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嗜酸细胞乳头状肾细胞癌3例报道并文献复习

夏燕 ,  胡怀远 ,  封扬 ,  吴玲玲

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文章导航 > 蚌埠医学院学报  > 2016,  41 > 4: (458-461)  
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嗜酸细胞乳头状肾细胞癌3例报道并文献复习

  • 1. 安徽省宿州市立医院 病理科, 234000;

  • 2. 皖北煤电集团总医院 病理科, 安徽 宿州 234000

    • 作者简介: 夏燕(1976-),女,副主任医师.

  • 中图分类号: R737.11

Oncocytic papillary renal cell carcinoma:a report of 3 cases and review of the literature

  • 1. Department of Pathology, Suzhou Municipal Hospital, Suzhou Anhui 234000;

  • 2. Department of Pathology, Wanbei Coal Group General Hospital, Suzhou Anhui 234000, China

  • CLC number: R737.11

  • 摘要: 目的:探讨嗜酸细胞乳头状肾细胞癌(OPRCC)的临床病理学特点。方法:对3例OPRCC进行光镜观察、免疫组织化学标记及荧光原位杂交检测并复习相关文献。结果:3例OPRCC中,2例男性,1例女性,年龄分别为41、45、65岁。3例均为体检发现肾肿块,例1及例2肿块位于肾下极,例3位于肾中上级,与周围肾组织分界清楚,长径分别为3.0、3.5及4.5 cm,瘤细胞细胞质丰富,嗜酸性,核Fuhrman分级2~3级,瘤细胞排列呈乳头状,乳头内见泡沫细胞聚集。免疫表型3例瘤细胞vimentin、CK7、CD10、AMACR、EMA、CK均阳性,而TFE3、CD15、CD117、RCC、E-cadherin等均阴性。荧光原位杂交检测显示3例瘤细胞均有7、17号染色体扩增。结论:OPRCC是肾细胞癌的罕见亚型,免疫表型及分子遗传学与1型乳头状肾细胞癌相似。应与嗜酸细胞瘤、嫌色性肾细胞癌、Xp11.2易位肾细胞癌等相鉴别。
    Abstract: Objective: To investigate the clinicopathological characteristics of the oncocytic papillary renal cell carcinoma(OPRCC). Methods: Three cases of OPRCC were investigated by light microscopy, immunohistochemistry, fluorescence in situ hybridization(FISH), and review of the literature. Results: Among 3 cases, 2 cases were male, 1 case was female, and their ages were 41, 45 and 65 years old, respectively. The renal masses in 3 cases were found by medical examination. The masses in 2 cases located in the low pole of the kidney, and 1 case mass located in the middle and high pole of the kidney, the surrounding boundaries between the renal tissue and tumor was clear, and the long diameter of 3 masses were 3.0 cm, 3.5 cm and 4.5 cm, respectively. The cytoplasm of tumor cells were plentiful and eosinophilic, the Fuhrman grades of nuclear were from 2 to 3 grade. Tumor cells arranged in papillary pattern with accumulation of foam cells in the stroma. In 3 cases of tumor cells, vimentin, CD10, AMACR, EMA and CK7 were positive, while TFE3, CD15, CD117, RCC and E-cadherin were negative. FISH test showed that the 7 and 17 chromosomes were amplified in 3 cases of tumor cells. Conclusions: OPRCC is a rarely subtype of renal cell carcinoma, and its immune phenotype and molecular genetics are similar to that of type 1 papillary renal cell carcinoma. The OPRCC should be differentiated with oncocytoma, chromophobe renal cell carcinoma, Xp11.2 translocation of renal cell carcinoma.
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    [2] SRIGLEY JR.Mucinous tubular and spindle cell carcinoma[M]//EBLE JN,SAUTER G,EPSTEIN JI,et al.Pathology and genetics of tumors of the urinary system and male genital organs.Lyon:IARC Press,2004:40.
    [3] CHEVARIE-DAVIS M,RIAZALHOSSEINI Y,ARSENEAULT M,et al.The morphologic and immunohistochemical spectrum of papillary renal cell carcinoma:study including 132 cases with pure type 1 and type 2 morphology as well as tumors with overlapping features[J].Am J Surg Pathol,2014,38(7):887.
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  • 收稿日期:  2015-06-26

嗜酸细胞乳头状肾细胞癌3例报道并文献复习

    作者简介: 夏燕(1976-),女,副主任医师.
  • 1. 安徽省宿州市立医院 病理科, 234000;
  • 2. 皖北煤电集团总医院 病理科, 安徽 宿州 234000
  • 收稿日期: 2015-06-26

摘要: 目的:探讨嗜酸细胞乳头状肾细胞癌(OPRCC)的临床病理学特点。方法:对3例OPRCC进行光镜观察、免疫组织化学标记及荧光原位杂交检测并复习相关文献。结果:3例OPRCC中,2例男性,1例女性,年龄分别为41、45、65岁。3例均为体检发现肾肿块,例1及例2肿块位于肾下极,例3位于肾中上级,与周围肾组织分界清楚,长径分别为3.0、3.5及4.5 cm,瘤细胞细胞质丰富,嗜酸性,核Fuhrman分级2~3级,瘤细胞排列呈乳头状,乳头内见泡沫细胞聚集。免疫表型3例瘤细胞vimentin、CK7、CD10、AMACR、EMA、CK均阳性,而TFE3、CD15、CD117、RCC、E-cadherin等均阴性。荧光原位杂交检测显示3例瘤细胞均有7、17号染色体扩增。结论:OPRCC是肾细胞癌的罕见亚型,免疫表型及分子遗传学与1型乳头状肾细胞癌相似。应与嗜酸细胞瘤、嫌色性肾细胞癌、Xp11.2易位肾细胞癌等相鉴别。

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