肾嗜酸细胞腺瘤侵袭性的病理特征分析

Invasive histopathologic features of renal oncocytoma

目的 探讨肾嗜酸细胞腺瘤侵袭性的临床病理学特征。方法 回顾性分析4例肾嗜酸细胞腺瘤侵袭性的临床病理学及免疫表型特征,并复习相关文献。结果 4例嗜酸细胞腺瘤中1例侵及肾被膜纤维囊,1例侵透肾被膜纤维囊,2例侵及肾周脂肪;侵透肾被膜纤维囊者局部区域肿瘤细胞核异型明显。患者均行肾部分切除术,随访3个月~6年,无复发或转移。结论肾嗜酸细胞腺瘤虽然是一种良性肿瘤,但部分具有侵袭性的组织学特征,属于一种具有恶性潜能的肿瘤。由于部分病例具有局部异型性及侵袭性组织学特征,容易误诊为肾细胞癌而被过度治疗。因此正确评估肾嗜酸细胞腺瘤的预后,有助于对组织学特征的全面分析。

Purpose To study the invasive histopatho｜ogic features of renal oncocytoma to improve the understanding level of renal oncocytoma. Methods The clinicopathological features and immunohistochemical staining results in 4 eases of renal oneocytomas with invasive histopathologic features were retrospeetively analyzed, with review of the relevant literature. Results Four eases of renal on- eoeytomas included 1 ease invading fibrous capsule of renal capsule, 1 ease penetrating fibrous capsule of renal eapsule, and 2 cases invading perirenal fat. Cellular atypia and loci of bizarre cells were evident in 1 ease of penetrating fibrous capsule. 4 patients under- went partial nephrectomy, followed up for 3 months to 6 years, without metastasis or recurrence. Conclusion Although renal oncocy- toma is a benign tumor, some of them have invasive histopathologie features, and belong to tumors with malignant potential. Because some eases show local atypia and invasive histopathologic features, those are easily misdiagnosed as renal cell carcinoma and exeessive- ly treated. So correct evaluation of the prognosis of renal oncocytoma depends on comprehensive analysis of the histopathologic features.