摘要
目的探讨肾混合性上皮和间质肿瘤的病理形态学特点、诊断及鉴别诊断。方法应用光镜观察及免疫组化方法对1例男性肾混合性上皮和间质肿瘤进行临床病理分析,并复习文献。结果肿瘤由上皮和间质两种成分构成,其中上皮成分主要是形态不一的腺管样结构,部分区域可见大小不等的囊,细胞无明显异型性;另见梭形细胞围绕在腺管或囊周围构成肿瘤的间叶成分,部分呈束状排列,形似平滑肌细胞,部分呈短梭形,似纤维母细胞或肌纤维母细胞样,梭形细胞轻度异型,核分裂罕见。免疫组化:上皮细胞AE1/AE3、CK7和CK34βE12(+);梭形细胞SMA(),desmin、vimentin、ER和PR(+),CD10部分(+)。结论肾混合性上皮和间质肿瘤具有独特的组织病理学特点,预后良好,多见于女性。本例特殊之处在于患者为成年男性,且无激素类药物应用史,极为少见。该肿瘤与成人囊性肾瘤、先天性中胚层细胞肾瘤等多种肿瘤易混淆,应依据形态学特点结合免疫组化结果鉴别。
Objective To investigate the pathological features,diagnosis and differential diagnosis of mixed epithelial and stromal tumour in the kidney.Methods Morphological observation and immunohistochemistry were applied in a male case of mixed epithelial and stromal tumour of the kidney,and the literatures were also reviewed.Results Histopathologically,the tumor was classically biphasic comprising mesenchymal and epithelial elements.The epithelial components varied from round and regular tubules to more complex tubulopapillary structures with or without cystic dilatation.The mesenchymal components were characterized by fascicles of spindle cells showing variable degrees of smooth muscle,fibroblastic,or myofibroblastic differentiation associated with interspersed bundles of collagen.The immunostaining showed biphasic patterns.The epithelial elements were expressed with AE1 /AE3,CK7 and CK34βE12,and mesenchymal components were positive for SMA,desmin,vimentin,CD10,ER and PR.Conclusion Mixed epithelial and stromal tumour of the kidney in men is a very rare neoplasm.This tumor is easily confused with adult cystic nephroma,ongenital mesoblastic nephroma and others,and immunohistochemistry helps in the differential diagnosis,combined with morphologicl features.
出处
《诊断病理学杂志》
CSCD
2011年第1期27-30,共4页
Chinese Journal of Diagnostic Pathology
关键词
肾
混合性上皮和间质肿瘤
病理形态
免疫表型
鉴别诊断
Kidney
Mixed epithelial and stromal tumour
Histopathology
Immunohistochemical phenotype
Diferential diagnosis
