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目的探讨肾脏混合性上皮间质肿瘤的临床病理特征。方法观察2例肾脏混合性上皮间质肿瘤的临床、病理组织学及免疫组织化学特点并复习文献。结果 2例均为女性。1例临床无症状,体检时偶然发现,超声、CT、MRI示左肾上极实质内直径约7cm实性占位性病变,其中散在囊腔样结构;1例临床表现为无痛性全程肉眼血尿,超声、CT、MRI示右肾下极至肾门处直径约8cm的囊性占位,可见较多分隔。病理检查:肉眼1例主要呈实性,其中散在囊性结构;1例主要由大小不等的囊肿构成,混有部分实性组织。镜下肿瘤均由上皮和间质成分共同组成。免疫组织化学:上皮细胞CK阳性,间质细胞vimentin、SMA、desmin、ER、PR阳性。患者均行肾切除术,术后随访无复发和转移。结论肾脏混合性上皮间质肿瘤临床少见,组织病理学表现独特而多样。生物学行为大部分为良性,单纯手术切除预后良好;恶性罕见,尚无明确有效的治疗方案。
Objective To investigate the clinical and pathological features of mixed renal interstitial tumors. Methods The clinical, histopathological and immunohistochemical features of 2 cases of mixed renal interstitial neoplasms were observed and reviewed. Results 2 cases were female. 1 case of clinical asymptomatic, physical examination accidentally found, ultrasound, CT, MRI showed the left renal parenchyma within the actual diameter of about 7cm solid mass lesions, which scattered in the cystic structure; 1 case of clinical manifestations of painless whole eye Hematuria, ultrasound, CT, MRI showed the right renal capsule to the renal pole diameter of about 8cm cystic occupying more partitions can be seen. Pathological examination: one case of the naked eye was mainly solid, which scattered in the cystic structure; one case mainly composed of cysts of varying sizes, mixed with some solid tissue. Microscopic tumor by the epithelial and interstitial components together. Immunohistochemistry: CK positive epithelial cells, stromal cells vimentin, SMA, desmin, ER, PR positive. All patients underwent nephrectomy without recurrence and metastasis. Conclusions Kidney mixed epithelial mesenchymal tumor is rare and its histopathology is unique and diverse. Most of the biological behavior of benign, simple surgical resection of a good prognosis; malignant rare, there is no clear and effective treatment options.