肾脏嫌色细胞癌11例临床病理特点

Clinicopathological features of chromophobe cell carcinoma of kidney:an analysis of 11 cases

目的 探讨肾脏嫌色细胞癌的临床病理特点。方法 收集2017年2月至2020年12月解放军总医院第一医学中心确诊的嫌色细胞癌11例,总结其临床病理资料,并复习文献。结果 男性稍多见,右侧稍多见。组织切面呈结节状。镜下见细胞有清晰的细胞膜,细胞大部分呈平铺状排列,少数呈腺泡状排列,细胞核常呈皱缩的葡萄干样,细胞质丰富,胞质淡染、透亮及部分核周透亮的空晕明显,部分胞质嗜伊红染。厚壁的小血管可见。散在点状钙化。常缺乏肿瘤性坏死。免疫组化显示CD117及CK7大部分阳性,CD10部分阳性,EMA阳性,CK20阳性(4/4),Ksp-cadherin阳性,S-100A1大部分阴性。Ki67指数低(1%~5%不等),平均2.2%。需要和多种肾脏肿瘤鉴别。结论 嫌色细胞癌具有独特的形态及免疫组化特点,形态显示有清晰的细胞膜,胞质多透亮,细胞核皱缩及见核周空晕,免疫组化S-100A1常阴性,CD117及CK7常阳性,Ki67指数低,是一种生物学行为惰性的恶性肿瘤。

Objective To explore the clinicopathological features of chromophobe cell carcinoma of the kidney.Methods Data of 11 cases of chromophobe cell carcinoma,diagnosed in The First Medical Center of the PLA General Hospital from February 2017 to December 2020,were collected to summarize their clinicopathological features and to review the literature.Results Which was slightly more common in men and on the right.The section was nodular.Under the microscope,the cells had a clear cell membrane,most of which were arranged in a flat shape,a few in an acinar shape,and the nuclei were often wrinkled raisin-like.The cytoplasm was rich,lightly stained and translucent,and some cytoplasm was eosinophilic,and perinuclear translucent halo was often seen.Thick walled small blood vessels could be seen.There was scattered punctate calcification,and no distinct tumor necrosis was found.Immunohistochemistry showed that CD117 and CK7 were mostly positive,CD10 partially positive,EMA positive,CK20 positive(4/4),Ksp-cadherin positive,and S-100A1 mostly negative.Ki67 index was low(ranging from 1%to 5%)with an average of 2.2%.It was necessary to distinguish it from a variety of renal tumors.Conclusions Chromophobe cell carcinoma has unique morphological and immunohistochemical characteristics.The tissue morphology shows a clear cell membrane,bright cytoplasm,shrunk nucleus and halo nucleus.Immunohistochemistry shows that S-100A1 is negative,CD117 and CK7 are often positive,and Ki67 index is low,which indicates that chromophobe cell carcinoma is a malignant tumor with inert biological behavior.