肾上腺皮质嗜酸细胞性肿瘤9例临床病理学特征

Clinical and pathological features of adrenocortical oncocytic tumors:report of nine cases

目的探讨肾上腺皮质嗜酸细胞性肿瘤的临床病理特征及免疫表型。方法收集9例肾上腺皮质嗜酸细胞性肿瘤,肿瘤组织均进行HE、免疫组化及网状纤维染色,分析其临床病理特征及免疫表型,并复习相关文献。结果9例患者中男性5例,女性4例,年龄26~64岁,平均46岁,发病部位左侧8例,右侧1例。9例均为含有>90%嗜酸性细胞的单纯性肾上腺皮质嗜酸细胞性肿瘤,参照Lin-Weiss-Bisceglia(LWB)评分系统,2例为恶性,2例为恶性潜能未定,5例为良性。9例肿瘤细胞均表达SF-1,Ki-67增殖指数在良性肿瘤中均≤5%,而在恶性肿瘤中均>10%。网状纤维染色显示良性肿瘤细胞巢网状纤维支架存在,恶性潜能未定及恶性肿瘤网状纤维支架不同程度被破坏。9例中1例失访,余8例随访4~104个月,均未发生转移或复发。结论嗜酸细胞性肿瘤诊断主要依靠组织病理学及免疫组化检测,治疗以手术切除为主。

Purpose To explore the clinicopathological characteristics and immunophenotype of adrenocortical oncocytic tumors.Methods Nine cases of adrenocortical oncocytoma were collected and detected by HE,immunohistochemistry and reticular fiber staining.The clinicopathological features and immunophenotype were analyzed,and the relevant literatures were reviewed.Results Nine cases of adrenocortical oncocytic tumors were presented,with 5 males and 4 females,the age ranged from 26 to 64 years(with average age of 46 years).There were 8 cases on the left side and 1 case on the right side.All the 9 cases were composed of more than 90%oncocytic cells,according to the Lin-Weiss-Bisceglia(LWB)system,2 cases were oncocytic carcinomas,2 cases were borderline oncocytomas of uncertain malignant potential,and 5 cases were benign oncocytomas.All cases were immunoreactive for SF-1,Ki-67 proliferation index was less than 5%in benign tumors and>10%in malignant tumors.Reticulin staining showed an intact reticulin framework of benign tumor,demonstrated reticulin disruption of uncertain malignant potential and malignant tumors.One case was lost to follow-up,the other 8 cases were followed up for 4-104 months,and no metastasis or recurrence occurred.Conclusion Oncocytic tumor is the diagnosis that mainly depends on pathology and immunohistochemistry,and surgical resection is the main treatment method.