MiT家族易位性肾细胞癌的影像学表现

The Imaging Findings of MiT Family Translocation Renal Cell Carcinoma

目的探讨MiT家族易位性肾细胞癌的影像学表现。方法回顾性分析11例MiT家族易位性肾细胞癌患者的临床、病理及影像学资料。11例均行CT检查,7例同时行MRI检查。结果患者平均年龄为(35.9±20.3)岁。男7例,女4例。病灶平均最大径约(5.4±3.0)cm。影像上5例呈实性结构,6例呈囊实性结构。CT上病灶的实性成分表现为稍高密度,3例可见钙化,2例可见出血;MRI上病灶T_(1)WI及T_(2)WI信号均不均匀;5例可见出血;7例均可见囊变及假包膜;DWI上均呈高信号;增强扫描病灶轻-中度强化,呈延迟型或渐进型强化,强化程度低于肾皮质。病理上大体标本肿瘤切面呈灰白、灰黄色;镜下肿瘤细胞呈乳头状、巢状及腺泡状结构排列,胞质透明或嗜酸性。免疫表型:11例TEF3、CD10、PAX-8及P504S均呈阳性表达。结论MiT家族易位性肾细胞癌在CT上以稍高密度为主,MRI上多见出血、假包膜,以轻-中度渐进性强化为主,确诊仍需依靠病理检查。

Objective Purpose To evaluate the imaging manifestations of MiT family translocation renal cell carcinoma.Methods imaging features,clinical and pathological data of 11 patients with MiT family translocation RCC confirmed by pathology were analyzed retrospectively.11 cases underwent CT examination,and 7 cases underwent MRI examination.Results The average age of the patients was(35.9±20.3)years.7 cases were men and 4 cases were women.The average maximum diameter was about(5.4±3.0)cm.On the image,5 cases showed solid structure,and 6 cases showed cystic solid structure;The solid component of the lesion on CT showed slightly higher density,3 cases showed calcification,and 2 cases showed bleeding.The T_(1)WI and T_(2)WI signals of the lesion on MRI were Heterogeneous.5 cases of visible bleeding.Capsules and pseudocapsules were seen in 7 cases.11 cases were high signal on DWI.Enhanced scan lesions have mild to moderate enhancement,with delayed or progressive enhancement,and the degree of enhancement was always lower than that of the renal cortex.Pathologically,the tumor section of the gross specimen was grayish white and grayish yellow.Microscopic examination:The tumor cells were arranged in papillary,nested and acinar structures,and the cytoplasm of the tumor cells was transparent or eosinophilic.Immunophenotype:All 11 cases positively expressed TEF3,CD10,PAX-8 and P504S.Conclusion MiT family translocation renal cell carcinoma is predominantly high density on CT,hemorrhage and pseudocapsule are more common on MRI,and it is mainly mild to moderate progressive enhancement.The diagnosis still needs to rely on pathological examination.