病理特点及治疗方法并结合文献复习。结果患者表现为肉眼血尿伴腰痛。病理:肿瘤细胞中等大小,细胞核呈圆形、卵圆形,染色质为细颗粒状,肿瘤细胞排列呈小梁状、条索状,见菊形团样结构;免疫组化:CK(+)、EMA(+)、CD56(+)、Ki-67(80%)、CgA(-)、Syn(-)、CD99(-)、WT-1(-)、Vimentin(-)、NSE(-)。结论肾脏NEC十分罕见,且临床表现与肾盂癌较为相似,其诊断主要根据病理学检查和免疫组化结果来做出判断。

Objective To improve the knowledge,diagnosis and treatment of neuroendocrine carcinoma(NEC)in the kidney by analyzing the clinicpathological features,biological and immunohistochemical characteristic. Methods The clinical features,pathological characteristic and treatment of a case of NEC were summarized. Results The main clinical features of this patient were gross hematuria with abdominal pain.Microscopic features:the renal tumor cells were medium-sized with circular to oval nuclei and fine granular nuclear chromatin.Renal carcinoid tumors typically present with a trabecular or ribbon-like growth pattern and the typical rosette-like structure can be seen inside the tumor cells.Immunohistochemical analysis:CK(+),EMA(+),CD56(+),Ki-67(80%),CgA(-),Syn(-),CD99(-),WT-1(-),Vimentin(-),NSE(-). ConclusionsRenal NEC is rare and its clinical manifestations are similar to that of renal pelvic carcinoma.The diagnosis of it is mainly based on the results of pathological examination and immunohistochemistry.